Objective:To investigate the protective effects of an anti-inflammatory mixture on acute lung injury (ALI) induced by sepsis in rats, as well as its possible mechanisms.Methods:A total of 40 Sprague-Dawley (SD) rats were randomly divided into the sham group, septic ALI model group (model group), 3-methyladenine (3-MA) control group, and anti-inflammatory mixture pretreatment group, with 10 rats in each group. Cecal ligation and perforation (CLP) was performed to reproduce a septic ALI model. The rats in the sham group only underwent opening and closing the abdomen without perforation and ligation. Both groups were given saline gavage and intraperitoneal injection for 3 consecutive days before surgery. The 3-MA control group was given intraperitoneal injection of saline and autophagy inhibitor 3-MA 15 mg/kg for 3 consecutive days before modeling. The anti-inflammatory mixture pretreatment group was given 8.8 mL/kg of anti-inflammatory mixture by gavage [the composition of anti-inflammatory mixture: rhubarb 15 g (after the next), coptis chinensis 15 g, baical skullcap root 12 g, magnoliae cortex 12 g, dahurian patrinia herb 30 g] and saline intraperitoneal injection for 3 consecutive days before modeling. The rats in each group were anesthetized 24 hours after surgery and died due to abdominal aortic blood collection. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum inflammatory cytokines interleukins (IL-1β and IL-6). Lung tissue was taken and then the bronchoalveolar lavage fluid (BALF) was collected, and the levels of IL-1β and IL-6 were detected by ELISA. Lung wet/dry weight (W/D) ratio was measured. After hematoxylin-eosin (HE) staining, the histopathological changes of the lungs were observed under light microscopy. Western blotting was used to detect the expression of autophagy markers microtubule-associated protein 1 light chain 3-Ⅱ/Ⅰ (LC3-Ⅱ/Ⅰ) and Beclin-1 protein in lung tissue. Autophagosomes in lung tissue were observed with transmission electron microscopy.Results:Compared with the sham group, the rats in the model group exhibited severe destruction of lung tissue structure, with significant infiltration of inflammatory cells, the lung W/D ratio and the levels of IL-1β and IL-6 in serum and BALF were significantly increased, the expressions of LC3-Ⅱ/Ⅰ and Beclin-1 protein were down-regulated, the autophagosomes were more. The rats in the 3-MA control group exhibited more severe lung tissue injury as compared with the model group, the lung W/D ratio and the levels of inflammatory cytokines in serum and BALF were further increased, the expressions of LC3-Ⅱ/Ⅰ and Beclin-1 protein still showed a decrease tendency as compared with the sham group, and the autophagosomes were less than that in the model group. Compared with the model group, the anti-inflammatory mixture pretreatment group showed milder lung tissue injury with a minimal amount of inflammatory cell infiltration, the lung W/D ratio was significantly reduced (7.07±1.02 vs. 11.33±1.85, P < 0.05), the levels of IL-1β and IL-6 in both serum and BALF were significantly decreased [IL-1β (ng/L): 26.04±3.86 vs. 40.83±5.46 in serum, 17.75±2.02 vs. 26.86±4.32 in BALF; IL-6 (ng/L): 91.28±10.15 vs. 129.44±13.05 in serum, 76.06±7.51 vs. 120.91±7.47 in BALF, all P < 0.05], and the ratio of LC3-Ⅱ/Ⅰ and Beclin-1 protein expression were significantly increased [LC3-Ⅱ/Ⅰ ratio: 1.23±0.02 vs. 0.60±0.02, Beclin-1 protein (Beclin-1/GAPDH): 2.37±0.33 vs. 0.62±0.05, both P < 0.05]. Furthermore, an increase in the number of autophagosomes was observed. Conclusion:The anti-inflammatory mixture improves lung injury in rats with sepsis induced by CLP and reduce inflammation levels, potentially through upregulation of Beclin-1-mediated autophagy.

Objective:To investigate the clinical features and risk factors of left ventricular systolic dysfunction in children with septic shock.Methods:A retrospective analysis was performed on the clinical data of children diagnosed with septic shock in the Department of Critical Care Medicine of Children’s Hospital, Capital Institute of Pediatrics from February 2016 to June 2021. Inclusion criteria: (1) patients met the diagnostic criteria of septic shock; (2) Cardiac ultrasound was performed within 48 h after shock treatment and was dynamically monitored during shock treatment. Exclusion criteria: (1) Previous history of chronic cardiac insufficiency, cardiomyopathy, or organic heart disease; (2) patients with acute cerebral infarction, cerebral hemorrhage and necrotizing encephalopathy; (3) congenital genetic metabolic diseases; and (4) incomplete information. Left ventricular systolic dysfunction was defined as a left ventricular ejection fraction (LVEF) <50% and a ≥10% decrease in the patient’s initial LVEF assessed on admission. Patients with left ventricular systolic dysfunction and without left ventricular systolic dysfunction were compared. Comparisons between groups were performed with unpaired Student’s t test, or Mann-Whitney U test, or chi-square test. Multivariate logistic regression analysis was used to analyze the correlation factors of left ventricular systolic dysfunction. Results:The incidence of left ventricular systolic dysfunction in children with septic shock was 30.0% with the lowest LVEF of (42±8)%. Left ventricular systolic dysfunction occurred on (2.4±1.3) days after shock onset, and the LVEF returned to normal on (6.7±3.3) days. Hematogenous infection was more frequent (77.8% vs. 40.5%, P=0.018), ventilator application (83.3% vs. 50.0%, P=0.033) and inotropes and vasopressor drugs (100.0% vs. 64.3%, P=0.009) were used more frequently in patients with left ventricular systolic dysfunction(n =18), compared with patients without left ventricular systolic dysfunction(n =42). Patients with left ventricular systolic dysfunction had a lower LVEF [(42±8)% vs. (67±5)%, P<0.001], a lower pediatric critical illness score [(64±13) vs. (76±14), P=0.003], a lower resuscitation success rate at 6 h (38.9% vs. 73.8%, P=0.010), a higher lactate at admission [3.80 (3.15, 5.88) mmol/L vs. 2.70 (1.85, 3.80) mmol/L, P=0.001) and a higher 28-d mortality (38.9% vs. 12.8%, P=0.025) compared with patients without left ventricular systolic dysfunction. Hematogenic infection ( OR=7.358, 95% CI: 1.198~45.197, P=0.031) and lactate at admission ( OR=1.743, 95% CI: 1.041~2.917, P=0.034) were independent risk factors for left ventricular systolic dysfunction. Conclusions:The incidence of left ventricular systolic dysfunction in children with septic shock was 30.0%. Left ventricular systolic dysfunction usually occurred on (2.4±1.3) days after shock onset and resolved within 7 days, which was associated with 28-d mortality. Hematogenous infection and high lactate value were independent risk factors for left ventricular systolic dysfunction.

AIM: To investigate the effect of extracorporeal membrane oxygenation (ECMO) on the pharmacokinetics/pharmacodynamics (PK/PD) of daptomycin in critically ill patients. METHODS: Twenty four patients with severe infection in our hospital were randomly selected and divided into ECMO group and non ECMO group. They were intravenously injected with daptomycin 500 mg qd. After the drug reached the stability statement, venous blood was collected at different time points before and after the infusion. The plasma drug concentration was measured and the pharmacokinetic parameters were calculated. The probability target acquisition (PTA) and the cumulative fraction response (CFR) were calculated by Monte Carlo simulation. RESULTS: After dosing, the main pharmacokinetic parameters in ECMO and non-ECMO group were calculated and listed as follows: C

【Objective】 To analyze the metagenomics and microbiology of voluntary blood donors in China, so as to assess the potential threats of emerging infectious diseases to the safety of blood transfusion. 【Methods】 12 300 plasma samples (10 mL each) collected by central blood stations in Chongqing, Liuzhou, Urumqi, Mianyang, Wuhan, Nanjing, Mudanjiang, and Dehong Prefecture area from 2012 to 2018 were subjected to total DNA extraction after ultracentrifugation (32 000 rpm/min, centrifugal radius 91.9 mm) in minipools of 160 donations. The metagenomic library was constructed, and deep sequencing was conducted by Illumina Hiseq 4 500. By comparing with reference sequences of bacteria, fungi, parasites and viruses, metagenomic data were analyzed, classification of microbes were identified, and potentially harmful pathogens were evaluated. 【Results】 A total of 632 GB clean data were obtained by deep sequencing, and the top three pathogens were Pseudomonas(0.561 1%), Burkholderia(0.468 7%) and Serratia(4.242 0%). Pathogens with potential threat which could be transmitted by blood transfusion or blood products were found, such as human parvovirus B19(0.126 6%), Leishmania spp(1.348 5%) and Toxoplasma gondii(0.615 8%). 【Conclusion】 Our study analyzed metagenomics of voluntary blood donors in parts of China and revealed pathogens that may cause potential harm to blood safety, which were helpful for targeted prevention and control of emerging infectious diseases.

Objective: To apply the semi-quantitative risk assessment model in the Technical Guidelines for Occupational Health Risk Assessment of Chemical Hazardous Factors in the Workplace to assess the occupational health risk of electroplating enterprises and explore its applicable conditions and characteristics. Methods: Three electroplating enterprises were selected as the research objects. Occupational hygiene survey and hazard factor detection were conducted on the spot. Three semi-quantitative risk assessment methods were used to assess the risk, and the evaluation results were compared. Results: The consistency between the contact index method and the comprehensive index method was strong. The weighted Kappa value was 0.946 and the P value was less than 0.001, but the consistency between the contact ratio method, the contact index method and the comprehensive index method was poor. The weighted Kappa value was 0.345 and 0.391, and the P value was 0.009 and 0.004, respectively. When the contact concentration is less than 50% OELs, the evaluation results of the contact ratio method are lower than those of the exponential method and the comprehensive exponential method. The consistency of the three methods was the highest when the contact concentration (>50%) and (OELs, the results of the contact ratio method are higher than those of the index method and the comprehensive index method. Conclusion Contact ratio method is suitable for occupational health risk assessment under the condition of incomplete occupational health information and for enterprise managers to identify key control points of health risk through self-assessment; Contact index method is suitable for hazard risk assessment of occupational hazards without sampling test conditions or OELs, and pre-assessment of occupational hazards of construction projects without access to analogical test data. The index method is suitable for occupational health risk assessment with available testing data and complete occupational health information.

Objective To identify the risk factors for postoperative cognitive dysfunction (POCD) in elderly patients undergoing total knee arthroplasty (TKA).Methods Ninety-six American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients,aged 65-80 yr,with body mass index of 18-25 kg/m2,undergoing elective TKA under total Ⅳ anesthesia,were divided into POCD group and non-POCD group according to whether POCD occurred on 7th day after surgery.The patient baseline characteristics in the perioperative period,plasma concentrations of interleukin-1beta (IL-1β),tumor necrosis factor-alpha (TNFα),neuron-specific enolase (NSE) and S-100β protein,and visual analogue scale (VAS) scores at 1 and 2 days after operation were recorded.Logistic regression analysis was used to identify the risk factors for POCD.Results Thirty-eight patients developed POCD at 7 days after operation,and the incidence was 39％.The results of logistic regression analysis showed that the number of operations,VAS score during activity at 1 day after operation,and concentrations of TNF-α,IL-1β,NSE and S-100β protein in plasma were risk factors for POCD (P＜0.05).Conclusion The number of operations,VAS score during activity at 1 day after operation,and concentrations of TNF-α,IL-1β,NSE and S-100β protein in plasma are risk factors for POCD in elderly patients undergoing TKA.

Objective To explore the indications for percutaneous renal biopsy of asymptomatic hematuria in children. Methods The renal pathological types of 485 children with asymptomatic hematuria were analyzed retrospectively. According to the degree of hematuria and whether or not combined with proteinuria, the children were divided into microscopic hematuria group, gross hematuria group and hematuria with proteinuria group. The microscopic hematuria group was further divided into urine red blood cell<15/HPF group, (15～30)/HPF group, and >30/HPF group according to hematuria degree. Results In 227 males and 258 females with the average age of 7.23±2.93 years, there were 318 cases in microscopic hematuria group, in which the most common pathological types were minor lesions (64.8%), followed by focal glomerular lesions (16.7%) and focal segmental glomerulosclerosis (8.2%). There were 119 cases in gross hematuria group, in which the most common pathological types were also minor lesions (26.1%), followed by IgA nephropathy (24.4%) and mesangial proliferative glomerulopathy (20.2%). There were 48 cases in hematuria with proteinuria group, in which the most common pathological types were IgA nephropathy (29.2%) and minor lesions (29.2%). The distribution of the pathological types among microscopic hematuria group, gross hematuria group and hematuria with proteinuria group were statistically different (χ2=152.03, P<0.001). In three groups, microscopic hematuria group had the highest proportion of minor lesions, while gross hematuria group and hematuria with proteinuria group had higher proportion of IgA nephropathy and mesangial proliferative glomerulonephritis . In microscopic hematuria group, there were 149 children with urine red blood cell<15/HPF, 96 with urine red blood cell (15～30)/HPF, and 73 with urine red blood cell >30/HPF. There was no difference in pathological types among three sub-groups (χ2=15.18, P=0.51), and mild lesions were the most common pathological types in each group. Conclusion Renal biopsy should be performed at earliest possible time to make pathological diagnosis in asymptomatic hematuria children with gross hematuria or proteinuria.

[Objective] This prospective study was conducted to assess the influence of overnight orthokeratology (OK) on low,middle and high myopia in southern Chinese teenagers.[Methods] Fifty-four subjects (107 eyes,age 11.65 ± 2.44 years,mean±SD)who matched the inclusion criteria for OK were enrolled in the study.The subjects were divided into three groups according to the different refraction baseline (low myopia group:0.75 ～ 3.00 D,51 eyes;middle myopia group:3.25 ～ 5.00 D,36 eyes;high myopia group:5.25 ～ 9.00 D,20 eyes).Refraction,central corneal thickness,corneal keratometry,anterior chamber depth and axial length (AL) were measured at baseline and after 1 years using ocular biometry.The changes were evaluated and compared among the groups.Results were analyzed by SPSS 17.0 software.[Results] Fifty-four subjects (total 107 eyes) completed the 1-year follow-up examinations.At baseline,the spherical equivalent refractive error (SER) was-2.15 D ± 0.63 D,-4.20 D ± 0.54 D,and-6.63 D ±1.18 D in three groups.The axial length was (24.50-± 0.66) mm,(25.16-± 0.65) mm,and (26.35 ± 0.87) mm in the three groups,respectively.There were no significant differences among the groups in initial central corneal thickness,anterior chamber depth,central,flat and steep kerotometry.The increase in axial length during the 1-year study period was (0.22 ± 0.27) mm,(0.09-± 0.22)mm and (0.02-± 0.22) mm in three groups,respectively,and the difference was significant between low myopia group and middle myopia group (P =0.04),low myopia group and high myopia group (P =0.008),whereas no significant difference was found between middle myopia group and high myopia group (P =0.35).Spherical equivalence decreased dramatically in three groups after one year (all P ＜ 0.0001).And the difference was significant between low myopia group and middle myopia group (P ＜ 0.0001),low myopia group and high myopia group (P ＜ 0.0001).Central,flat and steep kerotometry after one year became flatten in all group (all P ＜0.0001).There were no significant differences in the change of central corneal thickness,anterior chamber depth and corneal diameter.[Conclusions] OK lens is more effective in middle and high myopia control than in the low myopia control.The change in corneal keratometry may be one of the main factors influencing the OK treatment effect.

Objective To study the pathogenesis of lower limb motor disorder in vascular parkinsonism(VP)using diffusion tensor image(DTI). Methods A case?control study was performed in a cohort of 16 VP patients and 32 PD patients. Patients were all recruited from the first affiliated hospital of China Medical University from Dec. 2011 to Dec. 2012. The lower limb motor function of those patients was assessed using measurement scales. All patients received magnetic resonance image(MRI)and diffusion tensor image(DTI). Results Patients in VP group showed more seri?ous movement disorders such as freezing of gait(gait ignition failure)than these in PD group,and the movement disorders of their lower limbs prog?ress more rapidly in VP group than the PD group. Movement disorders of their lower limbs in VP group were related to fibers in bilateral frontal lobes (P=0.008). Movement disorder of their lower limbs in PD group were related to fibers in substantia nigra(P=0.030). There are statistically signifi?cant differences in both the FA values of substantia nigra,bilateral frontal lobes and the ADC values of frontal lobes,and the pars compacta and pars reticulata of substantia nigra between these two groups(all P<0.05). Conclusion Movement disorders of bilateral lower limbs are more seriously manifested in VP patients than in PD patients. The onset movement dysfunction of bilateral lower limbs is closely related to fibers in the frontal lobe.

Purpose To investigate the clinical effect of ultrasound guided drainage combined with different hardeners for simple breast cysts,and to further provide reference for individual treatment.Materials and Methods Clinical data of 117 cases breast simple cysts were analyzed retrospectively,of which 42 cases were routine ultrasound-guided puncture combined with fluid injection of hypertonic sugar (group A),40 cases were routine ultrasound guided drainage combined with ethanol injection therapy (group B),and 35 cases were routine ultrasound guided therapy alone (control group).The clinical efficacy and adverse reactions were compared among the three groups after treatment.Results The total effective rate of group A was 95.24％,group B was 97.50％,and control group was 82.86％.Total effective rate of group A and B had no significant difference (P＞0.05),which were both higher than control group (P＜0.05).The adverse reactions rate of group B was higher than group A and control group,which had statistical significance (P＜0.05).Conclusion Ultrasound guided injection of hypertonic sugar or ethanol after drainage treatment for simple breast cysts can both obtain satisfactory clinical results,but adverse reactions of the former one are mild,it should be widely applied.