Hepatic encephalopathy （HE） is a common severe liver disease syndrome in clinical practice and is one of the critical and severe diseases in internal medicine， and more than half of liver failure patients diagnosed with overt HE have a survival time of less than 1 year. A comprehensive analysis of the complex pathogenesis of HE and the development of diagnosis and treatment regimens based on evidence-based medicine are of great importance for alleviating high medical resource consumption， high medical expenses， and high incidence and mortality rates in clinical practice. The latest studies have shown that the intestinal tract and the central nervous system can perform bidirectional continuous interaction and signal transmission and regulate the function of inflammation signals， molecules， cells， and organs， which is known as neuroimmune communication and is highly consistent with the main pathological features of HE. With a focus on the mechanism of neuroimmune communication in HE， this article reviews the association between inflammation signal transduction via the gut-brain axis and neurotransmitter regulation and its role in neuroimmune communication in HE， which provides new ideas for the clinical diagnosis and treatment of HE and the research and development of related drugs.

Objective:To access the benefits and harms of remote ischemic preconditioning(RIPC) in patients undergoing cardiac surgery with cardiopulmonary bypass.Methods:An electronic and manual search of literature published before Mar 2020 was conducted using Pubmed, EMBASE, Cochrane Library for randomized controlled trials(RCTs), CNKI, CBM, WanFang and VIP. 23 studies involving in 5 025 participants were included. Patients were randomly assigned to either remote ischemic preconditioning group(n=2 524) or control group(n=2 521). Remote ischemic preconditioning consisted of 3-4 cycles of lower limbs or upper limbs ischemia and reperfusion with an automated cuff inflator. Clinical data and the levels of injury biomarkers were collected. The main outcomes were the incidence of adverse events, mortality in the hospital, and the post-operative troponin concentration. The effective values of dichotomous variables or continuous variables were estimated by Relative risk( RR) or by mean differences( MD), standardized mean differences( SMD) with 95% confidence intervals( CI) respectively. Results:In general risk of bias varied from low to moderate risk of bias across included studies, and insufficient detail was provided to inform judgement in several cases. There were no significant differences between the two groups with regard to all-cause mortality in hospital( RR=1.27, 95% CI: 0.84-1.91, P=0.26), no-fatal myocardial infarction( RR=0.92, 95% CI: 0.79-1.07, P=0.27) , new stroke( RR=0.96, 95% CI: 0.61-1.50, P=0.84), new atrial fibrillation( RR=0.98, 95% CI: 0.83-1.15, P=0.77) and acute renal failure( RR=1.01, 95% CI: 0.90-1.14, P=0.83). Conclusion:There is no evidence that RIPC has a treatment effect on clinical outcomes(measured as all-cause mortality in hospital, no-fatal myocardial infarction, new stroke, new atrial fibrillation, and acute renal failure). More research should be designed to confirm the effect of RIPC on myocardial protection with cardiopulmonary bypass.

OBJECTIVE: To establish a headspace gas chromatography-mass spectrometry method for the determination of 14 chlorinated hydrocarbons in urine. METHODS: The urine sample 4.00 mL and anhydrous sodium sulfate 3.00 g were added into a 10.00 mL headspace bottle, then the headspace bottle was maintained at 70 ℃ for 40.0 min. After headspace pretreatment, 14 chlorinated hydrocarbons in headspace air were separated in the DB-5 MS capillary column of the gas chromatography and detected by mass spectrometer. RESULTS: There was a good linear relationship of 14 chlorinated hydrocarbons in urine in the range of 0.62-1 630.00 μg/L. The linear correlation coefficient was greater than 0.999 0.The minimum detectable concentration was 0.19-0.43 μg/L and the minimum quantitative concentration was 0.62-1.44 μg/L. The average recovery rate was 89.8%-107.1%. The within-run relative standard deviation(RSD) was 4.0%-8.5% and the between-run RSD was 6.3%-9.1%. Urine samples can be stored at 4 ℃ or-8 ℃ for 3 days and below-20 ℃ for 7 days. CONCLUSION: This method is rapid, simple, sensitive, accurate and has little interference,which can be used as a method for detecting 14 kinds of chlorinated hydrocarbons in urine samples of patients with occupational poisoning.

Objective:To report our experience of treating open comminuted limb fractures caused by gunshots using the Masquelet technique.Methods:Between January 2016 and July 2018, 3 patients were admitted to Institute of Orthopedics, 920 Hospital of Joint Logistic Service of People's Liberation Army for open comminuted limb fractures caused by gunshots.They were all male, aged from 18 to 41 years (average, 30.7 years).Their fractures were complicated with perforating wounds and belonged to Gustilo type ⅢB for open fractures.The bone defects were 5 to 9 cm in length (average, 6.7 cm), located at the proximal femur in 2 cases and at the upper middle humerus in one.They were treated by standard Masquelet technique at 2 stages.The postoperative functions of the hip, knee and shoulder were evaluated according to the Harris hip score, Lowa knee score and Constant-Murley shoulder function score.Results:The 3 patients obtained an average follow-up of 17.3 months.The bone defects were all repaired in the 3 patients without any signs of infection.The 2 patients with femoral defects were rated as both excellent by the Harris hip score, as excellent in one and as good in the other by the Lowa knee score; the patient with humeral defects was rated as excellent by the Constant-Murley shoulder function score.Conclusion:Masquelet technique is a desirable treat-ment of segmental long bone defects caused by gunshots.

OBJECTIVE: To establish a method for simultaneous detection of five kinds of olefine chlorides in workplace air by solvent desorption-gas chromatography. METHODS: The olefine chlorides in workplace air were collected using activated charcoal tubes,desorbed by carbon disulfide,separated on a HP-INNOWAX capillary column and detected with flame ionization detector. RESULTS: The linear range of the five kinds of chlorinated olefins( vinyl chloride,allyl chloride,chloroprene,trans-1, 2-dichloroethylene, cis-1, 2-dichloroethene) was wide and the linear correlation coefficient was greater than 0. 999 8. The detection limit and the minimum detectable concentrations were 0. 30-0. 80 mg/L and 0. 05-0. 13 mg/m~3,respectively( air sample volume 6. 0 L). The recovery rate was 95. 90%-102. 67%. The within-run and betweenrun relative standard deviations were 0. 00%-3. 74% and 0. 21%-6. 12%,respectively. The samples could be preserved at room temperature for at least 14 days. CONCLUSION: This method has simple operation,good linear range,high sensitivity and good reproducibility,which is suitable for detecting 5 kinds of olefine chlorides in workplace air.

Objective: To analyze relative risk factors of hyperamylasemia after open-heart surgery, and provide basis for clinical prevention and treatment. Methods: A total of 521 adult patients, who received open-heart surgery under general anesthesia and low temperature in our hospital from Jan 1, 2013 to Jun 30, 2013, were selected. The 2ml peripheral venous blood was taken in each patient instant after ICU hospitalization, 24h, 48h and 72h after surgery, then serum was separated and measured for serum amylase level by Somogyi method. According to the measured results of serum amylase level, patients were divided into hyperamylasemia group (serum amylase≥500U/dl, n=76) and non- hyperamylasemia group (serum amylase<500 U/dl, n=445). Single factor and gradual Logistic regression analysis were used to analyze risk factors of hyperamylasemia in patients after open-heart surgery. Results: Gradual Logistic regression analysis indicated that cardiopulmonary bypass (CPB) time and hypotension during operation, renal dysfunction and infection after operation were independent risk factors for postoperative hyperamylasemia (OR=1.02~4.12, P<0.05 or <0.01). Conclusion: During perioperative treatment of open-heart surgery, shortening CPB time, avoiding hypotension during surgery, protecting renal function and preventing infection may reduce morbidity of postoperative hyperamylasemia and improve prognosis of patients.

BACKGROUND:Many experiments and clinical studies have reported that venous blood, absorbable colagen sponge and rich fibrin clot, without the use of bone graft material, can al promote new bone formation; therefore, whether only transplanting concentrated growth factor in the maxilary sinus lift could effectively promote bone regeneration? OBJECTIVE: To conduct the maxilary sinus lift with concentrated growth factor as the graft material, and to observe the peri-implant bone level change. METHODS: Totaly 26 patients were involved, including 14 males and 12 females, aged 35-73 years. Maxilary sinus lift was conducted and autologous concentrated growth factor was taken as the graft material. Astra Tech implants were implanted simultaneously. Patients were divided into 6-12 months, 13-18 months and > 18 months groups according to the folow-up time. Patients were divided into≤ 5 mm, 5-7 mm, and≥ 7 mm groups according to the preoperative alveolar bone height. Patients were divided into≤ 2 mm, 2.0-3.0 mm, and≥3 mm groups according to the postoperative maxilary sinus lift height. The survival rate of implants and marginal bone level changes were observed during the folow-up. RESULTS AND CONCLUSION: Totaly 44 implants were implanted, of which 43 implants were considered as successful repair during the 6-18 months of postoperative folow-up. The survival rate of implants was 98%. There were no significant differences in the changes of mesial, distal and middle marginal bone levels between different folow-up time groups. The maxilary sinus lift with transplantation of concentrated growth factor resulted in a good osseointegration within 6-18 months post-operation. In addition, no significant differences were found in the changes of mesial, distal and middle marginal bone levels between different residual alveolar bone height groups, as wel as between different maxilary sinus lift height groups. It showed that the residual alveolar bone height and maxilary sinus lifting height had no significant effect on the peri-implant bone formation. Briefly, these findings demonstrate that the maxilary sinus lift with concentrated growth factor transplantation can result in a high survival rate of implants that are simultaneous implanted, and the alveolar bone around the implant is stable. But the long-term effect needs further observation.

BACKGROUND:Research on rough-surfaced implants has demonstrated similar survival rates for short and conventional-length implants. It is not clear whether ultrashort implant in limited alveolar bone of the posterior maxila can achieve good clinical results. OBJECTIVE:To evaluate the clinical effect of ultrashort implants in limited alveolar bone of the posterior maxila. METHODS:Eighteen patients with 21 ultrashort implants in limited alveolar bone of posterior maxila (the mean residual alveolar height=3.19 mm) were included in the study, including 10 males and 8 females, aged 25-68 years. At 12 months after restoration, the patients were detected with cone-beam CT to evaluate the osseointegration and marginal bone level around the implant. RESULTS AND CONCLUSION:Al the 18 patients completed the 12-month folow-up, and the 21 pieces of implants had good osseointegration. No soft tissue inflammation was found. At 12 months after restoration, the marginal bone height in the mesial and distal was (-0.21±0.78) mm and (-0.16±0.55) mm, respectively. Implant marginal bone changes in the mesial and distal had no statistical difference (P > 0.05). Ultrashort implants in limited alveolar bone of the posterior maxila can have good osseointegration, maintain the marginal bone mass around the implant, but stil need long-term clinical observation.

Interleukin-32 is a newly descovered cytokine. In vivo and in vitro studies show that it inhibits the proliferation and induces apoptosis of colon cancer and melanoma by inhibiting NF-κB and signaling and transcription activated factor 3 pathways.In addition,IL-32 suppresses tumor growth in different ways in chronic myelogenous leukemia,sarcoma and prostate cancer.

A HPLC method was developed for the determination of mangiferin in rat plasma and aqueous humor. 4-Nitrophenol was used as internal standard. Analysis was performed on a Cosmosil ODS C18 analytical column (4.6 mm x 250 mm, 5 microm) with mobile phase consisting of methanol-water (40: 60) with 2% glacial acetic acid at a flow rate of 1.0 mL x min(-1). The calibration curve of mangiferin in rat plasma and aqueous humor showed excellent linear behaviors over the investigated concentration of 0. 50-250.00 mg x L(-1) in plasma and 0.10-10.00 mg x L(-1) in aqueous humor, respectively, and the correlation coefficients were all above 0.995 4. The intra-day and inter-day precisions for all samples were measured to be below 12%. The limit of quantitation was 0.10 mg x L(-1) and low enough for the determination of mangiferin in all samples. The validated method has been successfully applied to preliminary pharmacokinetics study of mangiferin in rat plasma and aqueous humor.
Animals ; Aqueous Humor ; chemistry ; Chromatography, High Pressure Liquid ; Female ; Male ; Nitrophenols ; analysis ; Rats ; Rats, Wistar ; Reproducibility of Results ; Sensitivity and Specificity ; Xanthones ; blood ; pharmacokinetics