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The TFe grade of the mixed magnetic concentrate from a Liaoning iron ore processing plant is 53.92%. The main iron minerals are magnetic/hematite and the main gangue minerals are quartz. TD-II collector is used for reverse flotation in tins concentrator, but the pulp temperature Is 40 °C, winch leads to waste of resources. In order to improve the production index, a new low temperature collector DZ with multipolar base independently developed by Northeastern University Is used for reverse flotation of the mixed magnetic concentrate in thus concentrator. The effects of DZ dosage, pulp pH value, flotation temperature, starch dosage and CaO dosage on the flotation behavior of the mixed magnetic separation concentrate were investigated. For the mixed magnetic concentrate with TFe grade 53.92%, a new low temperature collector DZ was used under the conditions of flotation temperature 15 ± 2 °C, pulp pH value 9, depressant starch dosage 750 g/t, collector DZ dosage 150 g/t, and no activator was added. The flotation lockedcycle test of "one roughing, two cleanings and three scavergings" showed that a flotation concentrate with TFe grade 65.24% and iron recovery of 93.03% can be obtained, whereas under the conditions of flotation temperature 40 ± 2°C, pulp pH value 11, starch dosage 900 g/t, CaO dosage 900 g/t and collector TD-II dosage 350 g/t, a flotation concentrate with TFe grade 65.47% and iron recovery 90.71% can be obtained through the lockedcycle flotation test of "one roughing, one cleanings and three scavengings". The product inspections for the flotation concentrates obtained from the new low-temperature collector DZ and from the field reagent TD-II were carried out. By comparing the flotation results with the product inspection, t can be found that the new low-temperature collector DZ is a high-efficiency and high-selectivity low-temperature flotation collector, which can effectively solve the problem of energy waste in the reverse flotation process of the concentrator, save the beneficiation cost and improve the resource utilization efficiency. [ABSTRACT FROM AUTHOR]

: In order to investigate the effect of the process conditions on the morphology and particle size of Ag hexagonal nanoplates prepared by liquid-phase reduction method, the Ag hexagonal nanoplates were prepared by stepwise liquid phase reduction method using AgNO3 as raw material, H2O2 as oxidizing etchant, NaBH4 and AA as reducing agents, TSC as morphology inducer. We investigated the influence law of process conditions such as H2O2 and NaBH4 dosage at the stage of crystal seeding, TSC dosage at the stage of growth, and solution pH on the morphology and particle size of nanosilver, and analyzed the influence mechanism. The results showed that the production of Ag hexagonal nanoplates was more favorable when the molar ratio of H2O2/AgNO3 in the growth phase was 50 : 1, the molar ratio of NaBH4/AgNO3 was 2 : 1, the molar ratio of TSC/AgNO3 in the growth phase was 2 : 1, and the pH of the reaction solution was 8, the average edge length of Ag hexagonal nanoplates was between 40 and 60 nm. The amount of H2O2 in the crystal seeding stage was the key factor affecting the morphology of the nano-silver, with the increase of H2O2, the morphology of the nanosilver experiences a transformation from sphere to flaky, and the excess of H2O2 can make the edge of sliver nanoplate experiences an etching effect. The pH of the reaction solution during the growth phase was a key factor affecting the particle size of the nanosilver, with the increase of the pH of the reaction solution, the average particle size of the nano- silver decreases. Sodium irate can undergo selective adsorption on the surface of nanosilver, which induced anisotropic growth of nanosilver and generates a lamellar structure. [ABSTRACT FROM AUTHOR]

As a mainstream equipment in the field of "more crushing and less grinding" and selective crushing application in the mining industry, high-pressure grinding mill has been widely used in both metal and non-metal industries due to is advantages of large ore processing capacity, high crushing efficiency, and line particle size of the crushed products. This paper briefly introduces the working principle and crushing process of high pressure grinding rolls, and analyzes the application, advantages and disadvantages of three crushing processes of high pressure grinding rolls in mines combined with practical cases. The typical application of high pressure grinding rolls in mineral processing industry Is introduced, the application of new technology of high pressure grinding rolls at home and abroad Is emphatically expounded, and the application of new technology in mineral processing industry !s prospected. The process of high pressure grinding rolls combined with agitating mill/tower mill, the process of high pressure grinding rolls combined with air classifier, the process of two high pressure grinding rolls in series, the technology of two high pressure grinders in parallel and the technology of double layer vibrating screen with high pressure rolls have obvious advantages in energy saving and consumption reduction, which is expected to provide a new scheme for efficient crushing of materials. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the associations between factors in life course and physiological disorders in the middle-aged and elderly population of Zhoushan city of Zhejiang province, and the mediating roles of lifestyle and mental health., Methods: A total of 1553 island residents aged ≥45 years were enrolled from the Zhejiang Metabolic Syndrome Cohort Zhoushan Liuheng Sub-cohort. The demographic information, life-course information, lifestyle, and mental health information of participants were documented, and blood samples of were collected. The status of aging was evaluated by physiological disorders calculation model developed by authors previously. The Shapley value decomposition method was used to assess the cumulative and relative contribution of multiple factors in life course to the aging. Principal component analysis and hierarchical cluster analysis were used to classify subgroups. General linear regression model was used to assess the associations between the life-course subgroups and physiological disorders. Five key factors associated with aging were finally identified. Logistic regression model, general linear regression model, and mediation analysis model were used to assess the complex associations between life-course subgroups, key factors, unhealthy lifestyle, mental health, and aging., Results: Shapley value decomposition method indicated that eight types of life-course factors explained 6.63% ( SE =0.0008) of the individual physiological disorders variance, with the greatest relative contribution (2.78%) from adversity experiences in adulthood. The study participants were clustered into 4 subgroups, and subgroups experiencing more adversity in adulthood and having low educational attainment or experiencing more trauma and having poorer relationships in childhood had significantly higher levels of physiological disorders. Life-course subgroups and key factors (childhood trauma and health, adversity experience in adulthood, and lower education) were positively associated with unhealthy lifestyles ( β =0.12-0.41, P <0.05). In addition, life-course subgroups and key factors (adversity experience in adulthood) were positively associated with psychological problems ( OR =2.14-4.68, P <0.05). Unhealthy lifestyle scores showed a marginal significant association with physiological disorders ( β =0.03, P =0.055). However, no significant association was found between psychological problems and physiological disorders ( β= 0.03, P =0.748). The results of the mediation analysis model suggested that unhealthy lifestyles partially mediated the associations between life-course subgroups, adversity experience in adulthood and physiological disorders., Conclusions: Multiple life-course factors contribute about 6% of the variance in physiological disorders in the middle aged and elderly population of the study area; subgroups with adverse life course experiences have higher levels of aging; and the association may be partially mediated by unhealthy lifestyles.

Preimplantation genetic testing is an important part in assisted reproductive technology, which can block the intergenerational inheritance of a single gene or chromosomal diseases. Preimplantation genetic testing for polygenic disease risk (PGT-P) is one of the latest developments in the field. With the development of artificial intelligence and genetic detection technology, PGT-P can be used to analyze genetic material, calculate polygenic risk scores and convert these into incidence probability. Embryos with relatively low incidence probability can be screened for transfer, in order to reduce the possibility that the offspring suffers from the disease in the future. This has significant clinical and social significance. At present, PGT-P has been applied clinically and made phased progress at home and abroad. But as a developing technology, PGT-P still has some technical limitations as unstable results, environmental influences and racial differences cannot be ruled out. From the ethical perspective, if the screening indications are not strictly regulated, it is likely to cause new social problems. In this paper, we review the technical details and recent progress in PGT-P, and discuss the prospects of its future development, especially how to establish a complete and suitable screening model for Chinese population.

The report of death cases is an important source of information for cause analysis and monitoring of trends, which can reflect the death situation and characteristics of a population in a relatively accurate manner. It helps understand the health status of the population and the level of healthcare. The special deployment of case review for in-hospital deaths is not only the high priority for health authorities in terms of quality and safety of medical care but also a practical implementation of the concept that values people and life. Currently, there is a lack of scientific and standardized evaluation for the review of death cases in various specialties, excluding maternal and neonatal cases. To standardize the quality control and management of death cases in medical institutions, the Guidelines for quality control and management of death cases in medical institutions (2023) has been developed by the Hunan Province Resuscitation Quality Control Center. The members of the working group of this guideline visited medical institutions, conducted research, reviewed relevant guidelines from domestic and international sources, and integrated clinical experience to form a preliminary consensus. This consensus was submitted to the expert group for multiple discussions, underwent several revisions, and finally, it was sent to the experts in the form of a questionnaire for feedback. The guidelines clarify the scope, data collection, and quality control requirements for death case quality control, providing a reference for the quality control and management of death cases in medical institutions.

Temporary cardiac pacing is an essential technique in the diagnosis and treatment of arrhythmias. Due to its urgency, complexity, and uncertainty, it is necessary to develop an evidence-based emergency operation norms. Currently, there is no specific consensus guidelines at home or abroad. The Emergency Branch of Chinese Medical Association organized relevant experts to draft the Chinese emergency expert consensus on bedside temporary cardiac pacing (2023) to guide the operation and application of bedside cardiac pacing. The formulation of the consensus adopts the consensus meeting method and the evidentiary basis and recommendation grading of the Oxford Center for Evidence-based Medicine in the United States. A total of 13 recommendations were extracted from the discussion on the methods of bedside temporary cardiac pacing, the puncture site of transvenous temporary cardiac pacing, the selection of leads, the placement and placement of leads, pacemaker parameter settings, indications, complications and postoperative management. The recommended consensus includes the choice between transcutaneous and transvenous pacing, preferred venous access for temporary transvenous pacing, the target and best guidance method for implantation of bedside pacing electrodes, recommended default pacemaker settings, recommended indications for sinoatrial node dysfunction, atrioventricular block, acute myocardial infarction, cardiac arrest, ventricular and supraventricular arrhythmias. They also recommended ultrasound guidance and a shortened temporary pacing support time to reduce complications of temporary transvenous cardiac pacing, recommended bedrest, and anticoagulation after temporary transvenous pacing. Bedside temporary cardiac pacing is generally safe and effective. Accurate assessment, correct selection of the pacing mode, and timely performance of bedside temporary cardiac pacing can further improve the survival rate and prognosis of related emergency patients.

Objective: To analyze the predictors of successful weaning off extracorporeal membrane oxygenation (ECMO) after extracorporeal cardiopulmonary resuscitation (ECPR)., Methods: The clinical data of 56 patients with cardiac arrest who underwent ECPR in Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University) from July 2018 to September 2022 were retrospectively analyzed. According to whether ECMO was successfully weaning off, patients were divided into the successful weaning off group and the failed weaning off group. The basic data, duration of conventional cardiopulmonary resuscitation (CCPR, the time from cardiopulmonary resuscitation to ECMO), duration of ECMO, pulse pressure loss, complications, and the use of distal perfusion tube and intra-aortic balloon pump (IABP) were compared between the two groups. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors for weaning failure of ECMO., Results: Twenty-three patients (41.07%) were successfully weaned from ECMO. Compared with the successful weaning off group, patients in the failed weaning off group were older (years old: 46.7±15.6 vs. 37.8±16.8, P < 0.05), higher incidence of pulse pressure loss and ECMO complications [81.8% (27/33) vs. 21.7% (5/23), 84.8% (28/33) vs. 39.1% (9/23), both P < 0.01], and longer CCPR time (minutes: 72.3±19.5 vs. 54.4±24.6, P < 0.01), shorter duration of ECMO support (hours: 87.3±81.1 vs. 147.7±50.8, P < 0.01), and worse improvement in arterial blood pH and lactic acid (Lac) levels after ECPR support [pH: 7.1±0.1 vs. 7.3±0.1, Lac (mmol/L): 12.6±2.4 vs. 8.9±2.1, both P < 0.01]. There were no significant differences in the utilization rate of distal perfusion tube and IABP between the two groups. Univariate Logistic regression analysis showed that the factors affecting the weaning off ECMO of ECPR patients were pulse pressure loss, ECMO complications, arterial blood pH and Lac after installation [pulse pressure loss: odds ratio (OR) = 3.37, 95% confidence interval (95%CI) was 1.39-8.17, P = 0.007; ECMO complications: OR = 2.88, 95%CI was 1.11-7.45, P = 0.030; pH after installation: OR = 0.01, 95%CI was 0.00-0.16, P = 0.002; Lac after installation: OR = 1.21, 95%CI was 1.06-1.37, P = 0.003]. After adjusting for the effects of age, gender, ECMO complications, arterial blood pH and Lac after installation, and CCPR time, showed that pulse pressure loss was an independent predictor of weaning failure in ECPR patients (OR = 1.27, 95%CI was 1.01-1.61, P = 0.049)., Conclusions: Early loss of pulse pressure after ECPR is an independent predictor of failed weaning off ECMO in ECPR patients. Strengthening hemodynamic monitoring and management after ECPR is very important for the successful weaning off ECMO in ECPR.

In order to improve the popularity of first aid knowledge among the public, First Aid Professional Committee of China Geriatric Health Care Association has formulated the Public guide for "first aid onsite-first responders action" in China (2023). This guide aims at providing with the first eyewitness action guide that are critical but weak onsite rescue link of Chinese emergency medical service system to the public. In the first scene of injury and illness emergencies, it is very important for the first eyewitness to make a prompt and correct response in the first time. Based on best practice evidence, this guide combs the core concepts of onsite first aid in order to provide guidance and help in standardizing the popularization of public first aid knowledge and skills.

Objective: To investigate the predictive value of heparin binding protein (HBP) for sepsis., Methods: From June 2019 to December 2020, 188 patients admitted to the department of emergency of Hunan Provincial People's Hospital were enrolled. The patients were divided into non-sepsis group (87 patients) and sepsis group (101 patients) according to Sepsis-3 criteria. Gender, age, white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), HBP, sequential organ failure assessment (SOFA) score, quick SOFA (qSOFA) score, modified early warning score (MEWS) and patients' recent medication history were recorded, the differences in the above indicators between the two groups were compared. The risk factors of sepsis were analyzed by Logistic regression. Spearman correlation analysis was used to analyze the correlation between HBP, PCT, CRP and SOFA score to evaluate the predictive value of HBP, PCT and CRP for the severity of septic organ failure. Receiver operating characteristic curve (ROC curve) were drawn to evaluate the diagnostic value of HBP, PCT and CRP for sepsis., Results: Compared with the non-sepsis group, the sepsis group had significantly higher levels of HBP, PCT, CRP, WBC, SOFA score, qSOFA score, and MEWS [HBP (μg/L): 55.46 (24.57, 78.49) vs. 5.90 (5.90, 9.01), PCT (μg/L): 6.83 (1.75, 30.64) vs. 0.23 (0.12, 0.75), CRP (mg/L): 67.35 (26.23, 123.23) vs. 4.45 (2.62, 47.22), WBC (×10 9 /L): 11.84 (7.18, 16.06) vs. 6.58 (5.47, 8.99), SOFA score: 6 (4, 8) vs. 0 (0, 0), qSOFA score: 2 (1, 3) vs. 0 (0, 1), MEWS: 4 (3, 6) vs. 1 (0, 2)], the length of hospital stay was significantly prolonged [days: 10 (4, 17) vs. 0 (0, 7)], and the mortality was significantly increased [29.7% (30/101) vs. 4.6% (4/87)], with statistical significance (all P < 0.05). Correlation analysis showed that HBP, PCT and CRP were significantly positively correlated with SOFA score (r values were 0.60, 0.33, and 0.38, respectively, all P < 0.01), among which HBP had the strongest correlation, CRP was the second, and PCT was the weakest. Logistic regression analysis showed that HBP, PCT and CRP levels were independent risk factors for sepsis [odds ratio (OR) were 1.015, 1.094, 1.067, 95% confidence intervals (95%CI) were 1.007-1.022, 1.041-1.150, 1.043-1.093, all P < 0.01]. ROC curve analysis showed that HBP, PCT and CRP all had some diagnostic value for sepsis [the area under ROC curve (AUC) were 0.92, 0.87, 0.80, 95%CI were 0.88-0.97, 0.82-0.92, 0.74-0.87, respectively, all P < 0.01]. Among them, the diagnostic efficacy of HBP was higher when the cut-off value was ≥ 15.11 μg/L, its sensitivity and specificity were 86.14% and 89.66%, respectively, which were higher than the sensitivity (81.19%) and specificity (80.46%) when the PCT cut-off value was ≥ 1.17 μg/L. However, CRP had the best sensitivity of 94.06% for the diagnosis of sepsis but lacked of specificity (63.22%)., Conclusions: HBP can be used as a biological indicator for predicting sepsis and can assess the severity of organ failure in septic patients.

With the development of society and economy, people's requirements for emergency rescue technology and emergency services are gradually increasing. Building and improving the emergency of critical care system is an important issue currently facing. Controlling medical injuries is the goal of medical development. At present, people's requirements for first aid measures have shown a trend from invasive to minimally invasive even non-invasive. It is a new requirement for emergency medicine in the new era to establish a minimally invasive emergency system and apply the minimally invasive technology in the first-aid and critical care area, to help the patients with acute and critical illness overcome difficulties, improve outcome, and enhance the quality of life.

Objective: To investigate the people's cardiopulmonary resuscitation (CPR) ability in Hunan Province and whether there are differences in the skill level of CPR among respondents of different ages and education levels., Methods: A self-made questionnaire was conducted to survey people in Hunan Province by means of WeChat from May 2018 to April 2019. The questionnaire referred to 2016 National consensus on cardiopulmonary resuscitation in China issued by Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association and 2017 version of American Heart Association (AHA) CPR operational guide, and combined with the CPR assessment scale of Hunan Provincial People's Hospital. The contents of the survey included the basic information of the subjects, the common knowledge and skills of first aid, the willingness to learn CPR skills and implement CPR, and the operational requirements of high quality CPR, etc., Results: A total of 6 563 people received the on-site first aid knowledge questionnaire, and 4 355 people completed and submitted the questionnaire. The recovery rate was 66.36%, of which 3 602 valid questionnaires were from IP in Hunan Province, and the qualified rate was 82.71%. Among the subjects, 1 532 were men (42.53%) and 2 070 were women (57.47%). The majority aged group from 19 to 30 (59.41%) and from 31 to 50 (36.70%). 307 were rural (8.52%) and 3 295 were urban (91.48%); and the majority levels of education were senior or technical secondary school (38.26%) and undergraduate or junior college (44.50%). Of the 3 602 respondents, 39.09% indicated that they had been exposed to CPR knowledge and only 0.36% indicated that they did not wish to participate in CPR training. 69.93% of the respondents said they would actively to help if they wet cardic arrest, and 97.92% of those were willing to do so if the patients were relatives or friends. The survey results showed that only 8.91% of respondents chose relatively high-quality CPR options (chest compressions were performed first, the pressing point was located in the sternum of the midpoint of bilateral nipple line, the pressing frequency was 100-120 times/min, pressing depth was 5-6 cm, the ratio of chest compression to artificial ventilation was 30:2). Among these people, the correct rate was higher in the ages of 31-50 years old and ≤ 18, 19-30 than those ≥ 51 years old (12.71% vs. 0%, 6.87%, 8.70%, χ 2 = 41.420, P < 0.01). The correct rate of education at graduate level and above was higher than those in junior middle school and below, high school or technical secondary school, undergraduate or junior college (19.57% vs. 2.07%, 3.41%, 13.72%, χ 2 = 152.262, P < 0.01)., Conclusions: The public in Hunan Province have a strong sense of first aid, and some of the theoretical knowledge of CPR. People between 31 years old and 50 years old of age and with graduate education and above know more about CPR, but the overall mastery of CPR skills is poor. It is necessary to further improve the ability of the public as the first witness by teaching various skills of CPR in various forms.

Acute myocardial infarction with cardiogenic shock (AMI-CS) refers to the rapid decrease in cardiac output in a short period of time, and it leads to severe insufficient perfusion of various organs and causes systemic microcirculatory dysfunction, which is the most common cause of the death of patients with acute myocardial infarction (AMI). At present, the main strategy for clinical treatment of AMI-CS is revascularization, which reduces the mortality of AMI-CS. However, myocardial ischemia and reperfusion can cause ischemia/reperfusion (I/R) injury, induce myocardial mitochondrial dysfunction, and a large amount of reactive oxygen species (ROS) accumulation. Mitochondrial-mediated apoptosis of cardiomyocytes is the main reason of cardiomyocyte death during reperfusion injury. This article summarizes the role of mitochondrial in AMI-CS, which focus on three aspects of mitochondrial permeability transition pore (mPTP) opening, mitochondrial autophagy and mitochondrial fusion/division. It is expected to provide new ideas for clinical AMI-CS and identify potential complications targets.

Objective: To improve the popularization of the knowledge of the first responders and promote the establishment of the awareness of the first aid, First Aid Professional Committee of Chinese Aging Well Association formulated the Expert consensus on the first responder of the first aid. This consensus aims at the critical and weak link of emergency medical service system (EMSS) in China, providing the public with the first responders action guidance, and guiding the public how to effectively rescue the "first scene", "first time" and "first responder" in the event of sudden injury or illness. Strengthen risk pre-control, environmental control and overall joint control in the "first scene" of different emergencies were emphasized. How to correctly judge, recognize, call for help and give first aid in the "first time" were presented. The first aid skills of the "first responder" should include cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) defibrillation, Heimlich (abdominal impingement), hemostasis, dressing, fixation, and handling. The best place, the best training method and the best communication way to popularize the first aid knowledge and skills were proposed, and the first responder action plan was jointly promoted from various social levels such as policy, law, science and technology, culture and so on. This consensus refers to relevant foreign guidelines and scientific basis and combines with Chinese actual national conditions to provide guidance for the first responders' action and training, aiming to promote the development of first aid in China.

As a member of galectins family, galectin-1(Gal-1)is widely expressed in tissues and cells, and participates in a variety of physiological and pathological processes, such as cell adhesion, proliferation, apoptosis and inflammatory reaction. Recently, it has been found that Gal-1 is highly expressed at the maternal-fetal interface and plays important roles in trophoblast cell proliferation, differentiation and invasion, endometrial receptivity, placental angiogenesis and maternal-fetal immune tolerance. In this review, we outline the expression of Gal-1 at the maternal-fetal interface and the involvement of Gal-1 in embryo implantation and pregnancy maintenance, to provide novel insights for the early diagnosis, prognostic assessment and treatment of early pregnancy loss and pregnancy-related diseases.

Gonadotropin-releasing hormone (GnRH) plays an important role in the process of reproduction. Studies have shown that a family of peptides Kisspeptin can act on GnRH-related neurons, stimulating the secretion of GnRH, and activating the hypothalamic-pituitary-gonadal axis. Both animal experiments and clinical studies have shown that exogenous administration of Kisspeptin is able to induce physiological GnRH release in healthy individuals and those with endocrine-disorders, which brings great hope for treatment of reproductive endocrine diseases. The effect of Kisspeptin is similar to the physiological process in induction of ovulation and ovum maturation, leading to high security and efficiency for women receiving in vitro fertilization. Kisspeptin is involved in trophoblast invasion, so it may be useful for predicting pregnancy outcomes. In addition, Kisspeptin is the key hormone in the onset of puberty acting as a signal transducer in metabolism and reproduction, so it provides some directions for studies of polycystic ovary syndrome, hyperprolactinemia, and other metabolic-related reproductive endocrine diseases. This article reviews the character of Kisspeptin and the prospect of its application in treatment of reproductive endocrine diseases.

Objective: To reveal the pathophysiological changes of sepsis, the plasma metabonomics of septic rats was determined and differential metabolites were determined by gas chromatography-mass spectrometry (GC-MS)., Methods: Male Spraguee-Dawley (SD) rats about 8 weeks were randomly divided into sham group (n = 18) and sepsis group (n = 24). Cecal ligation and puncture (CLP) was used to build sepsis model, while cecum was kept intact only in the sham group. 6 hours after the operation, rats were anesthetized, and blood was harvested through heart thoracotomy. Then the plasma metabonomics was detected by GC-MS and metabolic profile analysis was performed to find the relative differential metabolites., Results: Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) showed that the metabolic profiling of the sepsis group was significantly different from the sham group. 259 kinds of metabolites were got by GC-MS, and 69 kinds of differential metabolites were found between sham group and sepsis group, in which 23 differential metabolites were related to amino acid metabolism. Compared with sham group, the contents of putrescine, N-glutamic acid, hydroxynorvaline, 3-cyanuric acid, D-alanyl-D-alanine and urea in the plasma of septic rats increased significantly, which ratios of sepsis/sham group were 10.876, 6.394, 2.800, 2.226, 1.323, 1.203, respectively (all P < 0.05). On the other hand, the contents of oxygen generation of proline, citrulline, glutamine, su-beta-hydroxy aspartic acid, citric acid, N-methyl-DL-alanine, serine, lysine, threonine, N-formyl-L-methionine, methionine, alanine, nicotinuric acid, N-methyl-L-glutamic acid, trans-4-hydroxy-L-proline, proline, L-glutamic acid in the plasma of septic rats decreased significantly, which ratios of sepsis/sham group were 0.858, 0.853, 0.834, 0.816, 0.816, 0.814, 0.813, 0.801, 0.793, 0.792, 0.774, 0.766, 0.748, 0.727, 0.716, 0.674, 0.603, respectively (all P < 0.05)., Conclusions: Through the GC-MS analysis of plasma metabonomics of septic rats, we found abnormal energy metabolism changes. The content of amino acid in plasma might be a method to evaluate the energy metabolism status of sepsis.

Objective: To investigate the curative effect of bronchoalveolar lavage with fiberoptic bronchoscopy combined with vibration sputum drainage in the treatment of severe pneumonia patients undergoing mechanical ventilation (MV)., Methods: A prospective randomized controlled trial was conducted. 286 severe pneumonia patients undergoing MV admitted to intensive care unit (ICU) of Hunan People's Hospital from January 2014 to July 2016 were enrolled, and they were divided into control group and observation group according to random number table, with 143 patients in each group. Patients in both groups received sensitive antibiotics for anti-infection, etiological treatment, and calefacient and humidifying treatment. The patients in the control group received bronchoalveolar lavage with fiberoptic bronchoscopy, and those in the observation group received bronchoalveolar lavage combined with vibration sputum drainage. The parameters of respiratory function and inflammation before and after treatment, curative effect, and prognosis were compared between the two groups., Results: (1) There were no significant differences in respiratory function parameters between the two groups before treatment, 2 hours after treatment, the parameters were improved in both groups. Moreover, oxygenation index (PaO 2 /FiO 2 ) in observation group was significantly higher than that of control group [mmHg (1 mmHg = 0.133 kPa): 379.1±20.2 vs. 351.8±24.7], and arterial partial pressure of carbon dioxide (PaCO 2 ) and airway resistance (Raw) were significantly lower than those of the control group [PaCO 2 (mmHg): 36.5±5.8 vs. 45.3±6.9, Raw (cmH 2 O, 1 cmH 2 O = 0.098 kPa): 12.9±0.6 vs. 13.1±0.8, all P < 0.01]. (2) There were no significant differences in inflammation parameters between the two groups before treatment, 24 hours after intervention, which were significantly decreased in both groups. Moreover, white blood cell count (WBC), procalcitonin (PCT) and C-reactive protein (CRP) in the observation group were significantly lower than those of the control group [WBC (×10 9 /L): 8.2±1.7 vs. 12.8±3.7, PCT (μg/L): 15.4±2.4 vs. 21.8±3.1, CRP (mg/L): 37.1±6.1 vs. 67.2±7.2, all P < 0.01]. (3) Compared with the control group, the treatment efficiency of observation group was improved [95.1% (136/143) vs. 87.4% (125/143)], the quantity of sputum excretion was increased (mL: 49.2±12.5 vs. 36.9±11.0), duration of MV and length of ICU stay were significantly shortened (days: 6.4±3.6 vs. 9.4±2.1, 8.6±5.7 vs. 12.4±4.6, both P < 0.01), however, there was no significantly statistical difference in 28-day mortality between control group and observation group [2.8% (4/143) vs. 2.1% (3/143), P > 0.05]., Conclusions: Compared with bronchoalveolar lavage with fiberoptic bronchoscopy alone, the treatment of bronchoalveolar lavage combined with vibration sputum drainage is more effective in sputum excretion for severe pneumonia patients undergoing MV, which could improve the respiratory function, reduce infection, shorten the duration of MV and the length of ICU stay, and improve the recovery.

Objective: To study the value of Pentraxin 3 (PTX3) in diagnosing the severity and cardiovascular function of the critically ill children. Method A total of 178 patients who were older than 28 days, with acute infection of respiratory or neurological system, excluding chronic or special disease, and admitted to the pediatric intensive care unit (PICU) of Hunan Children's Hospital from October 1, 2013 to April 30, 2014 were enrolled, including 102 male cases and 76 female cases. The ages ranged from 1 month to 13 years and 1 month, 78 of them were less than 1 year old ; 58 cases were between 1 to 3 years old; 42 cases were above 3 years old; 101 cases were diagnosed as respiratory system diseases, 77 cases had nervous system diseases. PTX3 was detected with enzyme-linked immunosorbent assay (ELISA) within 1 d after enrollment, at 3 days and 7 days, meanwhile, troponin, myocardial enzyme, brain-type natriuretic peptide (BNP), C-reactive protein (CRP), plasma calcitonin (PCT) and WBC etc. Were measured. According to the plasma PTX3 value which were measured within 24 h after enrollment the patients were divided into three groups: mildly elevated group (< 44 µg/L) 41 cases; moderately elevated group (44 - < 132 µg/L) in 66 cases; severely elevated group 71 cases (132 µg/L or higher). Those 178 patients were divided into 3 groups according to the degree of infection: non-sepsis group (78 cases), sepsis group (70 cases), severe sepsis group (30 cases), and in each group, those with heart failure were respectively 19 cases, 28 cases, 17 cases. Analysis of the plasma PTX3 expression changes in different clinical manifestations, different condition, different degrees of organ damages and prognosis for the patient. The continuous variables were analyzed with t-test, F-test, H-test, the categorical variables were analyzed with Chi-square test, and the correlation analysis was performed to calculate Pearson coefficients., Result: The PTX3 value measured within 24 h after enrollment increased with the degree of infection (50. 4(35. 2,70. 4) µg/L; 175. 8 (99. 6, 309. 9) µg/L;419. 9 (168. 3, 468. 6) µg/L; H = 88. 345, P = 0. 000). PTX3 level gradually declined, while in severe sepsis group decreased slowly (P <0. 05); the area under the ROC curve of Plasma PTX3 was larger than that of other inflammatory markers such as CRP and PCT, white blood cells and neutrophils in the diagnosis of sepsis; while the former three are PTX3, PCT and CRP (the sensitivity and specificity respectively were 0. 77, 0. 68; 0. 66, 0. 6; 0. 47, 0. 55); the PTX3 value of the severely elevated group was significantly higher than those of the mildly and moderately elevated groups (P <0. 05). The proportion of having 3 or more organs failure increased as the PTX3 rising among the groups of mildly elevated group, moderately elevated group and severely elevated group (1(2. 4%), 4(6. 1%), 14(19. 7%) χ2 =16. 16,P = 0. 000); and in each group, the proportion of having good and poor prognosis for these three groups were different (33 (80.5%) and 8 (19. 5%), 35 (53%) and 31 (47%), 28 (39.4%) and 43 (60.6%), χ = 17. 663, P = 0. 000). The K-M curve for these three groups had statistically significant difference (χ2 = 7. 086, P = 0. 029). Those with heart failure had higher PTX3 value than those in non-heart failure at the same degree of infection. PTX3 value increased with myocardial enzyme (troponin, creatine kinase isoenzyme, BNP) levels. In the diagnosis of heart failure, the area under the ROC curve were respectively PTX3 0. 824; BNP 0. 772; CM-KB 0. 643; CNTIO. 671, the sensitivity and specificity were PTX3 0. 8, 0. 58; CK-MB 0. 56,0. 79; CTNI 0. 60,0. 69; BNP 0. 73, 0. 58. In terms of predicting the prognosis of sepsis with heart failure complications, the PTX3 value's area under ROC curve was larger than that of BNP (respectively 0. 844, 0. 472)., Conclusion: The PTX3 is an objective biochemical marker in diagnosis of sepsis; it is helpful in assessment of severity and prognosis of sepsis; it also has a certain clinical value in the assessment of sepsis cardiovascular function damage.

Objective: To assess the performance of pediatric risk of mortality (PRISM), pediatric index of mortality 2 (PIM2) in predicting mortality in critically ill pediatric patients via a prospective study., Method: The outcome and the variables required to calculate PRISM and PIM2 were collected. The efficiency of PRISM and PIM2 in differentiation between death and survival by calculating the area under the receiver operating characteristic curve (ROC). Calibration across deciles of risk was evaluated using the Hosmer-Lemeshow goodness-of-fit χ(2) test., Result: A total of 412 critically ill pediatric patients transferred to Hunan Children's Hospital during August 1, 2012 and May 31, 2013 were enrolled in the study, and more than two-thirds of the children were suffering from respiratory and miscellaneous diseases; 45 (10.9%) inter-hospital transport of critically ill pediatric patients died at the time of hospitalization. The expected number of deaths were 45.01 by PRISM, and the expected number of deaths were 44.99 by PIM2. The expected mortality rate was 10.9% for PRISM or PIM2. The standardized mortality rate was 1.000 (0.710-1.290) for PRISM and 1.000 (0.710-1.290) for PIM2. The Hosmer-Lemeshow test gave a chi-square of 8.75 (P=0.364) for PRISM and 22.75 (P<0.05) for PIM2, PRISM had better fitting with the actual mortality than PIM2. The area under the receiver-operating characteristics (ROC) curve (95% confidence intervals, CI) were 0.829 (0.768-0.890) for PRISM and 0.758 (0.667-0.849) for PIM2., Conclusion: Although the PIM2 test is less well calibrated overall, both PRISM and PIM2 can offer a good capacity for discriminating between survivors and moribund patients. The good performance of PRISM and PIM2 are demonstrated in predicting mortality probability in critically ill pediatric patients.

Objective: To explore the safety and the efficacy of bronchoscopic argon plasma coagulation (APC) combined with CO2 freezing for the treatment of airway granulation hyperplasia after pediatric airway stenting., Method: From April 2010 to December 2012, APC combined CO2 cryotherapy was performed for granulation tissue hyperplasia in 8 children after airway stenting, their clinical data, complications and postoperative outcomes and follow-up data were analyzed., Result: Five of the 8 cases were male and 3 female, when stenting their age was 2 to 17 months, the average age was (8.63 ± 5.50) months. Granulation tissue hyperplasia appears in the range of bracket covering, common to both ends of the stent. The time from stentinging to find hyperplasia of granulation tissue was 20 days to 19 months. As a result, in 30%-100% of children airway narrowing was found. We applied APC treatment when the bronchoscopy found hyperplasia lesions, then we used CO2 cryotherapy, i.e., freezing was persisted for 1 min twice and more, then the probe was moved until the APC burning area was entirely frozen, dyspnea in children were significantly improved and two cases of atelectasis patients' lung were completely re-expanded. Eight patients had varying degrees of postoperative low to moderate fever, three cases had a small amount of active bleeding after APC treatment, hemostasis was achieved after topical application of endoscopic injection of epinephrine or reptilase bleeding and freezing, no complications occurred with CO2 cryotherapy. According to the efficacy criteria in this article, the result was significantly effective in 6 cases, effective in 1 case, and partially effective in 1 case., Conclusion: APC combined with CO2 cryotherapy may be one of the optional methods that rapidly eliminates granulation tissue and remove the airway obstruction, so it can be used in treatment of pediatric airway' benign lesions.

Colorectal cancer (CRC), one of the most common malignant tumors, is caused both by environmental and genetic factors. Genetic factor plays an important role in the pathogenesis of CRC. Genome-wide association study (GWAS) is a new tool of genetic research. A series of susceptibility genes and loci of the complex diseases has been identified with GWAS strategy. In this article, the research progress on GWAS of CRC is reviewed, and the advantages and limitations of GWAS study as well as the prospective of its application are discussed.

With the development of assisted reproductive technology (ART), more and more hepatitis B virus (HBV)-infected couples have their own children successfully; however,vertical transmission of HBV in ART, especially father-to-child transmission, cannot be avoided. The mechanism of attachment and penetration of HBV into human sperm is still not known. Therefore, understanding the state and mechanism of HBV infection of sperm and the impact of HBV on sperm parameters, following up the ART outcome in man with HBV infection are helpful to solve the fertility problem and to control father-to-child vertical HBV infection.

Objective: To report the outcomes of transvaginal ultrasound-guided multifetal pregnancy reduction (MFPR) in early high-order multiple gestation., Methods: Fifty-five cases of high-order multiple pregnancy including 1 septuplet, 7 quintuplets, 16 quadruplets and 31 triplets resulted from either superovulation/intrauterine insemination or in vitro fertilization-embryo transfer, were treated by transvaginal ultrasound guided MFPR at 49 - 79 days of gestational age. Their outcomes and complications were reported., Results: Multifetal reduction were successfully done in 53 cases (96%). Miscarriage occurred in 8 patients (15%). Twenty-one cases (47%) were premature delivery and 24 patients underwent term delivery resulting in 87 infants. Five preterm infants died of neonatal respiratory distress syndrome. Among them none has malformation. Of the 82 live infants, 1 had hexadactyly and another arterial septum defect occurred. No organ injury, massive hemorrhage and infection occurred after MFPR., Conclusions: MFPR during early pregnancy is a safe, effective, simple operation for the purpose of reducing perinatal and maternal complication.

Objective: To assess the effects of leptin on follicle-stimulating hormone (FSH) and insulin-like growth factor-I (IGF-I) induced production of estradiol (E(2))-17beta and progesterone (P) in cultured human luteinized granulosa cell (GC)., Methods: Human luteinized GCs were obtained from pre-ovulatory follicles in an in-vitro fertilization program, and were cultured for 24 hours in the presence of leptin (3.0 ng/ml) or FSH (1.0 ng/ml) or IGF-I (30.0 ng/ml) alone, leptin with FSH or IGF-I or both, and FSH with IGF-I. The conditioned media were aspirated for measuring E(2) and P content. Luteinized GC were also counted for cell number and detected the expression of the leptin receptor by reverse transcription polymerase chain reaction analysis., Results: In cultured luteinized GC system, leptin or FSH or IGF-I alone did not affect the growth of cultured human luteinized GC. Leptin alone or in the presence of FSH had no effect on E(2) production. E(2) levels in culture media without leptin or FSH were (0.103 +/- 0.036) pmol/1 000 cells, (0.323 +/- 0.042) pmol/1 000 cells respectively. When cultured with leptin alone or with leptin and FSH, E(2) levels were (0.120 +/- 0.008) pmol/1 000 cells, (0.343 +/- 0.034) pmol/1 000 cells. Leptin significantly inhibited FSH + IGF-I or IGF-I induced E(2) production. E(2) levels decreased from (0.318 +/- 0.037) pmol/1 000 cells to (0.193 +/- 0.025) pmol/1 000 cells (IGF-I) (P < 0.05) and from (0.493 +/- 0.036) pmol/1 000 cells to (0.251 +/- 0.033) pmol/1 000 cells (FSH + IGF-I) (P < 0.01). However, the production of P did not change. The leptin receptor expression was demonstrated in luteinized GC., Conclusions: Leptin may directly attenuate the IGF-I or IGF-I and FSH-stimulated E(2) synthesis in cultured human luteinized GC by the leptin receptor mechanism.