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ObjectiveTo investigate the role of the Wnt1/β-catenin signaling pathway in the intervention of medicated serum of Buyang Huanwutang （BYHWT） in endothelial-to-mesenchymal transition （EndMT） of human pulmonary artery endothelial cells （HPAECs） as well as its related mechanisms. MethodMedicated serum of BYHWT was prepared by gavage to New Zealand rabbits with a dosage of 53.36 g·kg-1·d-1 after decocting the medicine as usual. In addition， the same volume of normal saline was used to prepare blank serum. The HPAECs were cultured in vitro， and then induced by the transforming growth factor-β1 （TGF-β1） to establish the EndMT model. Five groups were established： blank group （10% blank serum）， model group （TGF-β1+10% blank serum）， low-dose BYHWT group （TGF-β1+2.5% medicated serum+7.5% blank serum）， medium-dose BYHWT group （TGF-β1+5% medicated serum+5% blank serum） and high-dose BYHWT group （TGF-β1+10% medicated serum）. Through Western blot， the expressions of Wnt1， β-catenin， and glycogen synthase kinase-3β （GSK-3β） were detected. In order to further clarify the mechanism of the Wnt1/β-catenin signaling pathway in the intervention of the medicated serum of BYHWT in inhibiting EndMT， the overexpression of β-catenin was confirmed by polymerase chain reaction after plasmid of overexpression β-catenin was constructed and transfected into the HPAECs. The HPAECs were intervened by 10% medicated serum with the optimal effect in previous studies. Then， they were divided into another five groups： the blank group （10% blank serum）， the model group （TGF-β1+10% blank serum）， the BYHWT group （TGF-β1+10% medicated serum）， the BYHWT+overexpression plasmid control group （TGF-β1+10% medicated serum+blank plasmid） and the BYHWT+β-catenin overexpression plasmid group （TGF-β1+10% medicated serum+β-catenin）. Apart from that， cell proliferation ability was detected by the methyl thiazolyl tetrazolium （MTT） method and cell migration ability by scratch assay and Transwell assay together. Immunofluorescence was adopted to detect the expressions of platelet endothelial cell adhesion molecule （PECAM-1/CD31）， vascular endothelial cadherin （VE-cadherin）， fibroblast-specific protein 1 （FSP1）， and α-smooth muscle actin （α-SMA）. ResultIn comparison to the blank group， the expressions of Wnt1 and β-catenin were significantly increased （P<0.01） while the expression of GSK-3β significantly decreased （P<0.01） in the model group. In comparison to the model group， the expressions of Wnt1 and β-catenin were significantly decreased （P<0.01） while the expression of GSK-3β was significantly increased （P<0.01） in the high-dose BYHWT group. The expression of β-catenin was significantly decreased （P<0.01） while the expression of GSK-3β was significantly increased （P<0.01） in the medium-dose BYHWT group. There was no significant difference in these indexes of the low-dose BYHWT group. In comparison to the blank group， proliferation and migration abilities were remarkably increased （P<0.01） and the immunofluorescence intensities of CD31 and VE-cadherin were decreased， while those of FSP1 and α-SMA were increased in the model group. In comparison to the model group， proliferation and migration abilities were significantly decreased （P<0.01） and the immunofluorescence intensities of CD31 and VE-cadherin were increased， while those of FSP1 and α-SMA diminished in the BYHWT group. Beyond that， the change trend of those indexes in the BYHWT+β-catenin overexpression plasmid group was consistent with that in the model group. In comparison to the BYHWT+overexpression plasmid control group， proliferation and migration abilities were significantly increased （P<0.01） and the immunofluorescence intensities of CD31 and VE-cadherin were decreased， while those of FSP1 and α-SMA were increased in the BYHWT+β-catenin overexpression plasmid group. ConclusionMedicated serum of BYHWT can inhibit EndMT of HPAECs by the Wnt1/β-catenin signaling pathway.
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Neuropathic pain is a clinical symptom with complex mechanisms and high incidence. The commonly used analgesics have limited efficacy and can cause serious side effects. The theory of chronic pain entering collaterals was proposed by YE Tianshi， a famous physician focusing on warm diseases in the Qing dynasty， on the basis of the ancient therapies for pain. This theory is particularly suitable for the diagnosis and treatment of neuropathic pain in view of the clinical course and manifestations. The chronic neuropathic pain can enter the Yin collateral in deeper sites. The pathogenesis of neuropathic pain is summarized as a deficiency in origin and excess in superficiality. The root cause is the dysfunction of Zang-Fu organs， mainly the liver, kidney and heart， while the superficial causes are phlegm and stasis caused by the obstructed Qi and blood movement due to the consumption of Qi and blood in collaterals. Accordingly， the therapies such as dispelling blood stasis， resolving phlegm， and dredging collaterals should be adopted. This paper expounds the traditional Chinese medicine （TCM） pathogenesis and treatment of neuropathic pain， enriching the knowledge and providing new ideas for the TCM prevention and treatment of this disease as a collateral disease.
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Objective To investigate the effect of budesonide atomization on tracheal extubation in children.Methods A total of 85 patients with tracheal intubation in Tianjin Children's Hospital from May 2013 to September 2016 were selected in this study.Patients were randomly divided into budesonide group (n=44) and dexamethasone group (n=41).The budesonide group was given 1 mg of budesonide for inhalation 30 min before extubation,and 1 mg of budesonide inhalation immediately after extubation.Then every 8 hours for 0.5-1.0 mg budesonide inhalation for 4 days.The dexamethasone group was given dexamethasone 0.2-0.3 mg/kg intravenously 30 min before extubation,and dexamethasone 2.5-5.0 mg inhalation immediately after extubation.Then dexamethasone 2.5-5.0 mg inhalation was given every 8 hours for 4 days.The incidence of laryngeal edema (stridor,hoarseness),the time of extinction,the expression of hypoxia,reintubation rate within 24 hours and secondary infection rate after extubation were compared between the two groups.Results There were no significant differences in the mission success rate,the incidence of laryngeal edema,the time of extinction,the incidence of hypoxia and re-intubation rate between the two groups (P ＞ 0.05).Two patients were found secondary infection after extubation in dexamethasone group.Conclusion Both budesonide and dexamethasone show curative effects on the prevention and treatment of laryngeal edema after extubation.Budesonide atomization can replace systemic corticosteroids,thus reducing the adverse reactions of glucocorticoids.We recommend the use of budesonide in treating adverse events after extubation.
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Early, rapid and accurate diagnosis of disease is of great significance for the prevention of disease progression and the best clinical rational treatment program. Respiratory tract infections are the common and frequently occurring diseases in infants and preschool children. About 90 percent of upper respiratory tract infections are caused by viruses, and followed by secondary bacterial infections. Bacterial pathogen often causes lower respiratory tract infections. This study describes the clinical features of typical pathogens of respiratory tract infections in children including respiratory syncytial virus, influenza virus, coronavirus and atypical pathogens-mycoplasma, chlamydia and legionella, and explains the clinical testing evaluation of widely used PCR method in the detection and diagnosis of respiratory tract infections in children. Finally, we analyzed the advantages and disadvantages of current used respiratory pathogen detection method-traditional culture method, based on pathogen antigen (antibody) assay and nucleic acids method.
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Objective To investigate the curative effect of sodium nitroprusside in the treatment of EV71-related pneumoedema/pneumorrhagia and hypotension in this study. Methods This was a retrospective study of a total 10 children with EV71-related pneumoedema/pneumorrhagia treated with sodium nitroprusside using case-control methods. The clinical manifestations and outcomes of the 10 children (present cohort) were compared with those of 8 children (past cohort) who had EV71-related pneumoedema/pneumorrhagia without sodium nitroprusside. Results Among these 10 patients,all were at the appearance of pneumoedema/pneumorrhagia, cardiac arrhythmia and hypotension. Two patients showed severe cardiac arrhythmia, two patients showed cardiac arrest for many times. All 10 patients were treated with mechanical ventilation and other conventional treatments. At the first time of the manifest of hypotension,sodium nitroprusside were put into practice in all 10 patients. Ten patients were treated with intravenously sodium nitroprusside in the stage of hypotension by maxi30 min ～ 1 h,the patients showed an improvement in vultus,pulse and peripheral circulation and decrease of heart rate and elevation of blood pressure after 30 min ～2 h,but at least 2～6 h later,the blood pressure tended to stabilize at normal standard. Conclusion Hypotension is the intensive stage in EV71-related hand,foot and mouth disease ,and the shock syndrome caused by acute left ventricular disorder is related to sympathetic nerve activity. Sodium nitroprusside can effectively reduce the cardiac afterload,and correct shock and improve the prognosis.
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Objective Summarize anterior open tension-free inguinal hemiorrhaphy, especially application experience and understanding in the 952 cases of day surgery, and clarify the advantages. Method During December 2004 - June 2007, we treated 952 Patients of inguinal hernia and femoral hernia,using local anesthesia, tension-free, in the form of day surgery. And the resulte were compare to traditional hemiorrhaphy, tension-free hemiorrhaphy of hospital in all aspects. Results Patients in this group were all cured.Intraoperative and postoperative pain was mild.All patients should be used only a small amount of postoperative oral analgesics, and no urinary retention. They got out of bed immediately after surgery, and they recorered fast ,with less complications. They could be discharged home in surgical day (2 h later). Af ter 18 months follow-up, only 2 cases recurrence. Conclusions (1) Compared with the traditional hemiorrhaphy and ambulatory tension-free hemiorrhaphy, tension-free during the day has lots of advantages, such as easier method, wider surgical indications, faster postoperative recovery, shorter hospital stay, less complications and lower recurrence rate;(2)Tension-free hernion'haphy day surgery is safe，feasible，and has obvi-ous advantages.
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Objective To compare the anesthesia and analgesic effect of ropivacaine to lidocaine during and after inguinal hernia repair field.Methods The study was designed as a single-centre,double blind,controlled trial,randomized with two parallel groups.One hundred males scheduled for inguinal hernia repair as day surgery under field block would be eligible to participate and then be randomized to receive field block using 0.75% ropivacaine 30 mL or 1%lidoeaine 40 mL.During the first 24 hours after the start of infiltration,assessments of the time from study drus administration to the first request of additional analgesics,wound pain at rest and on mobilization using NRS,as well as an evaluation of patients'ability to perform day-to-day activities were made.Wound healing would be judged by the assessor as normal or abnormal on day 7 after surgery.Results Median time from study drug administration to the first request of additional analgesics waft,22.4 hours in ropivaeaine group and 15.1 hours in lidocaine group respectively.Although there was no statistically significant treatment difference between groups(P>0.05),clinically relevant differences could be seen in favour of ropivacaine.The HRs(hazard rato) for this variable using Cox regression model showed a tendency favoring ropivacaine in increasing the time from study drug administration to the first request of additional analgesics when comparing ropivacaine group and lidocaine group,with an HR of 0.888(95%CI:0.521-1.514;P>0.05),corresponding to a risk reduction of 11.2%.Postoperative wound pain scores at rest at 2nd hour was lower in ropivacaine group than lidocaine group(P<0.05).Pestoperative wound pain scores upon mobilization in 4th hour and the total scores of day-to-day activity questionnaire in 4th hour were lower in ropivacaine group than that of lidocaine group(P<0.05).No any adverse effects were found in the two groups,and wound healing was normal in all patients in the two groups 7 days after surgery.Conclusion Ropivacaine provides effective peroperative anesthesia and postoperative pain relief for inguinal hernia repair in Chjnese patients.
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@#ObjectiveTo study the relationship between DNA aneuploidy and proliferative activity and the clinical and pathologic features.MethodsDNA ploidy and cell cycle analysis were analyzed in 119 colorectal fresh cancer apecimens using flow Cytometry and prospectively compared with the CEA in serum,tumor size,tumor morphology,lymph node metastases,Dukes' Classfication,histologic type and grade in colorectal cancer.ResultsThere was no relation between serum CEA and DNA aneuploidy and proliferative activity. Aneuploidy was detected at 56.5% in ulcerating carcinoma, which was significantly higher than 14.7% in bulge carcinoma (P<0.01). Aneuploidy was detected at 64.7% in middle and lower grade carcinoma, which was significantly higher than 36.5% of high grade carcinoma (P<0.01). No significant differences in aneuploidy were observed with respect to tumor size, lymph node metastases, Dukes' classfication,tumor histologic type.ConclusionsDNA aneuploidy of cancer cell can express the degree of malignancy of colorectal cancer. But proliferative activity does not relate to all the clinical and pathologic features. CEA in serum does not relate to DNA aneuploidy and proliferative activity.