Objectives. To assess the effects of electroacupuncture (EA) at the Zusanli (ST36), Guanyuan (CV4), Zhongwan (CV12), and Fenglong (ST40) acupoints on sirtuin 1 (SIRT1) and glucose transporter type 4 (GLUT4) expression in high-fat diet (HFD)-induced insulin-resistant (IR) rats. Methods. Wistar rats were divided into normal control (NC), HFD, and HFD+EA groups. NC rats were fed a standard chow diet and did not receive EA. After being fed an HFD for eight weeks, rats in the HFD+EA group received EA at 2 Hz five times a week for eight weeks. Rats in the HFD group did not receive EA. Results. In HFD-induced IR rats, EA inhibited body weight increase and water intake, which were observed in HFD rats. EA had no effect on fasting blood glucose and postprandial blood sugar levels. Intraperitoneal insulin tolerance testing revealed that EA enhanced insulin sensitivity in HFD-induced IR rats. Compared with NC rats, SIRT1 and GLUT4 were downregulated in the quadriceps femoris of HFD-fed rats but were increased after eight weeks of EA stimulation. Conclusions. EA enhanced HFD-induced insulin resistance by activating SIRT1 and GLUT4 in the quadriceps femoris. These results provide powerful evidence supporting the beneficial effects of EA on HFD-induced insulin resistance.

Objective To investigate the protective effects of cold autologous blood cardioplegic solution on immature myocardium by suppressing apoptosis via P13K/ Akt signal pathway. Methods Eighty-two infants with cyanotic congenital heart disease underwent cardiac surgery were randomly divided into cold non-autologous blood cardioplegic solution group( group A,33 cases)and cold autologous blood cardioplegic solution group(group B,49 cases),took heart right ear organization before the aortic cross-clamping and 30 minute after the aortic cross-clamping,phosphorylated Akt (P-Akt)and the Bcl-2,Bax protein in myocardial tissue was detected by the immunohistochemistry method,and the Bax / Bcl-2 ratio was calculated. The clinic parameters including the left ventricular Tei index,the cardiac index(CI),LVEF and positive inotropic drug dependence after two hours of cardiac operation,rate of cardiac arrhythmia after 24 hours of cardiac operation. Results The levels of P-Akt, Bcl-2,Bax protein and the Bax / Bcl-2 ratio before the aortic cross-clamping had no significant different (P ﹥ 0. 05),the levels of P-Akt,Bcl-2,Bax protein and the Bax / Bcl-2 ratio were elevated significantly (P ﹤ 0. 05)in the two groups 30 minute after the aortic cross-clamping. Bcl-2 protein levels in group B was higher than that in group A(P ﹤ 0. 05),Bax protein and the Bax / Bcl-2 ratio in group B were lower than those in group A(P ﹤ 0. 05). The left ventricular Tei index,CI,LVEF and positive inotropic drug dependence after two hours of cardiac operation,rate of cardiac arrhythmia after 24 hours of cardiac operation in the two groups had significant differences(P ﹤ 0. 05),and group B was significantly better than that of group A(P ﹤ 0. 05). There were negative correlation of P-Akt in myocardial tissue with the Bax / Bcl-2 ratio,left ventricular Tei index(P ﹤ 0. 05),P-Akt in myocardial tissue had positive correlation with the LVEF and CI(P ﹤ 0. 05). Conclusions Compared with cold non-autologous blood cardioplegic solution,cold autologous blood cardioplegic solution can promote myocardial P-Akt protein expression, reduce myocardial cell apoptosis,and has better protective effects for immature myocardium.

Objective To study the changes and significance of the frequencies of circulating follicular helper T cells (cTfh) and circulating regulatory follicular T cells (cTfr) as well as the cTfh/cTfr ratio in neuromyelitis optica spectrum disorder (NMOSD).Methods The frequencies of cTfh,cTfr and B cells in patients with NMOSD and health controls(HCs) were measured by flow cytometry.Enzyme-linked immunosorbent assay was used to detect the level of IL-21 and AQP4-Ab in patients and HCs.Results The frequencies of cTfh and B cells,the cTfh/cTfr ratio and the plasma level of IL-21 werc significantly higher in the relapsing patients than those in the remitting patients and HCs(P ＜ 0.05),and the cTfr level in the relapsing patients was lower than that in the remitting patients and healthy population (P ＜ 0.05).But no statistical differences were observed in the above indexes between the remitting paticnts and HCs.There was also no significant difference in AQP4-Ab level between the patients with relapse and remission (P ＞ 0.05).The frequency of cTfh in the patients wasc positively correlated with the level of B cells and IL-21(P ＜ 0.05),and the frequency of cTfr was negatively correlated with B cells and IL-21 (P ＜ 0.05).The ratio of cTfh/cTfr was positively correlated with B cell frequency and IL-21 level (P ＜ 0.05).AQP4-Ab level had no correlation with the frequencies of cTfh cells and B cells,cTfh/cTfr ratio and IL-21 concentration (P ＞ 0.05).Conclusion The changes in the frequencies of cTfh and cTfr as well as the imbalanced cTfh/cTfr ratio may promote the activation of humoral immunein NMOSD and participate in the pathogenesis of this disease.

OBJECTIVE:To preliminarily investigate the relationship between serum apelin level and pulmonary artery pressure in children with congenital heart disease.METHODS:One hundred and twenty-six children with congenital heart disease undergoing surgical treatment were enrolled as subjects. The serum level of apelin was determined before surgery and at 7 days after surgery. The ratio of pulmonary artery systolic pressure to aortic systolic pressure (Pp/Ps) was calculated before extracorporeal circulation. According to the Pp/Ps value, patients were classified into non-pulmonary arterial hypertension (PAH) group, mild PAH group, moderate PAH group, and severe PAH group. Pulmonary artery mean pressure was estimated by echocardiography at 7 days after surgery.RESULTS:The non-PAH group had the highest serum level of apelin before and after surgery, followed by the mild PAH group, moderate PAH group, and severe PAH group (P<0.05). All groups had significantly increased serum levels of apelin at 7 days after surgery (P<0.05). The serum level of apelin was negatively correlated with pulmonary artery pressure before surgery (r=-0.51, P<0.05) and at 7 days after surgery (r=-0.54, P<0.05).CONCLUSIONS:The decrease in serum apelin level is associated with the development of pulmonary hypertension in children with congenital heart disease. The significance of serum apelin in predicting the development and degree of pulmonary hypertension in children with congenital heart disease deserves further studies.

Objective To analyze the clinical and imaging features of serum NMO-IgG-positive and NMO-IgG-negative Chinese patients with neuromyelitis optica spectrum disorders (NMOSDs) based on the 2015 version of diagnostic criteria. Methods Retrospective analyses of clinical and imaging data were held on 96 patients with NMOSDs (64 NMO-IgG-positive patients and 32 NMO-IgG-negative patients) who were admitted to Tangdu Hospital of the Fourth Military Medical University from January 2013 to December 2015. Results Gender ratio, age, age of onset, duration and annual relapse rate between NMO-IgG-positive and NMO-IgG-negative patients were of no significant difference. Symptoms of spinal cord involvement were most common during the first attack, with incidence rate of 48.44% (31/64) and 56.25% (18/32), respectively, for NMO-IgG-positive and NMO-IgG-negative patients, while limb numbness was most frequent. Among the first-episode optic nerve symptoms, unilateral visual loss was more common in NMO-IgG-positive patients (12/16) and bilateral visual loss was more frequent in NMO-IgG-negative patients (6/9). Intractable hiccups and vomiting suggestive of area postrema involvement was more common in NMO-IgG-positive group than that in NMO-IgG-negative group (11/18 vs 2/7), but the difference between 2 groups was not significant (P = 0.087, 0.202). The first-episode lesions of spinal cord were most frequently located in the cervical cord in both groups [41.67% (15/36) vs 11/17]. The incidence rates of both cervicothoracic cord lesions [41.67% (15/36) vs 1/17] and spinal cord lesions ≥ 7 vertebral segments [36.11% (13/36) vs 1/17] were significantly higher in NMO-IgG-positive group than those in NMO-IgG-negative group (P = 0.008, 0.022). The occurrence rates of intracranial lesions [90.63% (29/32) vs 14/17] and contiguous lesions involving medulla and cervical cord (6/11 vs 1/2) between 2 groups had no significant difference (P = 0.702, 1.000). During the disease course, there were no significant differences in the incidence of spinal cord [84.38% (54/64) vs 84.38% (27/32)], contiguous lesions involving medulla and cervical cord (9/19 vs 3/6) and intracranial lesions [86.54% (45/52) vs 83.33% (25/30)] between 2 groups (P = 1.000, 1.000, 0.934). Conclusions Analysis of clinical and imaging features between NMO-IgG-positive and NMO-IgG-negative Chinese patients with NMOSDs according to the 2015 version of diagnostic criteria is helpful to further improve diagnostic level of the disease. DOI: 10.3969/j.issn.1672-6731.2016.09.007

针对基建、农网改造升级和应对突发灾害等遇到的新情况、新问题,分析青海省电力公司物资需求历史数据,建立物资需求预测模型,以项目类型、电压等级、需求时间、范围等维度预测物资需求分布,为集中批量采购、协议库存计划等提供科学依据与数据支撑.

OBJECTIVE:To study the protective effect of cold autologous blood cardioplegic solution on the heart of infants with cyanotic congenital heart disease (CCHD).METHODS:Ninety-six infants with CCHD who underwent cardiopulmonary bypass (CPB) were randomly and equally divided into three groups: histidine-tryptophan-ketoglutarate (HTK) solution, cold non-autologous blood cardioplegic solution, and cold autologous blood cardioplegic solution. The right auricular tissues were taken before aortic cross-clamping and at 30 minutes after aortic declamping, and ATP level and energy charge (EC) in the myocardium were measured. Venous blood was collected before and immediately after CPB, and the serum levels of creatine kinase (CK)-MB and cardiac troponin I (cTnI) were measured. The clinical parameters, such as the re-beat time and re-beat rate during CPB, cardiac index, dependence on positive inotropic agents, and left ventricular ejection fraction (LVEF) at 2 hours after CPB, the incidence rate of arrhythmia within 24 hours after CPB, and postoperative complications and mortality, were recorded.RESULTS:At 30 minutes after aortic declamping, the three groups showed significantly decreased ATP and EC levels (P<0.05), and the cold autologous blood group had significantly higher ATP and EC levels than the other two groups (P<0.05). Immediately after CPB, the three groups showed significantly increased serum levels of CK-MB and cTnI (P<0.05), and the cold autologous blood group had significantly lower serum levels of CK-MB and cTnI than the other two groups (P<0.05). The cold autologous blood group had significantly better outcomes than the other two groups in terms of the re-beat time during CPB and the dependence on positive inotropic agents and LVEF at 2 hours after CPB (P<0.05).CONCLUSIONS:Cold autologous blood cardioplegic solution is superior to HTK and cold non-autologous blood cardioplegic solutions in preserving myocardial energy and reducing myocardial injury in infants with CCHD who undergo CPB, thus providing a better protective effect on the heart.

Through the one-dimensional physical simulation combining with the actual production material,to carry out different conditions for one-dimensional constant reservoir speed water flooding experiments comparing different reservoir conditions,oil-water relative permeability curves,characteristic points,analysis of relative permeability curves,irreducible water saturation,residual oil saturation and water phase changes of the endpoint values,the results show that:(1) for heavy oil reservoirs,with different viscosity the relative permeability curve form a slightly different,but the overall performance for oil phase high relative permeability,water phase relative permeability is very low(water phase relative permeability endpoint value most below 0.1),and other seepage on the right point,the characteristics of small area of permeability;(2) for low permeability reservoirs,and the overall performance for binding water saturation and residual oil saturation is very high,and permeability of narrow area,oil phase relative permeability down sharply,water phase relative permeability of high.Through the relative permeability curve can judge the characteristics of qualitative reservoir property,to provide reasonable measures for the site construction guidance.

750kV Guandong Ⅰ line of Xibei 750kV transmission pilot project continues to adopting new technology into the daily operation and management of the transmission line,and plays an important role in long-term safe and stable operation for the demonstration project,sets the foundation for the status maintenance of the future 750kV transmission line.

在三塘湖油田牛圈湖区决N2吞吐的试验中,为研究注采参数对产量、采收率的影响,对各个参数进行优化配比,选取正交表L25(56),采用正交试验并进行方差分析,考察周期注入量、井底流压、注入压力、注气速度、采液速度和焖井时间6个因素对吞吐效果的影响.结果表明,井底流压的极差值最大,影响最大,其余依次是注气压力、周期注气量、注入速度、采液速度、焖井时间.

OBJECTIVE:To sum up one-stage complete correction of infantile aortic coarctation (CoA) or interrupted aortic arch (IAA) associated with intracardiac anomalies through median sternotomy.METHODS:The clinical data of 52 infants with CoA or IAA associated with intracardiac anomalies from May 2004 to March 2010 was analyzed. There were 32 male and 20 female, aged from 25 d to 7 months with a mean of (2.03 ± 0.15) months, weighted from 2.5 to 8.0 kg with a mean of (3.9 ± 0.5) kg. All of intracardiac defect were corrected by self-arcula cordisand. Forty cases with CoA were underwent by operative techniques, including resection with end to side anastomosis, extended end to side anastomosis (n = 34), and vertical incision and cross joint (n = 3). Three cases of pseudo-CoA were cut and ductus arteriosus or ligamentum arteriosus and dissected arch. Twelve cases of IAA were underwent by extended end to side anastomosis.RESULTS:The time of cardiopulmonary bypass was (98 ± 41) min, and all patients hemorrhaged (78 ± 13) ml during operation. One case of IAA associated with double outlet right ventricle died after 43 d post-operation because of left bronchial stenosis. The other patients were in good condition. The rate of aneurysm formation was 11% in 1 to 6 years' follow-up.CONCLUSIONS:One-stage complete correction of infantile CoA or IAA associated with intracardiac anomalies through median sternotomy yields excellent intermediate surgical results. This operative approach is beneficial, not only with shorten period of therapy and loss operative cost.

AIM: To investigate the effects of open lung ventilation on the haemodynamics and respiratory mechanics in infants with acute lung injury(ALI) after cardiopulmonary bypass(CPB).METHODS: Sixty-four infants with ALI undergoing open-heart surgery were randomized into Group A of no-lung recruitment maneuver(N-LRM),with only low tidal volume,and Group B of lung recruitment maneuver(LRM),with low tidal volume and lung recruitment maneuver remedy.RESULTS: The oxygenation was remarkably improved after LRM in group B.PaO2 in Group B was significantly higher than that in group A [(284±19) mmHg vs.(78±18) mmHg,P 0.01] and the respiratory mechanics in group B was superior to those in group A.No significant difference was observed in the haemodynamics between the two groups.CONCLUSION: LRM improves the oxygenation and the respiratory mechanics but has no obvious side effect on haemodynamics in infants with ALI after cardiopulmonary bypass.

Objective To investigate the effects and mechanisms of intensive insulin therapy on inflammatory mediators in the patients underwent heart valve replacement surgery with cardiopulmonary bypass(CPB).Methods 40 non-diabetic in-patients underwent valve replacement surgery were randomly assigned to the control group and the intensive insulin therapy group(IT group).Perioperative plasma cytokine levels were monitored.Results Compared to the control group,the IT group showed a smaller rise in plasma TNF-α,IL-1β,IL-6 levels and a more pronounced rise in IL-10 levels after initiation of CPB.After surgery,in the IT group,the time of artificial ventilation and postoperative length of stay in the hospital were markedly shortened.However,there were no significant differences in mortality and the nosocomial deep sternal wound infection rate between the IT and control groups.Conclusion Intensive insulin therapy could significantly attenuate the systemic inflammatory response,improve the prognosis,but can not reduce the in-hospital mortality.

BACKGROUND:Cardiopulmonary bypass may cause serious impairment of lung function. It has been reported that administration of mucosolvin can prevent acute respiratory insufficiency through the improvement of pulmonary surfactant.OBJECTIVES:This study aimed to explore the effects of high-dose mucosolvin on infant lungs following cardiopulmonary bypass.METHODS:One hundred infants were randomly divided into 2 groups. In Group 1, patients did not receive any respiratory drug perioperatively and underwent conventional mechanical ventilation postoperatively. In Group 2, patients were administered mucosolvin (15 mg/kg per day) perioperatively, and doxofylline (15 mg/kg per day) and ipratropium bromide solution (200 μg) were administrated postoperatively. Mechanical ventilation parameters, pulmonary surfactant-related protein (SP-B), and cytokines were evaluated after induction of anesthesia and 30 minutes, 24 hours, and 48 hours after CPB.RESULTS:At the end of CPB, all PaO2/FiO2 values in Group 2 were higher than those in Group 1. Postoperative SP-B levels in Group 1 decreased significantly compared to the baseline value (P < .05). There was no significant difference in hospitalization time between both groups, but both mechanical ventilation time and intensive care unit time of infants in Group 2 were significantly shorter than those in group 1 (P < .05).CONCLUSIONS:These findings indicate that high-dose mucosolvin has certain protective effects on respiratory functions in infants undergoing heart operations with CPB and that it that has no adverse effects.

OBJECTIVE To explore the effect of high-dose mucosolvin on infant lungs following extracorporeal circulation(ECC).METHODS Infants underwent cardiosurgery during March 2009 to June 2010 corresponding with the research condition were randomly divided into two groups: group 1 and group 2(50 cases in each group).The mean age and mean weight were(5.23±0.33) months and(5.38±0.62) kg in group 1,and(5.51±0.43) months and(5.26±0.22) kg in group 2 respectively.In group 1,patients did not receive any respiratory drug perioperatively and underwent conventional mechanical ventilation postoperatively.In group 2,mucosolvin(15 mg/(kg·d)) was administered perioperatively,and doxofylline(15 mg/(kg·d),5d) and pratropium bromide solution(200 μg,5d) were administrated postoperatively.Fix the same surgeon,anesthetist,perfusionist,custodial care and the nurse.Mechanical ventilation parameters,pulmonary surfactant-related protein(SP-B) and cytokines were evaluated after induction of anesthesia,and 30 minutes,24 hours and 48 hours after ECC.The differences of mechanical ventilation time,intensive care unit time and hospitalization time between two groups were also compared.RESULTS At the end of ECC,all PaO2/FiO2 values in group 2 were higher than those in group 1(P<0.01).Postoperative SP-B levels in group 1 decreased significantly compared to the baseline value(P<0.05).There was no significant difference in hospitalization time between both groups,but both mechanical ventilation time and intensive care unit time of infants in group 2 were significantly shorter than those in group 1(P<0.05).CONCLUSION These findings indicate that high-dose mucosolvin possesses certain protective effects on respiratory functions in infant underwent heart operations with ECC.

Objective To observe the effects of intensive insulin therapy on postoperative infection in patients undergoing valve replacement(VR)under cardiopulmonary bypass,and to summarize the nursing care experience of intensive insulin therapy.Methods A total of 414 non-diabetic patients recently undergoing VR were assigned to intensive therapy(IT)group,in which intensive insulin therapy was initiated from the beginning of VR,and the target blood glucose level was maintained at 5.0~8.3 mmol/L intraoperatively and at 3.9~6.1 mmol/L postoperatively.Other 325 nondiabetic patients receiving VR were assigned to routine therapy group(RT),in which blood glucose level was maintained at 10.0~11.1 mmol/L.The postoperative infection,the time on ventilator,days of postoperative hospital and mortality were compared.Results A total of 739 nondiabetic patients were enrolled into the present study.There were no significant differences between baseline measures of the two groups.Compared with RT group,the postoperative blood,respiratory and incision infection rates were decreased in IT group.The time on ventilator and days of postoperative hospital were shortened,and the mortality was significantly decreased as well(P<0.05).Conclusion Perioperative intensive insulin therapy may significantly decrease the postoperative infection rate and improve prognosis.The key points for successful implementation of intensive insulin therapy by nurses include the correct implementation of intensive insulin therapy protocol,punctual monitoring of blood glucose levels,and the recognition of complications such as hypoglycemia.

Objective:By the effects of taurine on plasma procalcitonin after cardiopulmonary bypass in infants with congenital heart disease,to evaluate the significance of taurine reduce the level of systemic in flammatory response syndrome.Methods:Sixty infants with congenital heart disease undergoing cardiac surgery were divided into control group(group C,n=30) and taurine group(group T,n=30) in which patients received 15.5 mg/(kg·d) of taurine was given before operation,plasma procalcitonin in venous blood were measured at the time of before operation,the time of operation termination,12,24,48 and 72 hours after operation.Results:Plasma procalcitonin increased in the two groups,the comparison of within groups at 12 hours after operation reach statistical significance.C group 's plasma procalcitonin was higher than those in group T at 12 hours after operation(P0.05).T group and C group,the incidence of systemic in flammatory response syndrome were 13.33% and 16.67% respectively.Conclusion:Taurine is beneficial for procalcitonin to improve the excessive release induced by cardiopulmonary bypass and to reduce the incidence of systemic in flammatory response syndrome,

Objective:To assess the incidence of optic neuritis in mice with experimental autoimmune encephalomyelitis(EAE) and to explore the possibility for establishing a mouse model of experimental optic neuritis.Methods:Twelve C57BL/6 mice were immunized with myelin oligodendroglia glycoprotein(MOG) 35-55 peptide emulsified in complete Freund's adjuvant(CFA) together with two i.p.injections of pertussis bacillus to induce EAE.During the peak of clinical symptoms,the mice were sacrificed;the incidence of optic neuritis and its pathological changes were examined.Results:The mice in the model group began to develop clinical signs of EAE on day 12 after immunization and reached the peak through day 17 to day 19 after immunization,with the incidence of 83.3%(10/12).No clinical symptoms were observed in the control group.By hematoxylin/eosin(HE) staining,a large number of inflammatory cells were present in the optic nerve tissues from the model group.The incidence of optic neuritis was 83.3%(5/6) and the scoring of inflammatory cell infiltration was 2.1 ± 0.8 for model group,with the differences between the both groups reaching the significance.By Luxol fast blue(LFB) staining,a severe demyelination occurred in optic nerve tissues of model group,where inflammatory cell infiltration was observed.In contrast,no obvious pathological changes were seen in control group.Conclusions:It is feasible to establish a mouse model of optic neuritis on a basis of EAE,which provide an ideal platform for further investigation of pathogenesis in optic neuritis.

In the production of low-permeability sandstone reservoir,as effective stress rises gradually,the stress sensitivity will be appear,which causes permeability to decline.In considering in-situ stress of reservoir,cores,taken from Tarim Oilfield,were studied.The results showed that the stress sensitivity of the block was very strong,and its variation is consistent with exponential relationship.In the same block,permeability restoration of the cores with higher permeability was lower when the confined pressure changed.In addition,the experiments of the four cores from four different blocks,which were saturated with water,showed that after saturation,the permeability of the cores declined rapidly and that of the ones with higher permeability declined obviously.

目的:通过对比自体冷血心脏停搏液与HTK液对未成熟心肌细胞ATP含量及三磷酸腺苷酶(ATPase)活性的影响,提示自体冷血心脏停搏液对未成熟心肌细胞的保护作用.方法:年龄≤1岁行体外循环室间隔缺损修补术的患儿40例随机分为2组,实验组20例、对照组20例.主动脉阻断后,分别用自体冷血停搏液、HTK液根部灌注.于心脏停跳前、复跳后30min取右心耳标本50mg,测定心肌ATP含量及ATPase活性.运用统计学t检验的方法,得出研究结果. 结果:主动脉阻断前两组患儿心肌ATP含量(μg/mg)与Na+-K+-ATPase、Ca2+-ATPase、Ca2+-Mg2+-ATPase活性(μmol/mgoh)无统计学差异(P＞0.05);主动脉开放后30min心肌ATP含量与ATPase活性均较阻断前显著减少(P＜0.01);主动脉开放后30min两组患儿心肌ATP含量与ATPase活性有明显差异(P＜0.01);对照组主动脉开放后30min心肌ATP的损耗量明显较实验组增多(P＜0.01).结论:自体冷血停搏液可提升体外循环心内直视手术术后未成熟心肌细胞ATP含量及ATPase活性, 对未成熟心肌的心肌保护效果明显优于HTK液.