Regulation of Mitochondria on Platelet Apoptosis and Activation / 中国实验血液学杂志

OBJECTIVE@#To explore the regulation of mitochondria on platelet apoptosis and activation, and the relationship between platelet apoptosis and activation.@*METHODS@#Platelets were isolated from peripheral venous blood of healthy volunteers. Cyclosporin A (CsA), which has a protective effect on the function of platelet mitochondria, BAPTA, which can chelate calcium ions across membranes in platelets, and NAC, an antioxidant that reduces the level of intracellular reactive oxygen species, were selected for coincubation with washed platelets, respectively. By flow cytometry, platelet aggregator was used to detect the changes of platelet mitochondrial function and platelet activation indexes after different interventions.@*RESULTS@#H89, staurosporine, and A23187 led to platelet mitochondrial abnormalities, while CsA could effectively reverse the decline of platelet mitochondrial membrane potential caused by them. Antioxidant NAC could reverse platelet mitochondrial damage correspondingly, and completely reverse platelet shrinkage and phosphatidylserine eversion induced by H89. BAPTA, prostaglandin E1, acetylsalicylic acid and other inhibitors could not reverse the decline of platelet mitochondrial membrane potential.@*CONCLUSION@#Mitochondrial function plays an important role in platelet apoptosis and activation. Abnormal mitochondrial function causes the imbalance of reduction/oxidation state in platelets, which leads to platelet apoptosis. Platelet apoptosis and activation are independent signal processes.

Research Progress on Application of Ultrasonic Microbubbles in Treatment of Liver Cancer / 肿瘤防治研究

Ultrasound therapy and considerable progress in molecular imaging technologies have allowed the use of ultrasonic microbubbles not only in image enhancement but also in targeted drug or gene delivery as drug or gene carriers, respectively. Hence, ultrasound microbubbles carrying drugs or genes have become a novel type of tumor-targeting therapy technology. They do not emit radiation and are thus safe. Additionally, they are efficient and easy to reuse and facilitate drug or gene release. All these features offer attractive prospects for the treatment of liver cancer and provide novel treatment ideas for the disease. This article reviews the mechanism, applications, and existing problems of ultrasonic microbubbles in the treatment of liver cancer.

Predictive value of Downes score on respiratory failure in term neonates / 中华围产医学杂志

Objective To explore the clinical significance of Downes score in predicting respiratory failure (RF) in term neonates.Methods From June 1, 2011 to December 31, 2013, 243 hospitalized term neonates with dyspnea, who were born at 37 to 42 gestational age and admitted to the hospital within 24 h after birth, were selected from Neonatal Medical Center of Huai'an Maternity and Child Healthcare.Downes scores were evaluated based on five indicators including respiratory rate, skin color, three depressions sign, moaning and lung breath sounds at the time of admission.RF was diagnosed based on clinical menifestations and radial arterial blood gas analysis.Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of Downes score on RF.Results The average Downes score of the 243 cases was 6.57±0.86 and the RF rate was 69.6％ (169/243).The RF rate was 93.4％ (169/181) when Downes score ≥ 4.5, with the sensitivity, specificity, misdiagnostic rate and missed diagnositic rate of 100.0％, 83.8％, 16.2％ and 0.0％, respectively.While, the RF rate was 80.7％ (130/161) when Downes score ≥ 5.5, with the sensitivity, specificity, misdiagnostic rate and missed diagnositic rate of 76.9％, 58.1％, 41.9％ and 23.1％, respectively.When Downes score ≥ 6.5, the incidence of RF was 97.6％ (123/126), with the sensitivity, specificity, misdiagnositic rate and missed diagnositic rate of 72.8％, 95.9％, 4.1％ and 27.2％, respectively.The cutoff value was 6.5 according to the Youden Index, which with lower rate of misdiagnosis and missed diagnosis.When Downes score ≥ 7.5, the incidence of RF was 100.0％(22/22), with the sensitivity, specificity, misdiagnositic rate and missed diagnosis rate of 13.1％, 100.0％, 0.0％ and 87.0％, respectively.The area under the ROC curve was 0.906 (95％CI: 0.866-0.955).The higher the Downes score, the greater the possibility of RF (P=0.000).Conclusions Dynamic Downes scores in term neonates with dyspnea could predict the risk of RF.The higher the Downes score, the greater the possibility of RF.

The target adjustment of the end-tidal carbon dioxide partial pressure in preterm infants under mechanical ventilation / 中华实用儿科临床杂志

Objective To reduce the incidence of the hypocapnia,the cutoff value of the end-tidal carbon dioxide partial pressure[Pet(CO2)] for predicting the hypocapnia so as to understand the suitable adjustment target and target range of the Pet(CO2) in preterm infants under mechanical ventilation.Methods From Jan.2012 to Oct.2013,96 cases of the preterm infants with respiratory distress syndrome(RDS) who needed mechanical support were selected from the Huaian Maternity and Child Health Care Hospital.Pet(CO2) value of each time point(1 h,24 h,48 h and 72 h after mechanical ventilation) were recorded,while radial artery blood was collected for blood gas analysis.The level of pa (CO2) ＜ 35 mmHg(1 mmHg =0.133 kPa) diagnosed hypocapnia;while the level of Pa (CO2) ＞ 60 mmHg was for diagnosing hypercapnia.The diagnostic cutoff and the suitable adjustment target and adjustment target range of the Pet(CO2) were confirmed by receiver operating characteristic (ROC) curve.Results The data from 381 arterial blood gas analysis results were gained,of which 151 times belonged to hypocapnia,and the rate was 39.6％,the other 230 cases were normal,and no case was of hypercapnia.The area under the ROC curve was 0.895,and the area of the standard error was 0.016.There was a statistical significance in Pet(CO2) value for the diagnosis of hypocapnia(P =0.000).The lower the value of Pet (CO2),the greater the likelihood of hypocapnia,and 95 ％ confidence interval area was 0.864-0.926.The Pet (CO2) optimal diagnostic cutoff value determined in accordance with Youden index was 30.5 mmHg.When Pet (CO2) among 41.5 mmHg,sensitivity was 100％.Conclusions Diagnostic cutoff value for forecasting hypocapnia is 30.5 mmHg.The suitable adjustment target of mechanical ventilation parameter adjustment is 41.5 mmHg for the Pet(CO2).The target range of mechanical ventilation parameter adjustment is 30.6-41.5 mmHg for the Pet(CO2).

Detection of soluble triggering receptor expressed on myeloid cell-1 for diagnosis of early-onset neonatal sepsis / 中华临床感染病杂志

Objective To assess the clinical value of serum soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) for diagnosis of early-onset neonatal sepsis (EONS).Methods A total of 90 neonatal cases with risk factors or symptoms of bacterial infections were enrolled in the study.All infants were admitted to Huai' an Maternity and Child Healthcare Hospital within 24 h after birth during January and June 2014.The enrolled neonates were divided into sepsis group (n =33),general infection group (n =23) and non-infected group (n =34);and the sepsis group was further divided into culture-confirmed group (n =6) and clinical-diagnosed group (n =27).Twenty healthy neonates were also enrolled as the healthy control group.Blood samples were obtained from neonatal patients on d1,d3 and d7 after birth,and for healthy controls,the blood samples were only obtained at the first day.Serum levels of sTREM-1 and interleukin (IL)-6 were measured by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA).The receiver operating characteristic (ROC) curve was applied to evaluate the values of sTREM-1 and IL-6 in diagnosis of EONS.Results Compared with that in general infection group,non-infected group and healthy control group,the serum level of sTREM-1 was significantly higher in sepsis group (all P ＜ 0.05);serum levels of sTREM-1 in general infection group and non-infected group were also higher than that in healthy control group (all P ＜ 0.05);but no difference was observed between general infection group and non-infected group,between culture-confirmed group and clinical-diagnosed group (P ＞ 0.05).Serum level of sTREM-1 showed upward trend during d1-3 after the birth,and downward trend during d3-7.The areas under the ROC curve (AUC) were 0.810 and 0.811 (all P ＜ 0.05) for sTREM-1 levels on d1 and d3 in diagnosis of EONS,and the optimal cut-off values were 234.44 ng/L and 269.79 ng/L,respectively.If sTREM-1 and IL-6 on d1 were combined for diagnosis of EONS,the AUC,sensitivity and specificity were 0.858,92.00％ and 93.10％,respectively.Conclusion Serum level of sTREM-1 in early stage is valuable for diagnosis of EONS,and the combined use of serum sTREM-1 and IL-6 may improve the diagnostic value.

Application of lung recruitment maneuver in preterm infants with respiratory distress syndrome ventilated by proportional assist ventilation / 中华儿科杂志

<p><b>OBJECTIVE</b>To understand the effect of lung recruitment maneuver (LRM) with positive end-expiratory pressure (PEEP) on oxygenation and outcomes in preterm infants with respiratory distress syndrome (RDS) ventilated by proportional assist ventilation (PAV).</p><p><b>METHOD</b>From January 2012 to June 2013, thirty neonates with a diagnosis of RDS who required mechanical ventilation were divided randomly into LRM group (n=15, received an LRM and surport by PAV) and control group (n=15, only surport by PAV). There were no statistically significant differences in female (7 vs. 6); gestational age [(29.3±1.2) vs. (29.5±1.1) weeks]; body weight[(1,319±97) vs. (1,295±85) g]; Silverman Anderson(SA) score for babies at start of ventilation (7.3±1.2 vs. 6.9±1.4); initial FiO2 (0.54±0.12 vs. 0.50±0.10) between the two groups (all P>0.05). LRM entailed increments of 0.2 cmH2O (1 cmH2O=0.098 kPa) PEEP every 5 minutes, until fraction of inspired oxygen (FiO2)=0.25. Then PEEP was reduced and the lung volume was set on the deflation limb of the pressure/volume curve.When saturation of peripheral oxygen fell and FiO2 rose, we reincremented PEEP until SpO2 became stable. The related clinical indicators of the two group were observed.</p><p><b>RESULT</b>The doses of surfactant administered (1.1±0.3 vs. 1.5±0.5, P=0.027), Lowest FiO2 (0.29±0.05 vs. 0.39±0.06, P=0.000), time to lowest FiO2[ (103±18) vs. (368±138) min, P=0.000] and O2 dependency [(7.6±1.0) vs.( 8.8±1.3) days, P=0.021] in LRM group were lower than that in control group (all P<0.05). The maximum PEEP during the first 12 hours of life [(8.4±0.8) vs. (6.8±0.8) cmH2O, P=0.000] in LRM group were higher than that in control group (P<0.05). FiO2 levels progressively decreased (F=35.681, P=0.000) and a/AO2 Gradually increased (F=37.654, P=0.000). No adverse events and no significant differences in the outcomes were observed.</p><p><b>CONCLUSION</b>LRM can reduce the doses of pulmonary surfactant administered, time of the respiratory support and the oxygen therapy in preterm children with RDS.</p>

Strategy of breast reconstruction for patients with caesarotomy scar using pedicled TRAM flap / 中华医学美学美容杂志

Objective To investigate the availability and strategy of breast reconstruction for patients with caesarotomy scar using pedicled TRAM flap.Methods From January 2007 to May 2011,12 cases of breast reconstruction with caesarotomy scar were carried out with pedicled TRAM flaps.All the patients that were classified as the class Ⅱ that was 0.5 or less by score were operated on by using the inverted trapezoid incision,of which the upper edge was 2 or 3 cm down to the umbilicus.Double pedicles were adopted for the patient with the longest vertical scar; single pedicle of the breast contralateral side and the muscle sheath of the breast ipsilateral side were harvested for the rest of the patients.A synthetic mesh was used for the enforcement of the muscle and sheath defect.Results No flap necrosis or abdominal complications were observed.With the follow-up from 3 months to 4 years and 4 months,the overall satisfactory rate was 100 ％.Conclusions The strict patient selection and the operating strategy are the keys to the successful breast reconstruction for patients with caesarotomy scar using pedicled TRAM flap.

Study the degree of cervical spinal canal stenosis by MRI in flexion and extension of the cervical vertebrae / 中国骨伤

<p><b>OBJECTIVE</b>To study the degree and changes of cervical spinal canal stenosis by MRI scans in flexion and extension of the cervical vertebrae.</p><p><b>METHODS</b>Thirty cases of cervical stenosis included 13 male and 17 female with an average age of 39 years ranging from 28 to 66 years. The sagittal diameter of cervical spinal canal were below 10 mm (absolute stenosis) in 12 cases,within 10 to 12 mm (correspondence stenosis) in 18 cases. MRI scans in neutrality, flexion, extension performanced and the degree of cervical spinal canal stenosis and the changes of spinal cord compression were evaluated after MRI scans obtained.</p><p><b>RESULTS</b>Nineteen patients of extension occurrenced stenosis more serious, 8 patients of flexion occurrenced (P < 0.05).</p><p><b>CONCLUSION</b>For the cervical stenosis imaging diagnostic, flexion and extension of cervical MRI scan can be used to supplement conventional MRI examination neutral position, and the extension of MRI is more sensitivity than neutral position and flexion bit.</p>