Sepsis, a serious clinical syndrome known as organs dysfunction caused by an unbalanced host inflammatory response to infection, is of great concern in emergency medicine. Over the past two decades, the definition of sepsis has changed from systemic inflammatory response syndrome lead by infection to organs damage caused by infection. Under the new diagnostic criterion, septic patients are too serious to be treated in Emergency Department, and need intensive treatment of Intensive Care Unit. In this paper, by analyzing the development process from infection to sepsis and expounding the role of cytokines in the development of sepsis, we think that measures should be taken at the early stage of infection in order to prevent and block the occurrence of sepsis.
ObjectiveTo establish paraquat (PQ)-induced acute respiratory distress syndrome (ARDS) mice model via gavage, in order to simulate oral adminitration in clinical situations.MethodsSeventy-eight 6-8-week-old, specific pathogen free female C57 mice were chosen in this study. The mice were randomly divided into the control group (n=6) and the PQ model group(n=36); the mice in the latter group were randomly divided into 6 poisoning model subgroups further, with 6 mice in each, to find out the suitable concentration of PQ to establish stable ARDS model. The mice in the control group were given phosphatebuffer saline (PBS) by gavage, 200 μL per mouse; while the mice in the 6 poisoning model subgroups were given PQ with varies doses of 3, 10, 30, 100, 150, 300 mg/kg respectively by gavage. The clinical manifestations were observed for 7 days, and the ratio of lung wet/dry (W/D) was measured. After the suitable concentration of PQ for stable ARDS mice model was found, the other 36 mice were randomly divided into the controlgroup and the poisoning model group, both were divided into 4 subgroups, according to different observation point in time (1 day and 2, 3, 4 days after PQ gavage). The mice in the 4 control subgroups (n=3) were given PBS by gavage, 200 μL per mouse; while the mice in the 4 poisoning model subgroups (n=6) were given PQ with the suitable concentration for ARDS mice model by gavage. Pathological manifestations by Haematoxylin-Eosin staining and lung injury score were observed and analyzed.ResultsThe mice began to die at the PQ dosage of 150 mg/kg; while the death rate was stable at 300 mg/kg. On the 2nd and 4th day after PQ gavage, lung W/D was 5.335, 6.113, and 5.525, and 6.403, respectively in the mice in 150 and 300 mg/kg subgroup, which differed much from those in the control group (P<0.001). Congestion, edema, hemorrhage, alveolar structure damage, inflammation cells infiltration of lung tissue were observed, and lung injury score increased.ConclusionPQ-induced ARDS mice model by gavage is established successfully.
Objective To explore the feasibility of recombinant adeno-associated virus (rAAV) as a vector for the gene therapy of liver cancer. Methods The rAAV/enhance green fluorescein protein (EGFP) recombinant was prepared by the routine method of two plasmids cotransfection.Results The experiment showed that one 10cm plate could produce 107-108 infection unit recombinant by the method of two plasmids cotransfection, and the transduction of HepG2 cell was increased with the increase of infection dosage of rAAV. About 100 multiplicity of infection (MOI) AAV vector could make all the tumor cell light. Conclusion Liver cancer cell can be efficiently transduced by rAAV, and AAV vector may be a valuable vector for the gene therapy of liver cancer.
目的 探讨多层螺旋CT血管造影（CTA）在主动脉夹层中的诊断价值及临床应用。 方法 回顾性分析2010年2月－2011年4月35例行CTA检查的主动脉夹层患者，所有患者原始数据在图像后处理工作站采用多平面重建、容积再重建、最大密度投影等方法进行主动脉成像。由2名有经验的放射科副主任医师进行诊断。 结果 35例均可明确显示主动脉夹层的真假腔、内膜片及破裂口部位。Ⅰ型12例，Ⅱ型3例，Ⅲ型20例；累及左锁骨下动脉5例，左颈总动脉2例，无名动脉2例，腹腔干3例，肠系膜上动脉4例，左肾动脉3例，右肾动脉2例，右髂总动脉受累6例，左髂总动脉受累8例，其中双侧髂总动脉均受累4例；合并动脉瘤3例；壁内血肿4例；所有患者均显示了单一或多发破口。 结论 CTA及图像后处理技术能快速、准确地诊断主动脉夹层，为临床治疗方案选择提供重要的影像学依据。
ObjectivesTo explore the efficacy and prognostic factors of neuroendoscopic intracerebral hematoma evacuation in the treatment of hypertension-related intracerebral hemorrhage.MethodsA total of 122 patients with hypertension-related intracerebral hemorrhage treated in our hospital from October 2015 to May 2019 were categorized into experimental group (n=62) and control group (n=60). The experimental group was treated with endoscopic intracerebral hematoma removal, while the control group was treated with traditional craniotomy. The operative indexes, postoperative recovery, serum endothelin, IL-6, CRP levels and the incidence of postoperative complications were observed and compared between the two groups, and the relevant factors affecting the prognosis of patients undergoing neuroendoscopic intracerebral hematoma evacuation were analyzed.ResultsThe operation time, intraoperative blood loss, hematoma clearance rate, ICU treatment time, the volume of brain edema 7 days after operation, the postoperative intracranial pressure, NIHSS score and ADL score in experimental group were significantly superior to those in control group. The levels of serum endothelin, IL-6 and CRP in the experimental group were significantly lower than those in the control group after operation. The incidence of complications in the experimental group was lower than that in control group. Univariate analysis showed that the prognosis of patients undergoing neuroendoscopic evacuation of intracerebral hematoma was significantly correlated with the history of hypertension, preoperative GCS score, the amount of bleeding and whether been broken into the ventricle (P<0.05), but not with age, sex and location of hemorrhage (P>0.05). Multivariate logistic regression analysis showed that the history of hypertension above 10 years, blood loss above 50 mL, intraventricular rupture and preoperative GCS score were the risk factors affecting the prognosis of patients undergoing neuroendoscopic intracerebral hematoma evacuation.ConclusionsCompared with traditional craniotomy, neuroendoscopic evacuation of intracerebral hematoma has the advantages of better curative effect and lower incidence of postoperative complications in the treatment of hypertension-related intracerebral hemorrhage. The history of hypertension above 10 years, bleeding volume above 50 mL, breaking into the ventricle and preoperative GCS score are the risk factors affecting the prognosis of patients undergoing neuroendoscopic intracerebral hematoma evacuation.