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Acute respiratory distress syndrome (ARDS) refers to acute diffuse lung injury caused by a variety of intrapulmonary and/or extrapulmonary factors such as infection and trauma. Uncontrolled inflammatory response is the main pathological feature. Different functional states of alveolar macrophages have different effects on inflammatory response. Transcription activating factor 3 (ATF3) is a fast response gene in the early stage of stress. In recent years, it has been found that ATF3 plays an important role in regulating the inflammatory response of ARDS by regulating the function of macrophages. This paper reviews the regulatory effects of ATF3 on alveolar macrophage polarization, autophagy and endoplasmic reticulum stress and its effects on the inflammatory process of ARDS, aiming to provide a new research direction for the prevention and treatment of ARDS.
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Objective To investigate the differences of hepatic pathology between the chronic hepatitis B (CHB) with pulmonary tuberculosis patients and CHB patients.Methods Seventy-nine treatment-naive patients with CHB complicated with pulmonary tuberculosis (co-infection group) were collected from January 2009 to December 2014,and 79 CHB patients were selected randomly during the same period as CHB group.Hepatic tissue inflammation and fibrosis between the two groups were compared according to Ishak scoring system.Comparison between two groups were conducted by t test when the variance was equal and Mann-Whitney U test when the variance was unequal.Categorical data were compared by x2 test.Results A total of 59 (74.7％) patients in co-infection group had inflammation≥ G2,compared to 59.5％ in the CHB group.The difference between the two groups was statistically significant (x2=4.128,P=0.042).Forty-one (51.9％) patients in co-infection group had fibrosis≥S2,compared with 44.3％ in the CHB group.The difference was not statistically significant (x2 =0.913,P=0.339).Ishak scoring system showed that piecemeal necrosis,portal area inflammation score and totalscore in co-infection group were all significantly higher than those in CHB group (2.45± 1.19 vs 2.05± 1.28,2.70±1.22 vs 2.32±1.08,13.16±6.51 vs 11.22±5.72,respectively),with all the differences statistically significant (t=2.055,2.068 and 1.984,respectively;P=0.042,0.040 and 0.049,respectively).However,the confluent necrosis in co infection group was 2.60±1.91 compared to 2.13± 1.68 in CHB group (Z=1.137,P=0.257),focal (dot) soluble necrosis was 2.35± 1.06 versus 2.16± 0.86 (Z=-1.148,P=0.251),and fibrosis was 3.03±1.63 versus 2.45±1.53 (Z=I.541,P=0.125).Conclusion The liver damage in co-infection patients is more severe compared with CHB patients.
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Objective To investigate the clinical effect of IFNα combined with mannan peptide in treatment of patients with HBeAg-positive chronic hepatitis B ( CHB ). Methods Eighty HBeAg-positive CHB patients with HBV DNA quantity ranging from 10 to 10 eopies/mL were enrolled and randomized into the treatment group and the control group ( n = 40 for each ). Patients in treatment group were given daily subcutaneous injection of IFNα-2b 5,000,000 U for 52 weeks, and received mannan peptide 10 mg per intravenous injection or 2. 5 mg per intramuscular injection for a total of 2 to 3 treatment courses (12 weeks for each). The control group received only IFNα-2b treatment. Liver function, serum markers of hepatitis B, HBV DNA quantity and blood tests were performed before the treatment and at 2, 4, 8, 16, 26 and 52-week during the treatment; and the adverse effects were recorded. Results The rates for ALT normalization, negative HBsAg, negative HBeAg, HBeAg seroconversion and negative HBV DNA were 91. 8% , 17. 5% , 52. 5% , 27. 5 % and 47. 5% at 52nd week in the treatment group, while those in the control group were 80. 0% , 12. 5% , 30. 0% , 10. 0 % and 25. 0% , respectively. There were significant differences in HBeAg-negative, HBeAg-seroeonversion and HBV DNA-negative rates between two groups (χ2 = 4. 178, 4.021 and 4.381, P < 0. 05 ) , and these indexes in the treatment group were increased to 57. 5% , 30. 0% and 50. 0 respectively at 52nd week after drug withdraw. White blood cells began to be elevated at 4th week and were restored to the normal levels at 8th week in the treatment group, while the count in the control was lower than the normal value even at 52nd week of the treatment with the average of (3.45±1. 18)×109/L. Conclusion Alpha-interferon combined with mannan peptide therapy is effective for patients with HBeAg-positive CHB, which may restore the declined peripheral WBC counts induced by interferon and improve the compliance.
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@#Objective To observe the therapeutic effect of balance cupping therapy on non-specific low back pain.Methods 75 patients with non-specific low back pain were randomly divided into the control group (n=25), cupping therapy group (n=25) and balance cupping therapy group (n=25). The patients in the control group were received diclofenac sodium enteric-coated capsule; the cases in other two groups were treated with cupping therapy and balance cupping therapy separately. After 3 weeks' treatment, the changes of the visual analogous scores and Oswestry disability index of two groups' patients were observed.Results The visual analogous scores and Oswestry disability index of the balance cupping therapy group were significantly lower than that of the control group and cupping therapy group ( P<0.05) after 3 weeks' treatment. But between the control group and cupping therapy group there was no difference.Conclusion Balance cupping therapy is one of effective treatment methods for non-specific low back pain.
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[Objective]To analyze the causes of complication following percutaneous vertebroplasty and to find out the methods on its prevention and treatment.[Method]Complications of 140 patients (233 vertebral bodies) performed percutaneous vertebroplasty from August 2002 to July 2006 and long-term complications and its correlative prognosis after followed-up 7-52 months (average 28.4 months were observed and analyzed.[Result]Sixty-one patients of 140 cases showed complications (43.6%).Forty-five of the 61 patients with complications revealed with leakage of bone cement,2 with transient low blood pressure or lethargy,3 with dyspneic respiration or slight cough or chest discomfort,1 with subcutaneous herniation.In 12 patients complicated with leakage of bone cement,10 complained aggravation of pain,1 of radiating pain of back and low limb,1 with incomplete paraplegia. The 11 patients complicated with various postoperative pain induced by bone-cement leakage were complete recovery after treatment with anti-imflamatory analgetics orally for 3-7 days.One patient with incomplete paraplagia caused by leakage of bone cement demonstrated satisfactory walking function recovery but still remained slight disability of lower limbs after 26 months by treatment of laminectomy decompression,with drawing of bone cement combined with anti-biotics,dehydration agent,hormone,nerve-nourisling agent and 3-month acupuncture. Two patients with transient low blood pressure or lethargy were treated and recovery after fluid infusion and 30-60 oxygen taking. Three patients with dypneic respiration or slight cough or chest discomfort but without abnormality on radiographs were convalesced after treatment of fluid infusion,taking oxygen and anti-biotics for 3-5 days.The subcutaneous homotoma of 1 patient was absorbed 7 days later.Ten patients complicated with new adjacent vertebral body fracture 1-12 months postoperatively were healed after conservative treatment of PVP operation.[Conclusion]Complications after percutaneous vertebroplasty are not uncommon(43.6%).Leakage of bone cement is most common complication. Strict pre-operation plan and improving operation skill are the most important preventive measures.
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The Experiments were performed on 63 urethane anesthetized, suxamethonium chloride paralyzed and artificially ventilated rats. The results were as follows: microinjection of L-Arg, NO precursor, into parabrachial nuclei (NPB) resulted in a marked decrease in the mean arterial pressure (MAP), but the heart rate had no significant change. Microinjection of N-nitro-L-arginine (L-NNA), NO synthase inhibitor, into NPB caused a significant increase in MAP. Preinjection of L-NNA and methylene blue into NPB separately blocked the depressor effect elicited by L-Arg. Preinjection of bicuculine, γ-aminobutyric acid (GABA) receptor antagonist, into NPB significantly reduced or abolished the depressor effect elicited by L-Arg. The above results indicated that: (1) NO has depressor effect in NPB by activating guanylate cyclase; (2) Endogenous NO in NPB has tonic depressor effect and takes part in maintenance of normal blood pressure level; (3) The depressor effect evoked by NO in NPB is at least partly mediated by local GABA receptor.
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Experiments were carried out in 31 urethane anesthetized, Suxamethonium chloride paralyzed and artificially ventilated rats. The results were as follows: microinjection of γ-amino butyric acid (GABA) into parabrachial nuclei (NPB) markedly decreased the mean arterial pressure (MAP) (P＜0. 001), while the microinjection of bicuculine (Bic) into NPB caused a significant increase in MAP (P＜0. 001). The depressor effect of GABA could be blocked by preinjection of Bic in NPB. The above agents microinjected into NPB had no significant effect on heart rate (P＞0. 05). The results indicated that: (1) GABA in NPB exerts tonic depressor effect; (2) Endogenous GABA in NPB exerts tonic depressor action and takes part in maintenance of normal blood pressure level.