AIM:To investigate the protective effects of soy isoflavones on retinal ganglion cells(RGCs)damage in diabetic rats and related mechanisms.METHODS: Totally 80 male SD rats(80 eyes), aged 4-6 weeks, were randomly divided into four groups(n=20 per group): a control group, a diabetic model group, a low-dose soy isoflavone treatment group, and a high-dose soy isoflavone treatment group. Among them, the control group was fed normal chow, while the diabetic group, soy isoflavone low-dose-treated group, and soy isoflavone high-dose-treated group were fed high-fat chow. After a feeding period of 4 wk, rats in the diabetic group, as well as those in the soy isoflavone low-dose and high-dose treatment groups, were injected intraperitoneally with streptozotocin(STZ)at a dose of 50 mg/kg to establish a diabetic model. Rats in the control group received an equivalent volume of sodium citrate buffer acid. The soy isoflavone low-dose-treated group was administered 360 mg/kg of soy isoflavones daily via gavage, while the soy isoflavone high-dose-treated group received 540 mg/kg of soy isoflavones daily via gavage. Both the control group and the diabetic group were given an equal amount of purified water daily via gavage. Body weight and blood glucose levels were measured at 4 and 8 wk post-gavage treatment. The eyes were extracted and the retinas were dissected at 8 wk following the gavage treatment. The number of RGCs in each group was determined using immunochemical tissue staining and protein blotting techniques, while the superoxide dismutase(SOD)activity and malondialdehyde(MDA)content of the rat retinal tissue were measured through histochemical methods.RESULTS: Compared with diabetic rats, treatment with high-dose soy isoflavones for 8 wk resulted in a reduction of blood glucose to 8.9±1.23 mmol/L, an increase in intraretinal SOD activity to 849.93±63.71 U/mgprot, a decrease in MDA content to 45.77±0.59 nmol/mgprot, and an increase in the number of RGCs to 76±1 cells/mm2, which is comparable to the control group's data(all P<0.05).CONCLUSION: Soy isoflavones can reduce retinal oxidative stress in diabetic rats and protect RGCs.

Objective:This study aimed to reveal the distribution and course of the branches of the infraorbital nerve(IN),its communication relationship between the branches of the infraorbital nerve and facial nerve,so as to provide morphological basis for clinical implementation of accurate infraorbital nerve trunk in the infraorbital canal,regional facial anesthesia and facial surgery,so as to improve the success rate of maxillofacial surgery.Methods:25 adult cada-vers with formalin immobilized semi-face were selected.Exclude facial defect samples caused by tumor,trauma,deformity,surgery,etc.The length and diameter of the trunk of the infraorbital nerve and the length of the infraorbital canal were measured.The total number of infraorbital nerve and the number of branches were counted,and the course,distribution and communication relationship between infraorbital nerve and facial nerve were investigated.Results:The length of infraorbital nerve trunk ranged from 19.61 to 44.47 mm,with an average length of(23.33±4.95)mm.The length of infraorbital canal ranged from 9.49 to 31.21 mm,with an average length of(12.87±3.99)mm.The number of infraorbital nerve branches ranged from 5 to 12,and the average number was(7.29±2.29).The number of upper labial branches was the widest,ranging from 1 to 5,while the distribution area of eyelid branches was the narrowest.There are(were)a large number of intersections and anastomoses between the infraorbital nerve and the facial nerve,forming a complex multi-layer network structure.Conclusion:The infraorbital nerve trunk and the infraorbital canal va-ry in length.The number and distribution range of infraorbital nerve branches are not constant,and the communication relationship between infraorbital nerve and facial nerve is complicated.

Background/Aims: To investigate the autoantibody against fumarate hydratase (FH), which is a specific liver failure-associated antigen (LFAA) and determine whether it can be used as a biomarker to evaluate the prognosis of acute-on-chronic liver failure (ACLF). Methods: An immunoproteomic approach was applied to screen specific LFAAs related to differential prognosis of ACLF (n=60). Enzyme-linked immunosorbent assay (ELISA) technology was employed for the validation of the frequency and titer of autoantibodies against FH in ACLF patients with different prognoses (n=82). Moreover, we clarified the expression of autoantibodies against FH in patients with chronic hepatitis B (n=60) and hepatitis B virus-related liver cirrhosis (n=60). The dynamic changes in the titers of autoantibodies against FH were analyzed by sample collection at multiple time points during the clinical course of eight ACLF patients with different prognoses. Results: Ultimately, 15 LFAAs were screened and identified by the immunoproteomic approach.Based on ELISA-based verification, anti-FH/Fumarate hydratase protein autoantibody was chosen to verify its expression in ACLF patients. ACLF patients had a much higher anti-FH autoantibody frequency (76.8%) than patients with liver cirrhosis (10%, p=0.000), patients with chronic hepatitis B (6.7%, p=0.022), and normal humans (0%, p=0.000). More importantly, the frequency and titer of anti-FH protein autoantibodies in the serum of ACLF patients with a good prognosis were much higher than that of patients with a poor prognosis (83.9% vs 61.5%, p=0.019; 1.41±0.85 vs 0.94±0.56, p=0.017, respectively). The titer of anti-FH autoantibodies showed dynamic changes in the clinical course of ACLF. Conclusions The anti-FH autoantibody in serum may be a potential biomarker for predicting the prognosis of ACLF.

Accurate judgment of conditions and prognosis has important clinical significance in improving survival rate and optimal distribution of liver source in patients with liver failure. This article reviews the current application of prognostic markers for liver failure such as alanine aminotransferase, aspartate aminotransferase, total bilirubin, prothrombin time, prothrombin time activity, and international normalized ratio and summarizes the new markers discovered in recent years, such as inflammatory response-related markers, neutrophil gelatinase-associated lipocalin, immune response-related markers, keratin, intestinal flora, microRNAs, liver failure autoantigen and autoantibody, and hemodynamic disorder. It is pointed out that the prognosis of liver failure is affected by many factors and there is still a lack of more sensitive and effective markers and a standardized prognostic scoring system. The new markers used alone or in combination with traditional markers may help to improve the sensitivity and specificity of prognostic evaluation of liver failure.

Objective To evaluate the prognostic value of iASPP for nasopharyngeal carcinoma (NPC).Methods One hundred and thirty patients with nasopharyngeal carcinoma were initially diagnosed and treated between January and December 2012 in Department of Radiation Oncology of the First Affiliated Hospital of Guangxi Medical University.The clinical staging was classified according to the cancer staging criteria 2009 AJCC/UICC.All patients were treated by IMRT.Cisplatin-based concurrent chemotherapy was given to patients with stages Ⅲ-ⅣB disease.Immunohistochemistry was used to detect the expression of iASPP in the carcinoma tissues,and the clinicopathological features were compared among the patients with different expressions of iASPP.Furthermore,the relationship between the expression of iASPP and the efficacy in patients was explored.Results Of 130 patients,positive expression of iASPP was observed in 86 patients (66.2％),and negative expression in 44 patients (33.8％).There was significant difference in the positive expression rate of iASPP among the patients with different N-stage and clinical stages(x2 =7.565,4.947,P ＜ 0.01).At three months after treatment,no significant difference was found in the response rate of tumor with different expression of iASPP.In univariate analysis,the expression of iASPP was significant predictor of 3 year-DMFS (x2 =4.335,P =0.037) and PFS (x2 =6.640,P =0.01).Furthermore,N-stage was significant predictor of 3y-DMFS (x2 =8.058,P =0.005),PFS (x2 =9.554,P =0.002) and OS (x2 =6.987,P =0.008),respectively.By using multivariate Cox analysis,the expression of iASPP and N-stage was independent prognostic factors for PFS (x2 =4.336,5.228,P ＜ 0.05),respectively.Conclusions Positive expression of iASPP may be a poor prognostic factor for NPC patients.

Objective To investigated the effects of patient controlled intravenous analgesia and ultrasound guided patient?controlled paravertebral block on pulmonary function in patients with multiple fractured ribs? Methods From May 2015 to March 2016,60 patients with multiple rib fractures in Ningbo NO?6 Hospital with American Society of Anesthesiologists Ⅱ-Ⅲ underwent internal fixation, including 30 males and 30 females aged from 16 to 70 years ( mean age ( 54?6 ± 15?2 ) years ) . All patients were randomly divided into 2 groups (n=30 each):patient controlled intravenous analgesia(PCIA) group and patient controlled thoracic paravertebral block(PCPB) group.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline. The PCIA pump was set up to deliver a 2 ml bolus dose with 15 minutes lockout interval and background infusion at 2 ml/hour.In PCPB group,the patients received paravertebral injection of 0?2% ropivocaine 15 ml on the corresponding area of fractured side under ultrasound guidance at the end of operation,and then received PCPB.PCPB solution contained 0?75% ropivacaine 67 ml in 250 ml of normal saline,and the pump was set up to deliver a 5 ml bolus dose, with 15 minutes lock out interval and background infusion at 5 ml/hour? Both analgesia lasted to 72 hours after operation.Before the operation,at 30 minutes,60 minutes,1 day,2 days,3 days after analgesia,arterial blood samples were collected to test the levels of pH,PaO2 ,PaCO2 ,PaO2/FiO2 and PA?aDO2 . The pulmonary function was also examined before and 3 days after the operation through FEV1 and FEV1%? Results Compared with PCIA group at 30 minutes, 60 minutes, 1 day, 2 days, 3 days after analgesia, the level of PaO2 ( ( 85?1 ± 9?7 ) mmHg vs? ( 72?4 ± 12?3)mmHg,(90?3±12?4)mmHg vs? (73?5±7?8)mmHg,(94?2±8?2)mmHg vs? (86?1±5?6)mmHg, (98?5±7?0)mmHg vs? (88?8±7?5)mmHg,(99?6±9?8)mmHg vs? (91?3±8?6)mmHg,P<0?05)) and PaO2/FiO2 were significantly increased ( ( 405?1 ± 46?0 ) mmHg vs? ( 340?1 ± 58?9 ) mmHg, ( 430?5 ± 59?1) mmHg vs? ( 344?0 ± 65?4 ) mmHg, ( 448?3 ± 39?1 ) mmHg vs? ( 410?1 ± 26?7 ) mmHg, ( 460?1 ± 33?5)mmHg vs? (423?2±36?5)mmHg,(465?1±28?2)mmHg vs? (435?1±40?8)mmHg,P<0?05)), the level of PA?aDO2 was decreased ((22?9±4?6)mmHg vs? (36?6±5?1)mmHg,(17?7±4?7)mmHg vs?(34?5±2?9)mmHg,(13?8±4?1)mmHg vs? (21?9±3?2)mmHg,(13?5±4?6)mmHg vs? (19?2± 3?8)mmHg,(12?4±2?0)mmHg vs? (17?7±2?4)mmHg,P<0?05)), and FEV1,FEV1% were significantly increased at 3 days after operation in PCPB group ((2?9±0?4)mmHg vs? (2?2±0?5)mmHg, (78?1± 4?7) mmHg vs? ( 64?8 ± 4?3 ) mmHg; P<0?01 ) ) . Conclusion Ultrasound guided patient?controlled paravertebral block improves the arterial oxygenation function and accelerates the recovery of pulmonary function in patients with multiple?fractured ribs after internal fixation operation.

Objective To investigated the effects of patient controlled intravenous analgesia and ultrasound guided patient?controlled paravertebral block on pulmonary function in patients with multiple fractured ribs? Methods From May 2015 to March 2016,60 patients with multiple rib fractures in Ningbo NO?6 Hospital with American Society of Anesthesiologists Ⅱ-Ⅲ underwent internal fixation, including 30 males and 30 females aged from 16 to 70 years ( mean age ( 54?6 ± 15?2 ) years ) . All patients were randomly divided into 2 groups (n=30 each):patient controlled intravenous analgesia(PCIA) group and patient controlled thoracic paravertebral block(PCPB) group.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline. The PCIA pump was set up to deliver a 2 ml bolus dose with 15 minutes lockout interval and background infusion at 2 ml/hour.In PCPB group,the patients received paravertebral injection of 0?2% ropivocaine 15 ml on the corresponding area of fractured side under ultrasound guidance at the end of operation,and then received PCPB.PCPB solution contained 0?75% ropivacaine 67 ml in 250 ml of normal saline,and the pump was set up to deliver a 5 ml bolus dose, with 15 minutes lock out interval and background infusion at 5 ml/hour? Both analgesia lasted to 72 hours after operation.Before the operation,at 30 minutes,60 minutes,1 day,2 days,3 days after analgesia,arterial blood samples were collected to test the levels of pH,PaO2 ,PaCO2 ,PaO2/FiO2 and PA?aDO2 . The pulmonary function was also examined before and 3 days after the operation through FEV1 and FEV1%? Results Compared with PCIA group at 30 minutes, 60 minutes, 1 day, 2 days, 3 days after analgesia, the level of PaO2 ( ( 85?1 ± 9?7 ) mmHg vs? ( 72?4 ± 12?3)mmHg,(90?3±12?4)mmHg vs? (73?5±7?8)mmHg,(94?2±8?2)mmHg vs? (86?1±5?6)mmHg, (98?5±7?0)mmHg vs? (88?8±7?5)mmHg,(99?6±9?8)mmHg vs? (91?3±8?6)mmHg,P<0?05)) and PaO2/FiO2 were significantly increased ( ( 405?1 ± 46?0 ) mmHg vs? ( 340?1 ± 58?9 ) mmHg, ( 430?5 ± 59?1) mmHg vs? ( 344?0 ± 65?4 ) mmHg, ( 448?3 ± 39?1 ) mmHg vs? ( 410?1 ± 26?7 ) mmHg, ( 460?1 ± 33?5)mmHg vs? (423?2±36?5)mmHg,(465?1±28?2)mmHg vs? (435?1±40?8)mmHg,P<0?05)), the level of PA?aDO2 was decreased ((22?9±4?6)mmHg vs? (36?6±5?1)mmHg,(17?7±4?7)mmHg vs?(34?5±2?9)mmHg,(13?8±4?1)mmHg vs? (21?9±3?2)mmHg,(13?5±4?6)mmHg vs? (19?2± 3?8)mmHg,(12?4±2?0)mmHg vs? (17?7±2?4)mmHg,P<0?05)), and FEV1,FEV1% were significantly increased at 3 days after operation in PCPB group ((2?9±0?4)mmHg vs? (2?2±0?5)mmHg, (78?1± 4?7) mmHg vs? ( 64?8 ± 4?3 ) mmHg; P<0?01 ) ) . Conclusion Ultrasound guided patient?controlled paravertebral block improves the arterial oxygenation function and accelerates the recovery of pulmonary function in patients with multiple?fractured ribs after internal fixation operation.

Objective To evaluate the short-term therapeutic effects of DNA immunoadsorbent (IA) combined with glucocorticoid and immune depressant on patients with severe systemic lupus erythematosus(SLE). Methods 32 patients with severe SLE were selected to undergo DNA IA treatment combined with glucocorticoid plus cyclophosphamide therapy, and each patient received IA therapy 3 times, once 2.5 hours, with an interval of 24-48 hours to take another two times of IA. The changes in SLE disease activity index(SLEDAI)score, health status evaluation indexes〔 physiologic functional( PF) and emotional health( MH) scores〕,renal function indexes〔 blood urea nitrogen(BUN)and serum creatinine(SCr)〕 were observed; and anti-double stranded DNA antibody( ds-DNA), immunoglobulin (IgA, IgG, IgM), complements(C3 and C4)and high-sensitivity C-reactive protein (hs-CRP) were examined before and after IA treatment for 2 weeks. Results Two weeks after the combination therapy, the SLEDAI score, BUN, SCr, dsDNA, IgA, IgG, IgM, hs-CRP were significantly lower than those before treatment 〔SLEDAI score : 14.38±3.85 vs. 15.69±1.40, BUN (mmol/L): 11.22±4.78 vs. 16.31±7.90, SCr (μmol/L): 127.02±38.17 vs. 167.25±45.63, dsDNA( U/L): 1.36±0.12 vs. 1.43±0.18, IgA( g/L): 2.41±0.73 vs. 2.59±0.86, IgG( g/L): 16.82±4.83 vs. 21.01±4.84, IgM( g/L): 1.64±0.45 vs. 1.75±0.58, hs-CRP( mg/L): 14.41±2.20 vs. 14.94±2.60, P<0.05 or P<0.01〕; PF score, MH score, complement C3 were increased〔 PF score : 71.19±17.53 vs. 56.66±22.41, MH score : 74.01±15.72 vs. 61.50±17.98, C3( g/L): 0.56±0.09 vs. 0.52±0.10, all P<0.05〕; clinical symptoms were improved significantly, and no significant adverse reactions were found. Conclusion IA combined with medical treatment has shown that it has significant therapeutic effect for treatment of patients with severe SLE, and it may decrease the levels of dsDNA, IgA, IgG, IgM,hs-CRP, and increase the level of complement C3.

Objective To investigate the prevalence of excessive daytime sleepiness and explore the associated factors in university teachers and staffs in Kunming.Methods Epworth sleepiness scale was used as the tool of diagnosis. We consecutively collected the data of teachers and staffs on duty in Yunnan Nationalities University,Yunnan Agricultural University,Yunnan Normal University,Kunming Medical University and Yunnan University of Finance and Economics within 8 months.Results The prevalence of excessive daytime sleepiness in university teachers and staffs was 12.45%, the prevalence of male was 16.82% and female was 7.70%, respectively. The results of Logistic regression showed that the main associated factors of excessive daytime sleepiness were male (OR=1.898),age (30 years and less was as control group,the ORs of 31-40 year group, 41-50 years group and more than 51 years group were 1.480, 2.366 and 2.719, respectively), family history of snoring (OR=3.371), consumption sedative (OR=1.815), memory failing (OR=2.044), dizzy and feeble (OR=2. 076),choking (OR=2.143),report apnea (OR=2.684),etc. Conclusions The prevalence of excessive daytime sleepiness is high in the university teachers and staffs that can partially represent the residents of Kunming city. The associated factors of excessive daytime sleepiness hint that excessive daytime sleepiness may be caused by sleep apnea/hyperpnoea syndrome in the sample population,hence the people with excessive sleepiness need further sleep monitoring .

OBJECTIVE: To determine the effect of lung protection mechanical ventilation on respiratory function in the elderly undergoing spinal fusion. METHODS: Sixty 70-85 year old patients, ASA class II or III, undergoing spinal fusion were randomly assigned into 2 groups (30 in each group): a protection mechanical ventilation group (group P) and a conventional mechanical ventilation group (group C). Low VT and low level positive end expiratory pressure (PEEP) mechanical ventilation were applied in group P (VT=6mL/kg, RR=12-18 b/min, I:E=1:2, PEEP=10 cmH2O, alveolar recruitment performed once every 15 min), while traditional ventilation was used in group C ( VT=10-12 mL/kg, RR=12 b/min, I:E=1:2). Arterial blood samples were taken and pH, PaO2, PaCO2, PaO2/FiO2, A-aDO2, HR, SBP, DBP and CVP were recorded before the operation (T0), 1 h after tracheal intubation (T1), tracheal extubation immediately (T2), 1 h after tracheal extubation (T3), 1 d, 2 d, and 3 d after the operation (T4, T5, and T6). The pulmonary complication was also examined 1 d after the operation. RESULTS: At T1, T2, T3, T4 and T5, PaO2 and PaO2/FiO2 in group P were higher than those in group C, but A-aDO2 in group P was lower than that in group C. Five patients had bronchitis, 5 had hyoxemia, and 3 had atelectasis in group C, but 2 bronchitis in group P. The incidence of pulmonary complication was 43.3% in group C and 6.6% in group P. There was no significant difference in HR, SBP, DBP and CVP between the 2 groups. CONCLUSION Lung protection mechanical ventilation improves the arterial oxygenation and accelerates the recovery of respiratory functions in elderly patients after spinal fusion operation, with no influence on hemodynamics.
Aged ; Aged, 80 and over ; Anesthesia, General ; Female ; Humans ; Hypoxia ; prevention & control ; Male ; Positive-Pressure Respiration ; methods ; Postoperative Complications ; prevention & control ; Pulmonary Ventilation ; Respiration, Artificial ; methods ; Respiratory Function Tests ; Spinal Fusion ; methods