Effect of acupotomy combined with electroacupuncture on knee function of patients with knee osteoarthritis. / åˆƒé’ˆç»“åˆç”µé’ˆæ²»ç–—å¯¹è†å ³èŠ‚éª¨å ³èŠ‚ç‚Žæ‚£è€ è†å ³èŠ‚åŠŸèƒ½çš„å½±å“.

OBJECTIVES: To compare the clinical effect of combined therapy of acupotomy and electroacupuncture (EA) with the simple application of EA on knee osteoarthritis (KOA), and their influence on knee function. METHODS: Sixty-eight KOA patients were randomly divided into 2 groups, an acupotomy group and an EA group. In the acupotomy group, the combined therapy of acupotomy and EA was adopted. In the EA group, EA was simply used, delivered once every two days, 3 treatments a week；and the duration of treatment was 4 weeks. In the acupotomy group, besides the treatment as the EA group, acupotomy was combined once weekly, and the duration of treatment was 4 weeks. Separately, before and after treatment, and in 4 and 12 weeks after treatment completion (1-month and 3-month follow-up), the results of the timed up and go test (TUG), the 9-step stair climb test (9-SCT) and the knee function (Western Ontario and McMaster University osteoarthritis index visualization scale ［WOMAC］) were measured in the two groups. RESULTS: By the intention-to-treat analysis, the results of TUG, 9-SCT and WOMAC scores were reduced after treatment and in 1-month and 3-month follow-up when compared with those before treatment in the patients of the two groups (P<0.05). Compared with the EA group at the same time point, TUG results were decreased after treatment and in 1-month follow-up, and WOMAC score was reduced after treatment in the acupotomy group. WOMAC score in 1-month follow-up was reduced when compared with that before treatment within the acupotomy group (P<0.05). CONCLUSIONS: Either the simple application of EA or the combined therapy of acupotomy and EA can improve knee function, but the combined therapy obviously increases the walking speed and relieves the symptoms such as joint pain and morning stiffness. The treatment with acupotomy and EA is safe and effective on KOA and the long-term effect is satisfactory.

Field Investigation of the Dynamic Response of Culvert-Embankment-Culvert Transitions in a High-Speed Railway.

The stiffnesses of embankments and culverts differ in the transition sections of high-speed railways (HSRs) due to their different supporting conditions. The dynamic irregularity caused by the different stiffnesses makes this transition area the weakest part of high-speed railways. Graded crushed stone combined with 5% cement is typically used to fill the subgrade in these transition areas. Thus, three different particle size ratios of crushed stone were matched and tested regarding the construction parameters to explore the most suitable materials to fill the roadbed in a transition section. Then, field dynamic tests were carried out on the culvert-embankment-culvert transition area where trains run at speeds of 5-360 km/h. A time-domain analysis of the test data was performed to obtain the laws of variation that cause the dynamic characteristics to change with the railway line and roadbed layer and the changes induced by a train's running speed, operating direction, and axle weight. The results indicate that (i) it is feasible to fill transition section roadbeds with well-graded crushed stone combined with 5% cement with optimal water contents; (ii) extreme dynamic responses in some special sections are observed, suggesting the value of taking special measures at the transition section. For example, the sections 14.5 m and 30 m from the 679 culvert and the bed layer should be specially stabilized; (iii) the train's axle load and driving direction show a great effect on corresponding sections and layers but present a small effect on the sections and layers nearby; and (iv) 260 km/h is a critical speed.

Air pollution associated with hospital visits for mental and behavioral disorders in Northeast China.

Background: Related studies have found that air pollution is an important factor affecting mental and behavioral disorders. Thus, we performed this time-series study to evaluate the relationship between short-term exposure to ambient air pollutants and visits to hospital by patients with mental and behavioral disorders in northeastern China. Methods: We used quasi-Poisson regression models and generalized additive models to probe the links between air pollution and mental and behavioral disorders. The possible influences were also explored stratified by season, age and gender. Results: We found that sulfur dioxide (SO2) had a cumulative effect on mental and behavioral disorders at lag04-lag07 and had the greatest effect at lag07 [Relative risk (RR) = 1.068, 95%CI = 1.021-1.117]. Particulate matter of size 2.5 µm (PM2.5) and SO2 had a cumulative effect on depression and both had the largest effect at lag07 (RR = 1.021, 95%CI = 1.002-1.041; RR = 1.103, 95%CI = 1.032-1.178); SO2 also had a cumulative effect on anxiety disorders, with the largest effect at lag06 (RR = 1.058, 95%CI = 1.009-1.110). In the stratified analysis, people are more susceptible in the cold season compared to the warm season and females and the 18-60-year age group are more sensitive to air pollutants. It is suggested to strengthen management and preventive measures to decrease air pollution exposure. Conclusion: This study found an association between increased concentrations of air pollutants and increased outpatient visits for mental and behavioral disorders. We recommend that preventive and protective measures should be strengthened in an effort to reduce exposure to air pollution in order to maintain physical and mental health.

Global, regional, and national burden of disease study of atrial fibrillation/flutter, 1990-2019: results from a global burden of disease study, 2019.

BACKGROUND: Data from the Global Burden of Disease, Injury, and Risk Factor Study 2019 (GBD 2019) was used to assess the burden and change in prevalence, incidence, deaths, disability-adjusted life years, and risk factors for atrial fibrillation/flutter in 204 countries and territories between 1990 and 2019. METHODS: Incidence, prevalence, deaths, disability-adjusted life years (DALYs), and their age-standardized rates of AF/AFL were analyzed by age, sex, socio-demographic index (SDI), and human development index (HDI) using the Global Burden of Disease study 2019 (GBD2019) results，and risk factors for AF/AFL (mainly high systolic blood pressure, high body-mass index, alcohol use, smoking and diet high in sodium) were differentially analyzed. RESULTS: There are 59.70 million (95% uncertainty interval (UI) 45.73-75.29 million) AF/AFL patients worldwide in 2019, with 4.72 million (95% uncertainty interval (UI) 3.64-5.96 million) new cases and 0.315 million deaths (95% uncertainty interval (UI) 0.268-0.361 million) and 8.39 million disability-adjusted years (95% uncertainty interval (UI) 6.69-10.54 million). The highest risk factor for deaths, DALYs attributable to AF/AFL in 2019 was high systolic blood pressure, high body-mass index, alcohol use, smoking, and diet high in sodium. It is estimated that between 2030 and 2034, the total incidence of male AF/ AFL will be 16.08 million, and the total number of deaths will be 1.01 million. For females, the total number of incidence is 16.85 million, and the total number of deaths is 1.49 million. CONCLUSIONS: AF/AFL remains a major global public health problem, although the ASR of prevalence, incidence, and DALY at the worldwide level showed a decreasing trend from 1990 to 2019(the ASR of deaths increased slightly). However, the unfavorable trend observed in this study in countries with lower SDI suggests that current prevention and treatment strategies should be reoriented. Some countries should develop more targeted and specific strategies to prevent the increase of AF/AFL.

Efficacy and safety of vernakalant for cardioversion of recent-onset atrial fibrillation: A protocol for systematic review and meta-analysis.

BACKGROUND: Atrial fibrillation (AF) is the most common tachyarrhythmia encountered in clinical practice and is associated with substantial morbidity and mortality. This study aimed to determine the efficacy and safety of vernakalant for cardioversion of recent-onset AF. METHODS: A comprehensive systematic literature search will be conducted in Cochrane Library, PubMed, Web of Science, EMBASE, for randomized controlled trials (RCTs) about the vernakalant with AF. Two reviewers will independently assess the quality of the selected studies according to the Cochrane Collaboration's tool for RCTs. The bias risk of the RCT will be assessed by the Cochrane risk of bias (ROB) tool. The quality of the evidence will be evaluated by Grading of Recommendations Assessment Development and Evaluation (GRADE) system. Results from these questions will be graphed and assessed using Review Manager 5.3. RESULTS: The results of this meta-analysis will be published in a peer-reviewed journal. CONCLUSION: This review will evaluate the safety and efficacy of vernakalant for patients with AF, provide more recommendations for patients or researchers, and high-level evidence for clinical decision-making.

Association of using biomass fuel for cooking with depression and anxiety symptoms in older Chinese adults.

BACKGROUNDS: Household air pollution exposure is a crucial public concern and have the potential to seriously affect human health. Using biomass fuels for cooking is the main contributor to household air pollution. However, current evidence linked between cooking with biomass fuels and mental health remains limited. OBJECTIVES: To explore whether cooking with biomass fuels is associated with depression and anxiety symptoms among older adults in China. METHODS: We obtained data from Chinese Longitudinal Healthy Longevity Survey (CLHLS). Depressive and anxiety symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Primary cooking fuel type was self-reported. We used logistic regression and linear regression to evaluate the effects of cooking with biomass fuels on depression and anxiety. RESULTS: A total of 13,361 participants aged 65 years and older (mean age, 84.2 ± 11.5 years) were included in the presented study. A positive association was found between cooking with biomass fuels and both depression symptoms (adjusted odds ratio 1.23, 95% CI 1.03 to 1.47) and anxiety symptoms (adjusted odds ratio 1.31, 95% CI 1.02 to 1.68). Biomass fuel users had a higher depression scores (0.33, 95% CI 0.03 to 0.61) and a higher anxiety scores (0.20, 95% CI 0.02 to 0.38) compared to clean fuel users. We found no significant interactions between participant characteristics and biomass fuel use on either depression or anxiety symptoms. CONCLUSIONS: Cooking with biomass fuels was associated with depression and anxiety symptoms in order adults. Further large prospective cohort studies are warranted to confirm this association.

Potential Mechanism of Dingji Fumai Decoction Against Atrial Fibrillation Based on Network Pharmacology, Molecular Docking, and Experimental Verification Integration Strategy.

Background: Dingji Fumai Decoction (DFD), a traditional herbal mixture, has been widely used to treat arrhythmia in clinical practice in China. However, the exploration of the active components and underlying mechanism of DFD in treating atrial fibrillation (AF) is still scarce. Methods: Compounds of DFD were collected from TCMSP, ETCM, and literature. The targets of active compounds were explored using SwissTargetPrediction. Meanwhile, targets of AF were collected from DrugBank, TTD, MalaCards, TCMSP, DisGeNET, and OMIM. Then, the H-C-T-D and PPI networks were constructed using STRING and analyzed using CytoNCA. Meanwhile, VarElect was utilized to detect the correlation between targets and diseases. Next, Metascape was employed for systematic analysis of the mechanism of potential targets and protein complexes in treating AF. AutoDock Vina, Pymol, and Discovery Studio were applied for molecular docking. Finally, the main findings were validated through molecular biology experiments. Results: A total of 168 active compounds and 1,093 targets of DFD were collected, and there were 89 shared targets between DFD and AF. H-C-T-D network showed the relationships among DFD, active compounds, targets, and AF. Three functional protein complexes of DFD were extracted from the PPI network. Further systematic analysis revealed that the regulation of cardiac oxidative stress, cardiac inflammation, and cardiac ion channels were the potential mechanism of DFD in treating AF. Addtionally, molecular docking verified the interactions between active compounds and targets. Finally, we found that DFD significantly increased the level of SIRT1 and reduced the levels of ACE, VCAM-1, and IL-6. Conclusions: DFD could be utilized in treating AF through a complicated mechanism, including interactions between related active compounds and targets, promoting the explanation and understanding of the molecular biological mechanism of DFD in the treatment of AF.

Knockdown of lncRNA ANRIL suppresses the production of inflammatory cytokines and mucin 5AC in nasal epithelial cells via the miR-15a-5p/JAK2 axis.

The incidence of allergic rhinitis (AR) is increasing worldwide. Human nasal epithelial cells (HNECs) are the key cells in the occurrence of AR. Antisense non-coding RNA in the INK4 locus (ANRIL) was discovered to be involved in the progression of AR. However, the mechanism by which ANRIL mediates the progression of AR remains to be determined. The present study aimed to further explore the mechanism by which ANRIL regulates AR. Thereby, HNECs were treated with IL-13 to mimic AR in vitro. The mRNA expression levels of ANRIL, microRNA (miR)-15a-5p, JAK2, mucin 5AC (MUC5AC), granulocyte-macrophage colony-stimulating factor (GM-CSF) and eotaxin-1, and protein expression levels of JAK2, STAT3 and phosphorylated-STAT3 in HNECs were analyzed using reverse transcription-quantitative PCR and western blotting, respectively. ELISAs were used to detect the secretory levels of inflammatory cytokines and mucin in cell supernatants. In addition, a dual luciferase reporter assay was used to confirm the downstream target of ANRIL and the target gene of miR-15a-5p. The results revealed that the secretory levels of eotaxin-1, GM-CSF and MUC5AC were significantly upregulated by IL-13 in the supernatant of HNECs. The expression levels of ANRIL and JAK2 were also upregulated in IL-13-induced HNECs, while the expression levels of miR-15a-5p were downregulated. In addition, ANRIL was identified to bind to miR-15a-5p. The IL-13-induced upregulation of eotaxin-1, GM-CSF and MUC5AC mRNA expression and secretory levels was significantly inhibited by the genetic knockdown of ANRIL, while the miR-15a-5p inhibitor effectively reversed this effect. JAK2 was also discovered to be directly targeted by miR-15a-5p. The overexpression of JAK2 significantly suppressed the therapeutic effect of miR-15a-5p mimics on IL-13-induced inflammation in vitro. In conclusion, the findings of the present study suggested that the genetic knockdown of ANRIL may suppress the production of inflammatory cytokines and mucin in IL-13-treated HNECs via regulation of the miR-15a-5p/JAK2 axis. Thus, ANRIL may serve as a novel target for AR treatment.

LINC00669 insulates the JAK/STAT suppressor SOCS1 to promote nasopharyngeal cancer cell proliferation and invasion.

Nasopharyngeal carcinoma (NPC) is an epithelial cancer emerging from the lining of nasopharyngeal mucosa, with extremely frequent occurrence in east and southeast Asia. For the purpose of exploring roles of the dysregulated long non-coding RNA (lncRNA) in NPC, we identified a novel lncRNA LINC00669 with an apparent negative correlation to the overall survival from human NPC mRNA expression profiling databases. We further performed RNA pulldown coupled with mass spectrum to find out its target protein, and applied a series of in vitro and in vivo loss-and-gain-of function assays to investigate its oncogenic roles in NPC tumor development and progression. Our results demonstrated that LINC00669 competitively binds to the key JAK/STAT signaling pathway suppressor SOCS1, and insulates it from imposing ubiquitination modification on the pathway component of STAT1, which leads to its abnormal stabilization and activation. The activated STAT1 is then transferred into the nucleus and initiates the transcription of genes related to proliferation and invasion. In summary, our study reveals that the cytoplasmic resident lncRNA LINC00669 confers malignant properties on NPC cancer cells by facilitating a persistent activation of the JAK/STAT signaling pathway. Findings in the current study shed lights on prospects for treating NPC using strategies targeting the novel regulator of the JAK/STAT signaling.

PET/CT-guided versus CT-guided percutaneous core biopsies in the diagnosis of bone tumors and tumor-like lesions: which is the better choice?

OBJECTIVE: The present study aimed to evaluate the diagnostic performance and safety of PET/CT-guided percutaneous core bone biopsy and to compare the PET/CT-guided method to conventional CT-guided percutaneous core biopsies to diagnose Chinese patients with bone tumors and tumor-like lesions. METHODS: Data for 97 patients with bone tumors and tumor-like lesions diagnosed by percutaneous core bone biopsy from February 2013 to November 2018 were retrospectively analyzed. The study included 42 cases in the PET/CT group and 55 cases in the CT alone group. The diagnostic performance, cost and complications associated with the intervention were compared between the two groups. All patients were eventually confirmed to have bone tumors and tumor-like lesions according to surgical pathology findings. RESULTS: There were no significant differences in patient characteristics (P > 0.05). For the patients in the PET/CT group, the overall diagnostic yield of the initial biopsies and the diagnostic accuracy derived from the surgically proven cases were both 97.62%, which was significantly higher than the values in the CT group during the same period (P < 0.05). No major biopsy-related complications (e.g., serious bleeding or tumor dissemination) occurred before, during, or after the intervention. Therefore, no significant difference was observed between the two groups with regard to the complication rate (P > 0.05). CONCLUSION: Compared with CT-guided percutaneous bone biopsy, PET/CT-guided percutaneous bone biopsy is an effective and safe alternative with high diagnostic performance in the evaluation of hypermetabolic bone lesions to diagnose bone tumors and tumor-like lesions.

Gene Expression Profiling of Broiler Liver under Cold Stress by High-Throughput Sequencing Technology.

Cold stress is a major environmental factor restricting the sustainable development of animal husbandry. To gain insight into the gene-regulation processes in broilers under cold stress, gene expression profiling was conducted using high-throughput Solexa sequencing of broiler liver tissue under cold stress conditions and control conditions. According to Solexa sequencing, we identified 255 genes whose expression levels differed between the treatment and control group. Under cold stress, 135 genes were up-regulated and 120 genes were down-regulated genes compared with levels in the control group. Moreover, 469 genes were expressed only in the control group, and 172 genes were expressed only in the treatment group. These data were confirmed by real-time quantitative PCR. Gene Ontology enrichment analysis showed that the differentially expressed genes (DEGs) were mainly enriched in material metabolism and immune functions. KEGG enrichment analysis showed that DEGs were enriched in pyruvate metabolism, glycolysis/gluconeogenesis, fatty acid metabolism, insulin signaling pathway and others. In conclusion, these results may serve as an important reference for broiler breeding and provide new clues for the elucidation of molecular mechanisms of cold stress.

Ameliorative Effects of Dietary Selenium Against Cadmium Toxicity Is Related to Changes in Trace Elements in Chicken Kidneys.

The ameliorative effects of selenium (Se) against cadmium (Cd)-induced toxicity have been reported extensively. However, few studies have assessed the effects of multiple ions simultaneously on the variations of elements. In this study, the changes in Se, Cd, and 26 other element concentrations were investigated in chicken kidneys. One hundred and twenty-eight 31-week-old laying hens were fed a diet supplemented with either Se, Cd, or both Se and Cd for 90 days. The ion content was analyzed by inductively coupled plasma mass spectrometry (ICP-MS). We found that the Se, Cd, and combined Se and Cd treatments significantly affected the trace elements in the chicken kidneys. The Cd supplement caused ion profile disorders, including reduced concentrations of V, Cr, Mn, Mo, As, Ba, Hg, Ti, and Pb and increased Si, Cu, Li, Cd, and Sb. The Se supplement reduced the contents of Co, Mo, and Pb and increased the contents of Cr, Fe, and Se. Moreover, Se also increased the concentrations of Cr, Mn, Zn, and Se and decreased those of Li and Pb, which in contrast were induced by Cd. Complex interactions between elements were analyzed, and both positive and negative correlations among these elements are presented. The present study indicated that Se can help against the negative effects of Cd and may be related to the homeostasis of the trace elements in chicken kidneys.

[A pilot study of diaphragmatic function evaluated as predictors of weaning in chronic obstructive pulmonary disease patients].

OBJECTIVE: To evaluate the predictive performance of neuro-mechanical coupling (NMC) and neuro-ventilatory coupling (NVC) in the weaning outcome in patients with chronic obstructive pulmonary disease (COPD). METHODS: Sixteen patients were enrolled when the criteria for their first spontaneous breathing trial (SBT) was met. A 30-minute SBT was attempted, with the measurement of electrical activity of the diaphragm (Edi), NMC, NVC, NVC × NMC, index of rapid shallow breathing (f/Vt), airway occlusion pressure (P(0.1)) and f/Vt × P(0.1) at 0, 5 and 30 min. The receiver operating characteristic (ROC) curve was calculated to evaluate the predictive performance of each index. RESULTS: Successful weaning (S group) was observed in 6 patients while weaning failure (F group) in 10 patients. (1) The predictive capacity of Edi: at 30 min of SBT, Edi showed higher values in the F group (P < 0.05), the area under the ROC curves (AUC) was 0.817(P < 0.05). (2) The predictive capacity of NVC and NMC: at 5, 30 min of SBT, NVC and NMC showed higher values in the S group (P < 0.05); at 30 min of SBT NVC presented the largest AUC than any other time of SBT (0.822, P < 0.05), while the AUC of NMC was 0.800(P > 0.05). (3) The predictive capacity of NVC × NMC: at 30 min of SBT, the AUC of NVC × NMC was larger than NVC (0.864, P < 0.05), showing greater sensitivity (100.0%) and specificity (83.3%). (4) The predictive capacity of f/Vt and P(0.1): f/Vt and f/Vt × P(0.1) presented poor predictive performance in the failed patients. CONCLUSIONS: Edi, NVC and NVC × NMC were good predictor for the weaning outcome in patients with COPD.

[Effects of neurally adjusted ventilatory assist on subject-ventilator synchrony in rabbits with acute respiratory distress syndrome].

OBJECTIVE: To observe the effects of neurally adjusted ventilatory assist (NAVA) on subject-ventilator synchrony in rabbits with acute respiratory distress syndrome (ARDS). METHODS: The rabbit model of ARDS was induced by intratracheal infusion of hydrochloric acid. After sufficient recruitment, the rabbits were randomly divided into 2 groups: pressure support ventilation (PSV) group and NAVA group. The parameters of subject-ventilator synchrony such as ventilation trigger, ventilation switching and magnitude of assist were observed at 0, 1, 2, 3 h respectively. RESULTS: (1) Ventilation trigger: 1) trigger delay: the trigger delay in the NAVA group were markedly lower than the PSV group at 0, 1, 2, 3 h (P < 0.05); as ventilation time elapsed, the trigger delay changed neither in NAVA nor in PSV group (P > 0.05). 2) Ineffective trigger index: the ineffective trigger index was 17.7% ± 13.7% in the PSV group. While all neural efforts were trigger, there was no ineffective trigger observed in the NAVA group. (2) Off-cycle delay: the off-cycle delay were significantly lower in the PSV group than that in the NAVA group at 0, 1, 2, 3 h (P < 0.05); as the ventilation time elapsed, the off-cycle delay changed neither in the NAVA group nor in the PSV group (P > 0.05). (3) Magnitude of assist: in the NAVA group, peak EAdi and peak pressure were markedly correlated (determination coefficient 0.86 ± 0.07, P < 0.05). But pressure delivery during the PSV group was not correlated with EAdi (P > 0.05). CONCLUSION: As compared with PSV, NAVA can improve subject-ventilator synchrony in rabbits with ARDS.

[Effects of neurally adjusted ventilatory assist on prevention of ventilator-induced diaphragmatic dysfunction in acute respiratory distress syndrome rabbits].

OBJECTIVE: To evaluate the effect of neurally adjusted ventilatory assist (NAVA) on prevention of ventilator-induced diaphragmatic dysfunction (VIDD) in ARDS rabbits. METHODS: Twenty New Zealand white rabbits were randomly divided into 4 groups: (1) control group (n = 5); (2) Volume control (VC) group (n = 5); (3) Pressure support (PSV) group (n = 5); (4) NAVA group (n = 5). In VC, PSV and NAVA groups, the rabbits were killed and the diaphragm was removed after 4 hours of ventilation. Animals in the control group were not mechanically ventilated, and the diaphragm was also removed immediately after anesthetizing. In all rabbits, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) of diaphragm were measured. Structure of diaphragm was observed by light microscope, electron microscope, constituent ratio and mean cross-sectional area (CSA) of diaphragm fiber. RESULTS: (1) MDA: Compared with the control [(0.15 ± 0.06) nmol/mg], PSV group [(0.30 ± 0.11) nmol/mg], there was no significant difference in MDA of diaphragm in NAVA group [(0.28 ± 0.19) nmol/mg] (F = 2.730, P > 0.05). MDA in VC group [(0.40 ± 0.16) nmol/mg] was significantly higher than the control group (P < 0.05). (2) SOD: Compared with control [(111 ± 12) U/mg], PSV group [(93 ± 4) U/mg], there was no significant difference in SOD of diaphragm in NAVA group [(94 ± 9) U/mg] (F = 4.422, P > 0.05). SOD in VC group [(80 ± 21) U/mg] was significantly lower than the control group (P < 0.05). (3) GSH: Compared with control [(5.3 ± 1.0) mg/g] and PSV group [(4.5 ± 1.2) mg/g], there was no significant difference in GSH of diaphragm in NAVA group [(5.6 ± 1.0) mg/g] (F = 3.001, P > 0.05). GSH in VC group [(3.3 ± 1.7) mg/g] is significantly lower than control and NAVA groups (P < 0.05). (4) Light microscope: In VC group, many changes were observed in the muscle, such as myelofibrosis, necrosis, and some of muscle fibers became atrophy, but these were no obvious changes of pathological structure in control, PSV or NAVA groups. (5) Electron microscope: In control, PSV and NAVA groups, the ultrastructure of diaphragm was normal. Different from the above 3 groups, some abnormal ultrastructure was observed in VC group, including disrupted myofibrils, swollen mitochondria. (6) CSA of diaphragm fiber: Compared with control and PSV group, there was no significant difference in CSA of diaphragm fiber in NAVA group (P > 0.05); The CSA of type II fibers in VC group was markedly lower than control group (P < 0.05). CONCLUSIONS: Compared with volume control ventilation, NAVA may mitigate diaphragmatic oxidative stress, atrophy and injury, and prevent VIDD better than VC.

Effects of pulmonary stretch reflex on lung injury in rabbits with acute respiratory distress syndrome.

BACKGROUND: Pulmonary stretch reflex plays an important role in regulation of respiratory movement. This study aimed to evaluate the effect of pulmonary stretch reflex on lung injury in rabbits with acute respiratory distress syndrome (ARDS). METHODS: ARDS rabbits were given intratracheal infusion of hydrochloric acid and ventilated with neurally adjusted ventilatory assistance (NAVA) with a tidal volume (VT) of 6 mL/kg and the electrical activity of diaphragm (EAdi)-determined positive end expiratory pressure. After isolation of the bilateral vagus nerve trunk, the rabbits were randomized into two groups: sham operation (SHAM) group (n=5) and bilateral vagotomy (VAG) group (n=5). Gas exchange and respiratory mechanics were detected at baseline, after lung injury and 1, 2, and 3 hours after ventilation respectively. Pulmonary permeability index, pathological changes and inflammatory response were also measured. RESULTS: Compared with the SHAM group, PaO2/FiO2 in the VAG group decreased significantly 2 and 3 hours after ventilation (P<0.05). There was no significant difference in PaCO2 between the SHAM and VAG groups (P>0.05), and the VAG group had a high VT, peak pressure (Ppeak), and mean pressure (Pm) compared with the SHAM group 1, 2, 3 hours after ventilation (P<0.05). Compared to the SHAM group, dead space fraction (VD/VT) and respiratory system elastance (Ers) in the VAG group increased (P<0.05) and static pulmonary compliance (Cst) decreased markedly (P<0.05) after ventilation for 3 hours. Lung wet/dry weight ratio (W/D) (8.4±1.2 vs. 6.6±1.0), lung injury score (6.3±1.8 vs. 3.8±1.3), tumor necrosis factor-α (TNF-α) (779±372 pg/mL vs. 355±130 pg/mL) and interleukin-8 (IL-8) (169±21 pg/mL vs. 118±17 pg/mL) increased significantly in the VAG group compared with the SHAM group (P<0.05). CONCLUSION: Lung injury is aggravated after bilateral vagotomy, demonstrating that pulmonary stretch reflex may have protective effect on the lung.

[Effects of electrical activity of diaphragm on the titration of positive end-expiratory pressure in a model of acute respiratory distress syndrome].

OBJECTIVE: To explore the relationship of electrical activity of diaphragm (EAdi) and positive end-expiratory pressure (PEEP) in a rabbit model of acute respiratory distress syndrome (ARDS). METHODS: The rabbit model of ARDS was induced by an intratracheal infusion of hydrochloric acid. After a sufficient amount of recruitment maneuvers (RM), the level: the PEEP levels were (10.4 ± 1.0) cm H2O in EAdi group and (9.7 ± 2.1) cm H2O in rabbits were divided into 2 groups: (1) PEEP titration with EAdi (EAdi group); (2) PEEP titration with maximum oxygenation (maximum oxygenation group). The tidal volume was 6 ml/kg in 2 groups. Pulmonary mechanics, gas exchange and hemodynamic were observed in two groups at baseline, after lung injury and ventilation 1, 2, 3 h respectively. RESULTS: (1) PEEP maximum oxygenation group. There was no significant difference between two groups (P > 0.05). (2) Pulmonary mechanics:there was no significant difference in peak pressure (Ppeak) and mean pressure (Pm) between two groups at ventilation 1, 2, 3 h (P > 0.05). (3) Gas exchange: at ventilation 1, 2, 3 h, the oxygenation index (PaO2/FiO2) in EAdi group was higher than that of after lung injury (P < 0.05) and there was no significant difference in PaO2/FiO2 and partial pressure of arterial carbon dioxide (PaCO2) between two groups (P > 0.05). (4) Hemodynamic: at ventilation 1, 2, 3 h, the heart rate (HR) and mean artery pressure (MAP) in EAdi group had no significant differences with baseline, after lung injury and maximum oxygenation group (P > 0.05). CONCLUSION: EAdi may be an ideal method for PEEP titration at post-RM in an ARDS model.

[Determination of the contents of chlorogenic acid and phillyrin of Shuanghuanglian oral fluid using NIRS].

The aim of the present study was to establish the model of predicting the contents of chlorogenic acid and phillyrin in Shuanghuanglian oral fluid using NIR to realize quick quality evaluation of Shuanghuanglian oral fluid. To this end, many batches of Shuanghuanglian oral fluid were selected, and the contents of chlorogenic acid and phillyrin were determined using HPLC. Meanwhile, the NIR spectra of the same samples were determined. The model used to predict the contents of chlorogenic acid and phillyrin in Shuanghuanglian oral fluid was established by correlation analysis between the results gained by HPLC and NIR spectra. According to the value of RSEP and r, the method of data processing was chosen. The method of spectra processing and wavelength range or wave numbers were chosen based on the value of RMSECV. The method of data processing was SMLR The original spectra were used to establish the model. The wave numbers in the model used to predict the contents of chlorogenic acid and phillyrin were 6 654.06/7 106.08 cm(-1), and 5 456.06/7 222.08 cm(-1) respectively. The RMSECV and the correlation coefficient of the best model of chlorogenic acid and phillyrin were 0.857 26, 0.889 87 and 0.857 26 and 0.889 87. The results of cross validation indicate that the predicting model was accurate and credible, and could be used as a rapid quality control method of Shuanghuanglian oral fluid.

[Effects of neurally adjusted ventilatory assist on patient-ventilator synchrony in patients with acute respiratory distress syndrome].

OBJECTIVE: To observe the effect of neurally adjusted ventilatory assist (NAVA) on patient-ventilator synchrony in patients with acute respiratory distress syndrome (ARDS). METHODS: Eighteen patients with ARDS were enrolled in the study. Each patient underwent both an incremental pressure support ventilation (PSV) and NAVA run randomly in 4 steps. The PSV level was gradually increased 5 cm H2O (1 cm H2O = 0.098 kPa) every 5 min from 5 cm H2O until to 20 cm H2O. Incremental NAVA was individually set in steps of 0.2 - 1.0 cm H2O/microV every 5 min to determine the NAVA level predicted to give an airway pressure in each step equivalent to that of PSV. Parameters in patient-ventilator synchrony such as ventilation trigger, ventilation switching and ventilation maintenance were observed at the same time during PSV(PSV1-PSV4) and NAVA(NAVA1-NAVA4). RESULTS: (1) Ventilation trigger:(1) trigger delay: with progressive increases in PSV, the trigger delays increased significantly (P < 0.05). With increasing NAVA, the trigger delay did not increase significantly (P > 0.05) and each of them was shorter than that of PSV in each corresponding step (P < 0.05). (2) Ineffective trigger: At PSV1, the ineffective triggers accounted for 2. 3% of the neural respiratory rate (NRR), but the ineffective triggers added up to 22% in PSV4 significantly (P < 0.05). All neural efforts were triggered and there were not ineffective triggers at all level in NAVA. (2) Off cycle delay: the off cycle delays in PSV2 - PSV4 increased significantly when compared with PSV1 (P < 0.05). With increasing NAVA, the off cycle delays did not increase significantly (P > 0.05) and each of them was shorter than that of PSV in each corresponding step (P < 0.05). (3) Magnitude of assist [tidal volume (VT)]: The VT [(361 +/- 69) ml] in NAVA1 was equivalent to the VT[(361 +/- 121) ml] in PSV1(P > 0.05). The VT [(417 +/- 71) ml, (427 +/- 80) ml, respectively] in NAVA3-NAVA4 was significantly lower than the VT[(604 +/- 141) ml, (675 +/- 108) ml, respectively] in PSV3-PSV4 (P < 0.05). (4)Respiratory muscle loading: Increasing NAVA and PSV level reduced the magnitude of diaphragm electrical activity (EAdi) and the pressure-time products of esophagus (PTPes) (P < 0.05), but there was no significant difference in each corresponding step of PSV and NAVA(P > 0.05). CONCLUSIONS: Compared with PSV, the ventilation cycle and the magnitude of assist in NAVA matched the patient's breathing pattern. NAVA improved patient-ventilator synchrony in patients with ARDS.

[Expression and significance of human beta-defensin in recurrent nasal polyps].

OBJECTIVE: To observe the expression of human beta-defensin-1 (hBD-1) and human beta-defensin-2 (hBD-2) in recurrent nasal polyps, and to investigate the role of beta-defensin in the recurrent nasal polyps. METHODS: Tissues of nasal polyps was obtained from 10 patients with nasal polyps undergoing endoscopic sinus surgery, recurrent nasal polyps from 10 patients 6 months after surgery, nasal mucosa from 10 recovered patients with nasal polyps postoperatively and,10 control subjects. hBD-1 mRNA and hBD-2 mRNA levels of tissue specimens in all groups were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: There was no significant difference in hBD-1 mRNA level between the 4 groups (P>0.05). Expression of hBD-2 mRNA was detected in patients with nasal polyps and recurrent nasal polyps, but rare in the recovered patients and the control subjects. CONCLUSION: hBD-1 is a constitutive expression and hBD-2 is an induced expression. beta-Defensin may play an important role in forming the nasal polyps.