Objective To investigate the protective effect of hyperbaric oxygen (HBO) combined with ω-3 polyunsaturated fatty acid (PUFA ω-3) on lipopolysaccharide-induced acute lung injury in the rats and its related mechanism.Methods Forty-eight SD rats were randomly divided into the control group,the model group,the experimental group and the combined group,each consisting of 12 rats.With exception of the rats in the control group,acute lung injury (ALI) model was established by LPS tracheal instillation in the rats of the model and experimental groups.The experimental group received PUFA ω-3 (150 mg/kg) by gavage,the combined group was treated with HBO on the basis of PUFA omega-3,and equal volume of distilled water was given to the control and model groups.The course of treatment lasted for 14 days.After last medication,pulmonary tissues of the rats were collected and wet/dry ratio was calculated,and the inflammatory factors,TNF-α and IL-1β in the lung tissue homogenate were detected by ELISA test kit.HE staining was used to observe the pathological damage of the lung tissue,and the expression levels of TLR4 and NF-κB proteins in the lung tissue were detected by Western-blotting.Results Compared with the control group,pulmonary edema in the model group could clearly be seen,and the wet/dry ratio of the lung tissue increased markedly (5.57 ± 0.57 vs.4.16 ±0.19) (P ＜0.05).Compared with the model group,the wet/dry ratio of the lung tissue in the experimental and the combined groups decreased (4.78 ±0.25,4.42 ±0.18 vs.5.57 ±0.37) (P ＜0.01 or P ＜ 0.05),and the wet/dry ratio of the combined group was obviously lower than that of the experimental group (4.42 ±0.18 vs.4.78 ±0.25) (P ＜0.05).As compared with the control group,the inflammatory factor levels of TNF-α and IL-1β in the model group all significantly increased(P ＜ 0.01 or P ＜ 0.05).Following treatment with simple PUFA ω-3 or coupled with HBO,the inflammatory factor levels of TNF-α and IL-1β in lung tissues of the experimental and the combined groups all decreased markedly,as compared with those of the model group (P ＜ 0.05),with those of the combined group decreased more significantly (P ＜ 0.05).As compared with those of the control group,the expression levels of TLR4 and NF-κB proteins in the model group were significantly up-regulated (P ＜ 0.01).Compared with the model group,the expression levels of TLR4 and NF-κB proteins in the experimental and the combined groups all decreased(P ＜0.01 or P ＜0.05),with the down-regualtion of TLR4 in the experimental group displaying more markedly (P ＜ 0.01).Compared with the experimental group,the down-regulation of NF-κB protein in the combined group was more significant (P ＜ 0.05).Conclusion HBO could obviously enhance the protective effect of PUFA ω-3 on the lung tissue of the rats with ALI and reduce the level of inflammatory factors,which might be associated with the regulation of TLR4/NF-κB signal pathway.

Objective To investigate the protective effect of hyperbaric oxygen (HBO) combined with ω-3 polyunsaturated fatty acid (PUFA ω-3) on lipopolysaccharide-induced acute lung injury in the rats and its related mechanism.Methods Forty-eight SD rats were randomly divided into the control group,the model group,the experimental group and the combined group,each consisting of 12 rats.With exception of the rats in the control group,acute lung injury (ALI) model was established by LPS tracheal instillation in the rats of the model and experimental groups.The experimental group received PUFA ω-3 (150 mg/kg) by gavage,the combined group was treated with HBO on the basis of PUFA omega-3,and equal volume of distilled water was given to the control and model groups.The course of treatment lasted for 14 days.After last medication,pulmonary tissues of the rats were collected and wet/dry ratio was calculated,and the inflammatory factors,TNF-α and IL-1β in the lung tissue homogenate were detected by ELISA test kit.HE staining was used to observe the pathological damage of the lung tissue,and the expression levels of TLR4 and NF-κB proteins in the lung tissue were detected by Western-blotting.Results Compared with the control group,pulmonary edema in the model group could clearly be seen,and the wet/dry ratio of the lung tissue increased markedly (5.57 ± 0.57 vs.4.16 ±0.19) (P ＜0.05).Compared with the model group,the wet/dry ratio of the lung tissue in the experimental and the combined groups decreased (4.78 ±0.25,4.42 ±0.18 vs.5.57 ±0.37) (P ＜0.01 or P ＜ 0.05),and the wet/dry ratio of the combined group was obviously lower than that of the experimental group (4.42 ±0.18 vs.4.78 ±0.25) (P ＜0.05).As compared with the control group,the inflammatory factor levels of TNF-α and IL-1β in the model group all significantly increased(P ＜ 0.01 or P ＜ 0.05).Following treatment with simple PUFA ω-3 or coupled with HBO,the inflammatory factor levels of TNF-α and IL-1β in lung tissues of the experimental and the combined groups all decreased markedly,as compared with those of the model group (P ＜ 0.05),with those of the combined group decreased more significantly (P ＜ 0.05).As compared with those of the control group,the expression levels of TLR4 and NF-κB proteins in the model group were significantly up-regulated (P ＜ 0.01).Compared with the model group,the expression levels of TLR4 and NF-κB proteins in the experimental and the combined groups all decreased(P ＜0.01 or P ＜0.05),with the down-regualtion of TLR4 in the experimental group displaying more markedly (P ＜ 0.01).Compared with the experimental group,the down-regulation of NF-κB protein in the combined group was more significant (P ＜ 0.05).Conclusion HBO could obviously enhance the protective effect of PUFA ω-3 on the lung tissue of the rats with ALI and reduce the level of inflammatory factors,which might be associated with the regulation of TLR4/NF-κB signal pathway.

ObjectiveTo systematically evaluate the efficacy and safety of octreotide in the treatment of hepatocellular carcinoma (HCC). MethodsOnline databases including PubMed, Cochrane Library, Embase, China National Knowledge Internet, Wanfang Data, and China Science and Technology Journal Database were comprehensively searched for relevant randomized controlled trials (RCTs) of octreotide in the treatment of HCC. The quality of included studies was assessed using the method recommended by the Cochrane handbook for systematic review. A meta-analysis was performed by using RevMan 5.3.4 software. ResultsEleven RCTs were included, which involved 909 cases (treatment group, 452 cases; control group, 457 cases). As for clinical efficacy, octreotide significantly increased the response rate (RR=2.30, 95% CI: 1.25~4.22, P=0.007) and decreased the progression rate (RR=0.78, 95% CI: 0.59~1.04, P=0.09), but there was no significant difference in disease control rate and progression rate between the two groups (P＞0.05). The overall survival rate and 6-month, 1-year, and 2-year survival rates in the treatment group were not significantly higher than those of the control group (all P＞0.05). As regards to safety, severe adverse events in the treatment group were significantly reduced (RR=0.72, 95% CI: 0.54~0.98, P=0.03), but there were no significant differences in diarrhea, nausea/vomiting, liver function abnormality, and blood glucose fluctuation between the two groups (all P＞0.05). ConclusionFor HCC patients, octreotide can significantly increase the clinical response rate incidence of grade 3/4 adverse events, but it does not lead to significant improvement in disease progression and survival rate.

ObjectiveTo systematically review the efficacy and safety of fast-track surgery (FTS) in perioperative nursing for biliary calculi surgery. MethodsOnline databases of PubMed, Cochrane Library, CBM, CNKI, VIP, and Wanfang Data were comprehensively searched for relevant randomized controlled trials (RCTs). Potential bias was evaluated by Cochrane tools and data were analyzed by RevMan 5.3. ResultsA total of 11 RCTs with 1455 patients were included (738 cases in FTS group and 717 cases in control group). The results of meta-analysis showed that FTS significantly reduced the length of postoperative hospital stay (MD=-4.10, 95% CI: -5.68 to -2.52, P＜0.000 01) and hospital costs (MD=-0.47, 95%CI: -0.60 to -0.34, P＜0.000 01); meanwhile, FTS shortened the time to gastrointestinal recovery (SMD=-2.05, 95%CI: -2.84 to -1.27, P＜0.000 01), as well as the time to first defecation (SMD=-1.27, 95% CI: -2.08 to -0.46, P＜0.000 01). As for safety, FTS significantly reduced the total complications of choledocholithiasis (RR=0.53, 95%CI: 0.43-0.65, P＜0.000 01) and hepatolithiasis (RR=0.52, 95% CI: 0.35-0.77, P=0.001). ConclusionFTS is effective and safe in perioperative nursing for biliary calculi surgery. It can significantly reduce the length of postoperative hospital stay, enhance gastrointestinal recovery, shorten the time to first defecation, and reduce total complications.

Objective To analyze and study the implication of dynamic changes in plasma CD62P among patients with obstructive jaundice and cholecystolithiasis.Methods A total of 58 patients diagnosed with choledocholithiasis and jaundice were included in the obstructive jaundice group,and 50 patients were in the cholecystolithiasis group.Peripheral venous blood was collected on preoperative day 3,on opera-tive day,and on postoperative days 3,6,9,12,15,18,and 21 in two groups,and the concentrations of plasma CD62P were measured by ELISA.Comparison of continuous data between the two groups was made by t test.Results The concentrations of plasma CD62P from preop-erative day 3 to postoperative day 18 were significantly higher in the obstructive jaundice group than in the cholecystolithiasis group (P<0.01 across all time points).In the cholecystolithiasis group,the concentrations of plasma CD62P significantly increased on operative day, and the increase continued and reached the peak on postoperative day 3,then followed by a decrease down to the preoperative level on post-operative day 9.In the obstructive jaundice group,the concentrations of plasma CD62P reached the peak on postoperative day 9,followed by a gradual decrease down to the preoperative level on postoperative day 18 and to an even lower level (preoperative level of patients with cho-lecystolithiasis)on postoperative day 21.Conclusion Extrahepatic biliary obstruction may lead to endothelial cell injury and platelet acti-vation,the condition of which is improved with the relief of obstruction.The surgery for obstructive jaundice may lead to much more endothe-lial cell injury and higher platelet activation than that for cholecystolithiasis.

Objective To construct recombinant adenovirus Ad/MDC-VP1 and investigate its im-muno-boosting effect of the mice primed with the experimental DNA vaccine against Coxsackievirus infection. Methods The recombinant adenovirus Ad/MDC-VP1 was constructed and packaged. The Western blot analysis was used to verify the target protein. BALB/c mice were divided into four groups: Ad/MDC-VP1 group, pcDNA3/MDC-VP1 group, pcDNA3/MDC-VP1 prime-Ad/MDC-VP1 boost group and PBS group. The mice in each group were immunized intramuscularly. The titers of serum IgG and neutralizing antibody were tested by ELISA and trace neutralization assay, respectively. The lymphocytes proliferation activity and specific CTL cytotoxic activity were tested by CCK-8 assay. The mice in each group were challenged with le-thal dose of Coxsackievirus, and the assay of the serum virus titers and the observation of protection efficacy against Coxsackievirus infection were carried out. Results The recombinant adenovirus Ad/MDC-VP1 was successfully constructed and the target protein was expressed. It was observed that the titers of CVB3 VP1 specific antibody, lymphocyte stimulation index, CTL cytotoxicity activities and protection rate of the pcDNA3/MDC-VP1 prime-Ad/MDC-VP1 boost group were much higher than those of the rest groups( P < 0.05), and the titer of serum virus was lower after CVB3 challenged ( P < 0.05 ). Conclusion Both the cellular and humoral immune responses in mice could been significantly enhanced by the pcDNA3/MDC-VP1 prime-Ad/MDC-VP1 boost strategy.

Objective To analyse the significance and relation between soluble P-selectin (sP-selectin),D-dimer (D-d) and endotoxin (ET) in the patient with obstructive jaundice (OJ). Methods Blood plasma sP-selectin and D-d in OJ group,acute cholecystitis group and healthy group were detected by ELISA and ET was detected by the colorimetric method, Results In healthy group,the concentration of blood plasma sP-selectin was ( 93.43 ? 17.65 ) ng/ml,ET(0.0030?0.0004)EU/ml,and D-d(0.39?0.21)mg/L; in acute cholecystitis group,sP-selectin was (233.32?82.12) ng/ml, ET(0.4012?0.1506) EU/ml,and D-d(0.76?0.27)mg/L; in OJ group,sP-selectin was (351.90?93.83) ng/ml ,ET (0.3814?0.1430)EU/ml,and D-d(2.14?0.37)mg/L.The sP-selectin, D-d and ET in the acute cholecystitis group and the OJ group were higher than those in healthy group (P 0.05). sP-selectin and D-d in the OJ group were significantly higher than that in the acute cholecystitis group (P