Objective To study the effects of different types of fluid resuscitation on mesenteric microcirculation and inflammatory factors in rabbits with hemorrhagic shock.Methods The model of hemorrhagic shock rabbits was established by reducing the basic mean arterial pressure by 40%through draining the blood from the common carotid artery.Animals were randomly divided into control group,saline group,lactate Ringer group,acetic acid Ringer group,hydroxyethyl starch group and succinyl gelatin group with 8 animals in each group.Mesenteric microcirculation was monitored with microcirculation monitor.Mean arterial pressure(MAP),heart rate(HR),microvascular perfusion ratio(PPV)and microvascular blood flow index(MFI)were recorded before bleeding(T0),at hemorrhagic shock(T1),at the beginning of fluid resuscitation(T2),at the completion of fluid resuscitation(T3),and at the end of the experiment(T4).The contents of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1)and lactic acid(Lac)were measured at T0,T2 and T4.Results Compared with hydroxyethyl starch group,there were statistically significant differences in T3 MAP(P<0.05),except for succinyl gelatin group,hydroxyethyl starch group had higher MAP at T4 than other groups,the difference was statistically significant(P<0.05).The differences in MAP between experimental control group and other groups were statistically significant at T4(P<0.05).PPV and MFI of hydroxyethyl starch group and succinyl gelatin group were higher than those of normal saline group,lactic acid Ringer group and acetic acid Ringer group at T4(P<0.05),and the lactic acid value of hydroxyethyl starch group at T4 was the lowest,compared with lactic acid Ringer group and normal saline group,the difference was statistically significant(P<0.05).There were statistical significances between all groups and experimental control group at T4(P<0.05).There were no significant differences in TNF-αand IL-1 in T0,T2 and T4 among all groups(P<0.05).Conclusion Hydroxyethyl starch solution and succinyl gelatin solution can improve the microcirculation of rabbits with hemorrhagic shock,but can not improve the level of inflammatory factors.

Objective:To investigate the early diagnostic value of red blood cell distribution width(RDW)in elderly patients with acute ischemic stroke(AIS), and to explore whether RDW can be used as an independent predictor of AIS.Methods:This retrospective study included elderly AIS patients who were hospitalized within the first 24 hours after the onset of symptoms from November 2018 to October 2019 as the AIS group, and elderly patients with various conditions that masqueraded as a stroke who were admitted to hospital during the same period were included as the control group.The demographic data, vascular risk factors, and baseline RDW levels were recorded, and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of RDW for AIS.Results:The median level of RDW in the AIS group was significantly higher than that in the control group(13.0% vs.12.4%, P<0.001). The area under the curve of RDW was 0.758(95% CI: 0.685-0.823). At the cut-off value was 12.7%, and its sensitivity and specificity were 73.2% and 75.3%, respectively.Multivariate Logistric regression analysis showed that after adjusting for covariates, the risk of AIS is 5.342-fold for each 1% increase in RDW( OR: 5.342, 95% CI: 2.520-11.324, P<0.001). Conclusions:The increased level of RDW is related to the risk of AIS, and it is an independent predictor of AIS.Thus, it may be used as a preliminary screening index for the diagnosis of AIS.

Objective:To investigate the normal range of exhaled nitric oxide in healthy children aged 6-18 in Jinan.Methods:The healthy school children aged 6-18 in Jinan from October 11 to 26, 2017 were selected for questionnaire survey, physical examination and exhaled nitric oxide test.The levels of mouth exhaled nitric oxide at the flow rate of 50 mL/s (FeNO 50) and mouth exhaled nitric oxide at the flow rate of 200 mL/s(FeNO 200), alveolar nitric oxide (CaNO), and nasal exhaled nitric oxide at the flow rate of 10 mL/s(FnNO 10) were measured by the electroche-mical method.The distributions of FeNO 50, FeNO 200, CaNO and FnNO 10 were analyzed, and their correlations with gender, age, height and body mass index (BMI) were discussed by the multiple linear regression model. Results:A total of 772 healthy children were enrolled in this study, including 364 males and 408 females, with a median age of 12.1(11.8-12.3) years old, a median height of 154.8(153.6-156.0) cm, and a median BMI of 20.3 (20.0-20.6) kg/m 2. The measured values of FeNO 50, FeNO 200, CaNO and FnNO 10 fluctuated in the range of 3.0-168.0 ppb, 2.0-44.0 ppb, 0.5-44.2 ppb and 0-1 253.0 ppb, respectively.FeNO 50, FeNO 200 and CaNO values showed skewed a distribution, and their 95% upper limits were 35.0 ppb, 13.3 ppb and 8.5 ppb, respectively.The geometric mean(95% CI) of FeNO 50 in males (95% CI)[14.6 (13.7-15.5) ppb] was significantly higher than that in females [13.3(12.7-14.0) ppb], and the difference was statistically significant ( Z=1.470, P=0.027). The multiple linear regression results suggested that, FeNO 50 was positively correlated with age and height ( β=0.023, 0.007, respectively, all P<0.05), and negatively correlated with BMI ( β=-0.016, P<0.05). The geometric mean (95% CI) of FeNO 200in males[7.1 (6.8-7.4) ppb] was significantly higher than that in females[6.4 (6.1-6.6) ppb], and the difference was statistically significant( Z=1.747, P=0.004). The multiple linear regression results suggested that, FeNO 200 was positively correlated with height ( β=0.005) and negatively correlated with gender(female β=-1.126) (all P<0.05). There was no significant difference between male and female in CaNO, which had no correlation with gender, age, height and BMI (all P>0.05). FnNO 10 showed a normal distribution, with a mean value of 456.2 ppb, 95% CI of 29.3-863.4 ppb.The geometric mean (95% CI) of FnNO 10 in males [408.7 (377.1-443.0) ppb] was significantly higher than that in females [368.8 (339.0-401.3) ppb], and the difference was statistically significant ( Z=1.722, P=0.005). The multiple linear regression results indicated that FnNO 10 was related to gender ( β=-36.098, P<0.05), and not correlated with age, height and BMI (all P>0.05). Conclusions:The normal ranges of FeNO 50, FeNO 200, CaNO and FnNO 10 in healthy children aged 6-18 in Jinan are 3.0-35.0 ppb, 2.0-13.3 ppb, 0.5~8.5 ppb and 29.3-863.4 ppb, respectively.FeNO 50 is correlated with age, height and BMI.FeNO 200 is correlated with gender and height.CaNO and FnNO 10 are not correlated with age, height or BMI.

Objective To investigate serum levels of lipoprotein-associated phospholipase A2 (Lp-PLA2),high-sensitivity C-reactive protein (hs-CRP),complement component C1q (C1q) and homocysteine(HCY) in patients with Alzheimer's disease(AD),in order to provide a basis for establishing laboratory markers in AD patients.Methods One hundred AD patients and one hundred healthy controls from Beijing Hospital were selected.Serum levels of Lp-PLA2,C1q,hs-CRP and HCY were determined using a biochemistry analyzer.Serum levels of amyloid β-protein 40(Aβ40)and Aβ42 were measured using enzyme-linked immunosorbent assays.Results Serum levels of Aβ40,Aβ42,Lp-PLA2,hs-CRP,C1 q and HCY were higher in AD patients than in the control group[(66.0±14.0) pmol/L vs.(7.1±8.2) pmol/L,(7.2±1.4) pmol/L vs.(1.9±1.7) pmol/L,(510.6±140.1)U/L vs.(419.0±91.8) U/L,(2.8±3.4) mg/L vs.(1.2±0.7) mg/L,(218.0±58.4) mg/L vs.(194.8 ± 27.7) mg/L and (18.8 ± 9.3) μmol/L vs.(14.9 ± 5.2) μmol/L,all P ＜ 0.01],and the differences were greater in female subjects than in male subjectss.Conclusions High serum levels of Lp-PLA2,C1q,hs-CRP and HCY may be associated with Alzheimer's disease,while the exact relationships need to be further investigated.

Objective To study the diagnosis and treatment of CO2 embolism in laparoscopic hepatectomy (LH).Methods A retrospective study was conducted on 80 patients who underwent various types of LH from June 2016 to November 2017.The clinical data of 4 patients who suffered from severe CO2 embolism were analyzed.Results The operation time of 80 patients varied from 65 min to 345 min (average 170 min).Tbe amount of blood loss ranged from 50 ml to 2 500 ml (average 450 ml).28 patients (35％) required blood transfusion.Two patients were converted to open operation because of uncontrollable bleeding.Four patients suffered from severe CO2 embolism with significant changes in circulation and respiration.After active and effective treatment,none required open conversion and all recovered well.Conclusions Any sudden respiratory and circulatory changes during LH should lead us to think of severe CO2 embolism.Timely and effective treatment could convert a dangerous situation to become safe.

Objective To observe the expression of SGK in decidua in patients with unexplained recurrent spontaneous abortion(URSA) and to investigate its role in the course of apoptosis.Methods The expression of SGK was detected by immunohistochemistry in decidua of URSA(abortion group,n =50) and normal first trimester pregnant women(control group,n =30).The apoptotic index was detected by TUNEL.Results Compared with the control group,the positive expression of SGK decreased significantly in the abortion group,and the difference was statistically significant(x2 =6.78,P ＜ 0.05).The average apoptotic index of the abortion group was (8.19 ± 3.58) ％,which was significantly higher than (2.87 ±1.07)％ of the control group(t =7.94,P＜0.05).Conclusion Intensive apoptosis,the decreasing positive expression rate of SGK in decidua cells may play critical roles in URSA.

Ultrasonography examinations were performed for carotid atherosclerosis in 548 patients with type 2 diabetes mellitus (T2DM). Blood glucose, glycosylated hemoglobin, total serum bilirubin, uric acid, total cholesterol ( TC ), triglycerides ( TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL) were measured. Total serum bilirubin level in T2DM patients without carotid atherosclerosis was (13.0±7. 1 )μmol/L, while that was (10. 9 ± 4. 9 )μmol/L in patients with carotid atherosclerosis (P ＜0. 01 ). The logistic analysis showed that total serum bilirubin level was negatively related to the presence of carotid atherosclerosis ( P ＜ 0. 05 ), which indicated that higher level of total serum bilirubin might be a protective factor for macroangiopathy in T2DM.

Objective To analyze the composition of and drug resistance in bacteria isolated from the lesions of patients with squamous cell carcinoma of the face and head.Methods Lesional tissue or discharges were obtained from 246 patients with squamous cell carcinoma of the face and head,and subjected to conventional bacterial culture.The isolated bacteria were identified by VITEK TWO automated microbiology system.Antimicrobial susceptibility testing was carried out by Kirby-bauer method.WHONET 5.3 software was utilized for statistical analysis.Results Totally,294 bacterial strains were isolated,including 168 Gram-negative bacteria (57.1％)and 126 Gram-positive bacteria(42.9％).The bacterial isolates were predominated by Staphylococcus aureus(21.4％),followed by Escherichia coli(20.4％),Staphylococcus epidermidis(18.4％),Klebsiellapneumoniae(15.4％)and Pseudomonas aeruginosa(9.5％).The prevalence was 40％,26.7％,42.9％ and 55.6％ respectively for extended spectrum β lactamases-producing E.coli and K.pneumoniae,methicillinresistant staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative S.epidermidis(MRCNS)respectively.P.aeruginosa,E.coli and K.pneumoniae were highly susceptible to imipenem and meropenem,and favorably sensitive to β-lactam and β-1actamase inhibitor combination.No resistance was observed for vancomycin,teicoplanin or linezolid in staphylococci.Conclusions The bacterial isolates from squamous cell carcinoma tissue on the head and neck are predominated by conditional pathogenic bacteria,and the proportion of Gram-negative bacteria is higher than that of Gram-positive bacteria.These isolates seem to be highly resistant to common antibiotics.

Interferon beta (IFN-beta) and TNF-related apoptosis-inducing ligand (TRAIL) are effective anticancer agents. Adeno-associated virus (AAV) is one of the current most promising gene delivery vectors. Previously, we constructed tumor-targeting AAV-hTERT-IFN-beta and AAV-hTERT-TRAIL by inserting IFN-beta or TRAIL gene into AAV controlled by hTERT promoter. The studies showed that either single IFN-beta or TRAIL gene therapy exhibited a certain extent anticancer effect. Here, we report their inhibitory effects on A549 lung cancer cell growth in vitro and in vivo by combined AAV-hTERT-IFN-beta and AAV-hTERT-TRAIL. Expression of secreted IFN-beta in lung cancer A549 cells infected by AAV-hTERT-IFN-beta was detected by enzyme-linked immunosorbent assay (ELISA). The growth-suppressing effect of AAV-hTERT-IFN-beta in combination with AAV-hTERT-TRAIL on several cancer cell lines was assessed by MTT assay. Apoptosis of A549 cancer cells infected by AAV-hTERT-IFN-beta alone, AAV-hTERT-TRAIL alone, and their combination was evaluated by apoptotic cell staining and flow cytometry (FCM), respectively. The antitumor effect of the combination of AAV-hTERT-IFN-beta with AAV-hTERT-TRAIL in vivo was further evaluated through A549 lung cancer xenograft in nude mice. The results showed that the combinational treatment was superior to any alone and presented intensified tumor cytotoxic and apoptotic effect on A549 cancer cells. Most importantly, the combination of AAV-hTERT-IFN-beta with AAV-hTERT-TRAIL exhibited significant antitumor effect and eliminated all tumor masses in nude mice, which lay a foundation for exploring the molecular mechanisms of combined IFN-beta and TRAIL anti-tumor activity.
Animals ; Antineoplastic Agents ; metabolism ; pharmacology ; Cell Line, Tumor ; Dependovirus ; genetics ; metabolism ; Genetic Therapy ; Genetic Vectors ; genetics ; Humans ; Interferon-beta ; genetics ; pharmacology ; Lung Neoplasms ; pathology ; therapy ; Mice ; Mice, Nude ; Neoplasm Transplantation ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; pharmacology ; TNF-Related Apoptosis-Inducing Ligand ; genetics ; pharmacology

Objective To investigate the methods for repairing skin defects after excision of small cutaneous malignant tumors at the lower one third part of nose and their clinical effects.Methods Lesions of small cutaneous malignant tumors at lower one third part of the nose were removed in 54 patients.Intraoperative pathology was performed to confirm the absence of survival carcinoma tissues after resection.According to the site,size,shape and neighborous skin status of defects,bilobed flaps,two-side rotation flaps and nasolabial flaps were selected to repair nasal skin tissue defects.Results There were 39(72.22%) cases of basal cell carcinoma, 9(16.67%) squamous cell carcinoma, 6(11.11%) keratoacanthoma.Skin defects after tumor removal were situated at the lower one third part of nose in all cases with less than 2.0 cm in diameter.Bilobed flaps were used to repair skin defects in 20 cases.rotation flaps in 2 cases,and nasolabial flap in 32 cases.As a result,all flaps survived and no obvious deformation of nose was observed in these cases.No recurrence occurred in a 5-year follow-up.Conclusion A satisfactory repair of skin defects at the lower one third part of nose with a diameter of less than 2.0 cm is achieved with bilobed flaps,two-side rotation flaps and nasolabial flaps.