Gene expression signature analysis of peripheral blood mononuclear cells from patients with for high altitude pulmonary hypertension and value for potential drug selection / 中华心血管病杂志

Objective: To investigate the gene expression characteristics of peripheral blood mononuclear cells from patients with high altitude pulmonary hypertension (HAPH) in Naxi residents living in Lijiang, Yunnan, and to explore the underlying pathogenesis and value for potential drug selection. Methods: This is a case-control study. Six patients with HPAH (HPAH group) and 4 normal subjects (control group) were selected from the Naxi residents who originally lived in Lijiang, Yunnan Province. The general clinical data of the two groups were collected, and the related indexes of pulmonary artery pressure were collected. Peripheral blood mononuclear cells of the subjects were collected for RNA sequencing. The differences on gene expression, regulatory network of transcription factors and drug similarity between the two groups were compared. The results were compared with the public data of idiopathic pulmonary arterial hypertension (IPAH). Biological processes and signal pathways were analyzed and compared between HPAH and IPAH patients. Results: The age of 6 patients with HAPH was (68.1±8.3) years old, and there were 2 males (2/6). The age of 4 subjects in the control group was (62.3±10.9) years old, and there were 2 males (2/4). Tricuspid regurgitation velocity, tricuspid pressure gradient and pulmonary systolic pressure in HAPH group were significantly higher than those in control group (all P<0.05). The results of RNA sequencing showed that compared with the control group, 174 genes were significantly upregulated and 169 genes were downregulated in peripheral blood mononuclear cells of HAPH group. These differentially expressed genes were associated with 220 biological processes, 52 molecular functions and 23 cell components. A total of 21 biological processes and 2 signal pathways differed between HPAH and IPAH groups, most of which were related to inflammation and immune response. ZNF384, SP1 and STAT3 were selected as highly correlated transcription factors by transcription factor prediction analysis. Trichostatin A and vorinostat were screened out as potential drugs for the treatment of HAPH by drug similarity analysis. Conclusions: There are significant differences in gene expression in peripheral blood monocytes between HAPH patients and normal population, and inflammation and immune dysfunction are the main pathogenic factors. Trichostatin A and Vorinostat are potential drugs for the treatment of HAPH.

Expert Consensus on Sepsis Responding Specifically to Traditional Chinese Medicine / 中国实验方剂学杂志

To give full play to the therapeutic advantages of traditional Chinese medicine （TCM） in sepsis， clarify the entry point of integrated TCM and western medicine， further standardize the clinical treatment of TCM， develop a recognized and integrated treatment protocol of TCM and western medicine， and improve the clinical efficacy on sepsis，the Chinese Association of Chinese Medicine organized TCM and western medicine experts specialized in sepsis treatment to conduct in-depth discussions on the advantages of TCM and integrated TCM and western medicine in the treatment of sepsis based on the TCM etiology and pathogenesis of sepsis， a representative acute and critical disease. They emphasized the pathogenesis characteristics of asthenia of healthy Qi and sthenia of pathogenic factors and summarized the roles of Chinese medicine in correcting the imbalance of inflammatory response， improving blood coagulation dysfunction， and relieving organ damage. Furthermore， they proposed the treatment protocol with integrated TCM and western medicine， which is expected to provide references for actual clinical treatment and scientific research.

Predictive role of interleukin-6 and CAT score in mechanical ventilation in patients with chronic obstructive pulmonary disease at the acute exacerbation stage in the emergency department / 世界急诊医学杂志（英文）

@#BACKGROUND: The study aimed to evaluate the predictive role of interleukin-6 (IL-6) and chronic obstructive pulmonary disease (COPD) assessment test (CAT) score in mechanical ventilation (MV) in COPD patients at the acute exacerbation stage in the emergency department (ED). METHODS: For a one-year period, among adult patients in the ED who met the criteria of acute exacerbation of COPD, 158 who received MV within 48 hours after admission were compared to 294 who didn't require MV within the same period after admission. IL-6 level and CAT score were compared between the two groups. The predicted value of IL-6 and CAT score was assessed by logistic regression analysis and a receiver operating characteristic (ROC) curve. RESULTS: The IL-6 and CAT scores in the 158 MV patients were much higher than those without. IL-6 and CAT scores were independent predictors of MV within 48 hours using logistic regression analysis (IL-6: odds ratio [OR] 1.053, 95% confidence interval [CI] 1.039–1.067, P<0.001; CAT score: OR 1.122, 95% CI 1.086–1.159, P<0.001). The combination of IL-6 and CAT scores (area under ROC curve [AUC] 0.826, 95% CI 0.786–0.866, P<0.001) improved the accuracy of predicting MV within 48 hours when compared with IL-6 (AUC 0.752, 95% CI 0.703–0.800, P<0.001) and CAT scores alone (AUC 0.739, 95% CI 0.692–0.786, P<0.001). The sensitivity and specificity were 69.6%, 74.1%, 75.32% and 63.6%, respectively. CONCLUSION: The combined of IL-6 and CAT scores is useful for evaluating the risk of COPD patients at acute exacerbation in ED, and can provide a predictive value for MV or not within 48 hours.

Lung metastases at the initial diagnosis of high-grade osteosarcoma: prevalence, risk factors and prognostic factors. A large population-based cohort study

ABSTRACT BACKGROUND: Osteosarcoma is the most prevalent malignant bone tumor in children and adolescents. Lung metastases are associated with poor prognosis. OBJECTIVE: The aim here was to explore the prevalence of and risk and prognostic factors for lung metastases in high-grade osteosarcoma patients. DESIGN AND SETTING: Retrospective cohort study based on the Surveillance, Epidemiology and End Results (SEER) database in the United States. METHODS: Data on 1,408 high-grade osteosarcoma patients registered in the SEER database between 2010 and 2015 were extracted. From these, all patients with high-grade osteosarcoma and initial lung metastasis were selected for analysis on risk and prognostic factors for lung metastases. Overall survival was estimated. RESULTS: There were 238 patients (16.90%) with lung metastases at diagnosis. Axial location, tumor size > 10 cm (odds ratio, OR 3.19; 95% confidence interval, CI: 1.58-6.45), higher N stage (OR 4.84; 95% CI: 1.94-12.13) and presence of bone metastases (OR 8.73; 95% CI: 4.37-17.48) or brain metastases (OR 25.63; 95% CI: 1.55-422.86) were significantly associated with lung metastases. Younger age and surgical treatment (hazard ratio, HR 0.46; 95% CI: 0.30-0.71) favored survival. Median survival was prolonged through primary tumor surgery. CONCLUSIONS: The factors revealed here may guide lung metastasis screening and prophylactic treatment for osteosarcoma patients. A primary tumor in an axial location, greater primary tumor size, higher lymph node stage and presence of bone or brain metastases were significantly correlated with lung metastases. The elderly group (≥ 60 years) showed significant correlation with poor overall survival. For improved survival among high-grade osteosarcoma patients with lung metastases, aggressive surgery on the primary tumor site should be encouraged.

Clinical characteristics of patients with Haff disease after eating crayfish / 世界急诊医学杂志（英文）

BACKGROUND@# The study aimed to explore the clinical presentations, laboratory findings, treatments and prognosis of patients with Haff disease after eating crayfish.@*METHODS@#Sixteen patients with Haff disease after eating crayfish were admitted to the Emergency Department of Beijing Chao-yang Hospital between June 2013 and August 2017. Clinical data was retrospectively analyzed.@*RESULTS@#Alcohol consumption and exercise were found to be most commonly associated with the onset of rhabdomyolysis after consuming crayfish. Most patients were young adults and the symptoms mostly occurred within 24 hours of consumption of crayfish. Clinical symptoms included myalgia (100%), fatigue (87.5%), nausea (43.8%), dizziness (62.5%), chest distress (37.5%) and fever (18.8%). Also found after laboratory testing was elevations in the levels of creatine kinase (11,376±5,535 U/L), myoglobin (350±158 ng/mL), lactate dehydrogenase (6,539±3,180 U/L), alanine transaminase (174±71 U/L) and aspartate aminase (348±100 U/L). The incidence of renal dysfunction was low (6.25%), and all 16 patients had a good prognosis.@*CONCLUSION@#Patients with Haff disease exhibited typical symptoms after consuming crayfish, and laboratory findings gave highly accurate diagnostic results. The development of rhabdomyolysis was considered to be associated with alcohol consumption and exercise, but further studies are needed to demonstrate its relationship with crayfish consumption. Compared with other causes of rhabdomyolysis, rhabdomyolysis after crayfish consumption has fewer complications and better prognosis.

Ang Ⅱ/AT1R pathway activates PP2A to down-regulate p-eNOS (Ser1177) in human umbilical vein endothelial cells / 中国病理生理杂志

AIM:To investigate whether angiotensin Ⅱ (Ang Ⅱ)/angiotensin Ⅱ type 1 receptor (AT1 R)pathway down-regulates endothelial nitric oxide synthase (eNOS) Ser1177 phosphorylation level in human umbilical vein endothelial cells by activating protein phosphatase 2A (PP2A).METHODS:Human umbilical vein endothelial cells were randomly divided into normal control (control) group,Ang Ⅱ group,candesartan (CAN;specific AT1R blocker) group and CAN pretreatment + Ang Ⅱ group.The protein levels of total eNOS,p-eNOS (Ser1177),PP2Ac,IPP2A2 and p-PP2Ac (Tyr307) were determined by Western blot.The content of NO in the cell culture medium was detected by chemical colorimetry.RESULTS:Compared with control group,the level of p-eNOS (Ser1177) and the content of NO decreased (P ＜0.05).Compared with the same concentration of Ang Ⅱ group,CAN pretreatment increased the level of p-eNOS (Ser1177) and the content of NO (P ＜ 0.05),but the protein expression of eNOS showed no significant difference.Compared with control group,the levels of p-PP2Ac (Tyr307) and IPP2A2 decreased (P ＜ 0.05).Compared with the same concentration of Ang Ⅱ group,CAN pretreatment increased the levels of p-PP2Ac (Tyr307) and IPP2A2 (P ＜ 0.05),but the protein expression of PP2Ac showed no significant difference.CONCLUSION:Ang Ⅱ down-regulates the level of p-eNOS (Ser1177),and decreases the production of NO in human umbilical vein endothelial cells via AT1 R pathway.This effect may be related to the reduction of p-PP2Ac (Tyr307) and protein expression of IPP2A2,which results in the enhancement of PP2A2 activity.Pretreatment with AT1 R blocker CAN increases p-PP2Ac (Tyr307) level and IPP2A2 protein expression,thus reducing the PP2A activity,and ultimately restoring eNOS Ser1177 phosphorylation level and eNOS activity.

Ang Ⅱ/AT1R pathway activates PP2A to down-regulate p-eNOS (Ser1177) in human umbilical vein endothelial cells / 中国病理生理杂志

AIM:To investigate whether angiotensin Ⅱ (Ang Ⅱ)/angiotensin Ⅱ type 1 receptor (AT1 R)pathway down-regulates endothelial nitric oxide synthase (eNOS) Ser1177 phosphorylation level in human umbilical vein endothelial cells by activating protein phosphatase 2A (PP2A).METHODS:Human umbilical vein endothelial cells were randomly divided into normal control (control) group,Ang Ⅱ group,candesartan (CAN;specific AT1R blocker) group and CAN pretreatment + Ang Ⅱ group.The protein levels of total eNOS,p-eNOS (Ser1177),PP2Ac,IPP2A2 and p-PP2Ac (Tyr307) were determined by Western blot.The content of NO in the cell culture medium was detected by chemical colorimetry.RESULTS:Compared with control group,the level of p-eNOS (Ser1177) and the content of NO decreased (P ＜0.05).Compared with the same concentration of Ang Ⅱ group,CAN pretreatment increased the level of p-eNOS (Ser1177) and the content of NO (P ＜ 0.05),but the protein expression of eNOS showed no significant difference.Compared with control group,the levels of p-PP2Ac (Tyr307) and IPP2A2 decreased (P ＜ 0.05).Compared with the same concentration of Ang Ⅱ group,CAN pretreatment increased the levels of p-PP2Ac (Tyr307) and IPP2A2 (P ＜ 0.05),but the protein expression of PP2Ac showed no significant difference.CONCLUSION:Ang Ⅱ down-regulates the level of p-eNOS (Ser1177),and decreases the production of NO in human umbilical vein endothelial cells via AT1 R pathway.This effect may be related to the reduction of p-PP2Ac (Tyr307) and protein expression of IPP2A2,which results in the enhancement of PP2A2 activity.Pretreatment with AT1 R blocker CAN increases p-PP2Ac (Tyr307) level and IPP2A2 protein expression,thus reducing the PP2A activity,and ultimately restoring eNOS Ser1177 phosphorylation level and eNOS activity.

Effects of Shenfu Injection () on cerebral metabolism in a porcine model of cardiac arrest / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of Shenfu Injection (, SFI) on cerebral metabolism in a porcine model of cardiac arrest (CA).</p><p><b>METHODS</b>Thirty Wuzhishan minipigs were randomly assigned to the control group (n=6), epinephrine group (EP group, n=12) and Sfigroup (n=12). After 8 min of untreated ventricular fifibrillation (VF), pigs in the EP group or Sfigroup were administered with either EP (0.02 mg/kg) or Sfi(1.0 mL/kg), respectively. After successful resuscitation, cerebrospinal fluid (CSF) levels of glucose, pyruvate, lactate, glutamate and glycerol were measured at 1, 6, 12 and 24 h after recover from spontaneous circulation (ROSC). In addition, neurologic defificit score (NDS) was calculated at 24 h after ROSC. Surviving pigs were killed at 24 h after ROSC, and the brain tissue was obtained for ultra-microstructure examination.</p><p><b>RESULTS</b>Compared with the EP group, CSF glucose and pyruvate levels were higher (all P<0.01), and lactate levels were lower in the Sfigroup (P<0.01). Meanwhile, CSF glutamate and glycerol levels in the Sfigroup were lower in comparison to the EP group (all P<0.05). In addition, Sfidecreased NDS at 24 h after ROSC (P<0.01), and alleviated the histopathological damage of the brain.</p><p><b>CONCLUSIONS</b>Sficould alleviate brain injury after CA, which may be associated with improving cerebral metabolism.</p>

From biological induction to engineering assembly—— the current status and perspective on vascularization of engineered heart tissue / 中国胸心血管外科临床杂志

@#The engineered heart tissues (EHTs) is regarded as a hope for myocardial repair and regeneration. But a series of “bottleneck” problems, such as vascularization, hinder their clinical translation. This review focuses on the strategies to vascularization of EHTs and encourages the emergence of novel EHTs that can meet clinic requirement properly.

Shen-Fu Injection () alleviates post-resuscitation myocardial dysfunction by up-regulating expression of sarcoplasmic reticulum Ca(2+)-ATPase / 中国结合医学杂志

<p><b>OBJECTIVE</b>To compare the effect of Shen-Fu Injection (SFI) and epinephrine on the expression of sarcoplasmic reticulum Ca(2+) ATPase 2a (SERCA2a) in a pig model with post-resuscitation myocardial dysfunction.</p><p><b>METHODS</b>Ventricular fibrillation (VF) was electrically induced in Wu-zhi-shan miniature pigs. After 8 min of untreated VF and 2 min of cardiopulmonary resuscitation (CPR), all animals were randomly administered a bolus injection of saline placebo (SA group, n=10), SFI (0.8 mg/kg, SFI group, n=10) or epinephrine (20 μg/kg, EPI group, n=10). After 4 min of CPR, a 100-J shock was delivered. If the defibrillation attempt failed to attain restoration of spontaneous circulation (ROSC), manual chest compressions were rapidly resumed for a further 2 min followed by a second defibrillation attempt. Hemodynamic variables were recorded, and plasma concentrations of catecholamines were measured. Adenylate cyclase (AC), cyclic adenosine monophosphate (cAMP) and the expressions of β1-adrenoceptor (AR) and SERCA 2a were determined.</p><p><b>RESULTS</b>Cardiac output, left ventricular dp/dtmax and negative dp/dtmax were significantly higher in the SFI group than in the SA and EPI groups at 4 and 6 h after ROSC. The expression of β1-AR and SERCA2a at 24 h after ROSC were significantly higher in the SFI group than in the SA and EPI groups (P<0.05 or P<0.01).</p><p><b>CONCLUSIONS</b>The administration of epinephrine during CPR decreased the expression of SERCA2a and aggravated postresuscitation myocardial function (P<0.01). SFI attenuated post-resuscitation myocardial dysfunction, and the mechanism might be related to the up-regulation of SERCA2a expression.</p>

Effect of Taohong Qinlian Decoction on HMGB1 in Septic Rat Cardiac Muscle / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the levels of high mobility group box-1 protein (HMGB1), tumor necrosis factor-alpha (TNF-α), IL-6, troponin I (Tn I) release in septic rats, and to explore themechanism of Taohong Qinlian Decoction (TQD) in the treatment of septic myocardial injury.</p><p><b>METHODS</b>A total of 48 healthy male Wistar rats of clean grade were randomly divided into the sham-operation group (Sham), the sepsis model group (CLP), and the TQD treatment group (ZY), 16 in each group. Concen-trations of TNF-α, IL-6, Tn I, and HMGB1 expression were detected in each group at 24 and 48 h after operation. Pathological changes of cardiac muscle were observed under light microscope.</p><p><b>RESULTS</b>Concentrations of TNF-α, IL-6, Tn I and HMGB1 at 24 and 48 h after operation were significantly higher in the CLP group than in the Sham group (P < 0.01). Concentrations of TNF-α, IL-6, Tn I, and HMGB1 at 24 and 48 h after operation were significantly lower in the ZY group than in the CLP group (P < 0.05). Myocardial injury occurred in the CLP and the ZY group under light microscope. And this injury was more severe in the CLP group than in the ZY group.</p><p><b>CONCLUSION</b>TQL could reduce the level of sepsis-related inflammatory cytokines and protect myocardium in septic rats.</p>

Risk factor analyses for the return of spontaneous circulation in the asphyxiation cardiac arrest porcine model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Animal models of asphyxiation cardiac arrest (ACA) are frequently used in basic research to mirror the clinical course of cardiac arrest (CA). The rates of the return of spontaneous circulation (ROSC) in ACA animal models are lower than those from studies that have utilized ventricular fibrillation (VF) animal models. The purpose of this study was to characterize the factors associated with the ROSC in the ACA porcine model.</p><p><b>METHODS</b>Forty-eight healthy miniature pigs underwent endotracheal tube clamping to induce CA. Once induced, CA was maintained untreated for a period of 8 min. Two minutes following the initiation of cardiopulmonary resuscitation (CPR), defibrillation was attempted until ROSC was achieved or the animal died. To assess the factors associated with ROSC in this CA model, logistic regression analyses were performed to analyze gender, the time of preparation, the amplitude spectrum area (AMSA) from the beginning of CPR and the pH at the beginning of CPR. A receiver-operating characteristic (ROC) curve was used to evaluate the predictive value of AMSA for ROSC.</p><p><b>RESULTS</b>ROSC was only 52.1% successful in this ACA porcine model. The multivariate logistic regression analyses revealed that ROSC significantly depended on the time of preparation, AMSA at the beginning of CPR and pH at the beginning of CPR. The area under the ROC curve in for AMSA at the beginning of CPR was 0.878 successful in predicting ROSC (95% confidence intervals: 0.773∼0.983), and the optimum cut-off value was 15.62 (specificity 95.7% and sensitivity 80.0%).</p><p><b>CONCLUSIONS</b>The time of preparation, AMSA and the pH at the beginning of CPR were associated with ROSC in this ACA porcine model. AMSA also predicted the likelihood of ROSC in this ACA animal model.</p>

Comparison of Cerebral Metabolism between Pig Ventricular Fibrillation and Asphyxial Cardiac Arrest Models / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Morbidity and mortality after resuscitation largely depend on the recovery of brain function. Ventricular fibrillation cardiac arrest (VFCA) and asphyxial cardiac arrest (ACA) are the two most prevalent causes of sudden cardiac death. Up to now, most studies have focused on VFCA. However, results from the two models have been largely variable. So, it is necessary to characterize the features of postresuscitation cerebral metabolism of both models.</p><p><b>METHODS</b>Forty-four Wuzhishan miniature inbred pigs were randomly divided into three groups: 18 for VFCA group, ACA group, respectively, and other 8 for sham-operated group (SHAM). VFCA was induced by programmed electric stimulation, and ACA was induced by endotracheal tube clamping. After 8 min without treatment, standard cardiopulmonary resuscitation (CPR) was initiated. Following neurological deficit scores (NDS) were evaluated at 24 h after achievement of spontaneous circulation, cerebral metabolism showed as the maximum standardized uptake value (SUVmax) was measured by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography. Levels of serum markers of brain injury, neuron specific enolase (NSE), and S100β were quantified with an enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>Compared with VFCA group, fewer ACA animals achieved restoration of spontaneous circulation (61.1% vs. 94.4%, P < 0.01) and survived 24-h after resuscitation (38.9% vs. 77.8%, P < 0.01) with worse neurological outcome (NDS: 244.3 ± 15.3 vs. 168.8 ± 9.71, P < 0.01). The CPR duration of ACA group was longer than that of VFCA group (8.1 ± 1.2 min vs. 4.5 ± 1.1 min, P < 0.01). Cerebral energy metabolism showed as SUVmax in ACA was lower than in VFCA (P < 0.05 or P < 0.01). Higher serum biomarkers of brain damage (NSE, S100β) were found in ACA than VFCA after resuscitation (P < 0.01).</p><p><b>CONCLUSIONS</b>Compared with VFCA, ACA causes more severe cerebral metabolism injuries with less successful resuscitation and worse neurological outcome.</p>

Application of positron emission tomography in the detection of myocardial metabolism in pig ventricular fibrillation and asphyxiation cardiac arrest models after resuscitation / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the application of positron emission tomography (PET) in detection of myocardial metabolism in pig ventricular fibrillation and asphyxiation cardiac arrest models after resuscitation.</p><p><b>METHODS</b>Thirty-two healthy miniature pigs were randomized into a ventricular fibrillation cardiac arrest (VFCA) group (n=16) and an asphyxiation cardiac arrest (ACA) group (n=16). Cardiac arrest (CA) was induced by programmed electric stimulation or endotracheal tube clamping followed by cardiopulmonary resuscitation (CPR) and defibrillation. At four hours and 24 h after spontaneous circulation was achieved, myocardial metabolism was assessed by PET. 18F-FDG myocardial uptake in PET was analyzed and the maximum standardized uptake value (SUVmax) was measured.</p><p><b>RESULTS</b>Spontaneous circulation was 100% and 62.5% in VFCA group and ACA group, respectively. PET demonstrated that the myocardial metabolism injuries was more severe and widespread after ACA than after VFCA. The SUVmax was higher in VFCA group than in ACA group (P<0.01). In VFCA group, SUVmax at 24 h after spontaneous circulation increased to the level of baseline.</p><p><b>CONCLUSION</b>ACA causes more severe cardiac metabolism injuries than VFCA. Myocardial dysfunction is associated with less successful resuscitation. Myocardial stunning does occur with VFCA but not with ACA.</p>

Neuroprotective effect of Shenfu Injection () following cardiac arrest in pig correlates with improved mitochondrial function and cerebral glucose uptake / 中国结合医学杂志

<p><b>OBJECTIVE</b>To test whether Shenfu Injection (, SFI) might attenuate the impact of cerebral energy dysfunction after resuscitation in a pig model of cardiac arrest (CA).</p><p><b>METHODS</b>Thirty-four Wuzhishan miniature inbred pigs were randomly divided into three groups: the SFI group (n=12), the saline group (SA group, n=12), and the sham-operated group (sham group, n=10). Following successful return of spontaneous circulation (ROSC) from 8-min untreated ventricular fibrillation, animals received a continuous infusion of either SFI (0.2 mL/min) or saline for 6 h. Cerebral performance category score was evaluated at 24 and 48 h after ROSC, followed by positron emission tomography and computed tomography scans of cerebral glucose uptake. Surviving pigs were euthanized 48 h after ROSC, and the brains were removed for detecting mitochondrial function.</p><p><b>RESULTS</b>Compared with the SA group, SFI treatment produced a better neurologic outcome 48 h after ROSC (P<0.05). However, there was no significant difference of survival rate between the SA and SFI groups (83.3% vs. 81.8%, P>0.05). After ROSC, the SA group showed a decrease in the maximum standardized uptake value of different regions in the brain tissue, where SFI treatment can ameliorate these decreases (P<0.01 or P<0.05). Improved mitochondrial respiratory properties and higher mitochondrial membrane potential were also found following SFI treatment compared with the SA group at 48 h after ROSC (P<0.05 or P<0.01).</p><p><b>CONCLUSION</b>SFI treatment after resuscitation has significant neuroprotective effects against disruption of cerebral energy metabolism from CA by improving glucose uptake and by normalizing mitochondrial function.</p>

Glycated hemoglobin A1C and diabetes mellitus in critically ill patients / 世界急诊医学杂志（英文）

BACKGROUND:Hyperglycemia has been detected in many critically ill patients in the department of emergency medicine. But its mechanism and prognosis have not been well elucidated. In this study, we measured the serum level of glycated hemoglobin A1C (HbA1c) in critically ill patients to evaluate the effects of hyperglycemia on the prognosis of the patients.METHODS:A total of 826 critically ill patients, who had been treated at the Department of Emergency Medicine of Chaoyang Hospital during October 2006 and November 2007, were divided into a diabetes mellitus group (n=184) and a non-diabetes mellitus group (642) according to whether they had diabetes mellitus. Fasting glucose and HbA1c were measured in all patients. Those in the diabetes mellitus group were further assigned to a drug therapy subgroup and a non-drug therapy subgroup; the serum level of HbA1c and its relationship with short-term outcome were evaluated.RESULTS:Fasting glucose increased in 78.8％ of the patients (88.6％ in the diabetes mellitus group, and 75.9％ in the non-diabetes mellitus group,P<0.05), and HbA1c was elevated in 45.5％ of the patients (78.3％ in the diabetes mellitus group, and 36.1％ in the non-diabetes mellitus group, P<0.01). Fasting glucose, HbA1c and 28-day mortality were improved more significantly (P<0.01) in the drug therapy subgroup than in the non-drug therapy subgroup. The 28-day mortality was more significantly different in patients with fasting blood glucose >8.33 mmol/L than in those with fasting blood glucose <8.33 mmol/L.CONCLUSIONS:Hyperglycemia of critically ill patients could not totally attribute to stress response, especially in those who have no history of diabetes mellitus. Prognosis of hyperglycemia may vary among critically ill patients.

Traumatic dislocation of superior tibiofibular joint / 中国骨伤

<p><b>OBJECTIVE</b>To explore the characteristics, diagnosis and treatment on traumatic dislocation.</p><p><b>METHODS</b>From April 2000 to August 2010, 12 patients with acute traumatic dislocation of superior tibiofibular joint were treated including 10 males and 2 females with an average age of 30.6 years old ranging from 18 to 60 years. According to Ogden classification, 8 cases were the anterolateral dislocation, 2 were posterior-medial dislocation, and 2 were upward dislocation. All patients had swelling in lateral-inferior of knee, fibular head prominent, fibular head pain, floating feeling in head of fibula. One case was treated by conservative treatment, and the remaining 11 cases by surgical treatment.</p><p><b>RESULTS</b>All patients were followed-up for 10 months to 3 years (means 18 months). Evaluation by Lysholm scoring,the total scores were 95.08 +/- 2.02, involving limbing 4.92 +/- 0.28, support 4.92 +/- 0.28, interlocking 15.00 +/- 0.00, instability 24.58 +/- 0.79, pain 22.50 +/- 1.24, swell 8.50 +/- 0.90, climbing stairs 9.75 +/- 0.62, squatting 4.92 +/- 0.28; 11 cases achieved excellent results and 1 good. Nerve functional recovered. X-ray was no longer dislocation.</p><p><b>CONCLUSION</b>The diagnosis of traumatic dislocation is easy misseddiagnosis, surgery is the main treatment method, the prognosis is good.</p>

Coracoclavicular ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate clinical effects of coracohumeral ligament reconstruction with autologous double-strand of long palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation.</p><p><b>METHODS</b>From April 2006 to June 2009, 31 patients with acromioclavicular joint dislocation were treated with coracohumeral ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament. There were 18 males and 13 females, ranging in age from 18 to 60 years, with an average of 35 years. Twenty-six patients were acute trauma and other 5 patients were chronic trauma. Preoperative symptoms included different degrees of pain, restricted movement, and instability of acromioclaviecular joint. The X-ray showed acromioclavicular joint dislocation.</p><p><b>RESULTS</b>The patients had good incision union without vascular and nerve injuries. All the patients were followed up, and the average duration was 23 months. The JOA scores decreased from preoperative (38.8 +/- 1.5) to (73.2 +/- 1.1) at 1 month after operation,and (93.5 +/- 0.8)at the last follow-up. Twenty-eight patients got an excellent result, 2 good and 1 fair.</p><p><b>CONCLUSION</b>The reconstruction of coracohumeral ligament using autologous double-strand palmaris longus tendon and artificial ligament is an effective method for the treatment of acromioclavicular joint dislocation.</p>

Optimal technique of wine-processed gentian / 中国中药杂志

<p><b>OBJECTIVE</b>To optimize technique of wine-processed gentian (root of Gentiana manshurica, G. scabra, G. triflora and G. rigescens.</p><p><b>METHOD</b>Orthogonal design L9 (3(4)) was used to select the best processing technical parameters by yields of the water extracts and amounts of gentiopicroside in the processing products.</p><p><b>RESULT</b>The optimal procedure was suggested as follows: Gentiana Radix was cut into 5-10 millimetres' long, added one-fifth amounts of wine by gentian's weight, moistened for two hours, and then dried by slow fire.</p><p><b>CONCLUSION</b>The amounts of gentiopicroside in wine-processed gentian were closely related to the types and amounts of wine, moistened time and dried method.</p>

Monocytes are more susceptible in vitro in rhesus macaques of Chinese origin to recombinant serotype 5 adenovirus with higher preexisting vector specific neutralizing antibody titer / 病毒学报

Human adenovirus serotype 5 (HAd5) infect dendritic cells with low efficiency which restricts the use of HAd5 as an antigen carrying vector in such cells. Aiming to find a novel strategy to detour the traditional method for more convenient clinical use, peripheral blood mononuclear cells isolated from Chinese rhesus macaques were chosen as the target cells for HAd5. In vitro infection protocol was optimized which indicated centrifugation at 1000g could ease the entry of adenovirus. By this protocol, CD14 positive monocytes were infected at high efficiencies (> 80%), and about 10% of natural killer cells were infected; while T and B lymphocytes were rarely infected. Interestingly and importantly, it was the first time to report that in our in vitro study monocytes were more susceptible to HAd5-EGFP in macaques with higher preexisting vector specific neutralizing antibody titers. This phenomenon indicates an expansion of application of adenovirus based vectors for vaccine development and clinical use, especially for the population with preexisting neutralizing antibodies.