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总结3例原发性色素沉着性结节性肾上腺皮质病（PPNAD）患者的临床特征及诊疗方案。PPNAD除符合促肾上腺皮质激素（ACTH）非依赖性库欣综合征特征外，有以下特点：（1）Liddle试验后尿游离皮质醇反常升高；（2）伴生长停滞或Carney综合征表现；（3）肾上腺为小结节改变；（4）基因检测分别为PRKACA、PRKAR1A突变；（5）病理均为肾上腺色素沉积的结节改变；（6）治疗最终需要行双侧肾上腺切除，并予终身激素替代。PPNAD是罕见的库欣综合征类型，临床不易识别，认识其特征并行基因检测对明确诊断和治疗具有重要意义。.

To clarify the effect of suppressor of cytokine signaling 1 (SOCS1) on diabetic nephropathy (DN)-induced renal injury by regulating the Toll-like receptor (TLR) signaling pathway.The Sprague-Dawley rats were divided into control group (n=10) and DN group (established with streptozotocin injection, n=20). The DN rats were administrated with SOCS1 lentivirus to upregulate the in vivo expression. The rat blood glucose was detected to confirm the successful preparation of the DN model. The hepatic and renal function indexes, including blood urea nitrogen (BUN), alkaline phosphatase (ALP), alanine aminotransferase (ALT) and creatinine (CR) were detected. The pathological lesions in the kidney were observed via hematoxylin-eosin (HE) staining. Besides, the serum levels of the inflammatory factors in rats were detected via enzyme-linked immunosorbent assay (ELISA). The relative levels of genes in the TLR signaling pathway were detected via RT-PCR and Western blotting.The blood glucose level in rats of the DN group was significantly enhanced, indicating the successful modeling. The expression of SOCS1 was significantly upregulated in rats administrated with SOCS1 lentivirus. The contents of BUN, ALP, ALT, and CR in rats of SOCS1 overexpression group were significantly lower than those in the DN group. The inflammatory infiltration in the kidney and the glomerular injury were pronounced in the DN group. The serum levels of interleukin-1 (IL-1), interferon-γ (INF-γ), and tumor necrosis factor-α (TNF-α) were significantly declined in SOCS1 overexpression group. Besides, the mRNA expressions of myeloid differential protein-88 (MyD88), TLR2, and INF-γ, and the protein expression of TLR2 were all remarkably downregulated in SOCS1 overexpression group.SOCS1 can promote renal injury repair in DN rats by inhibiting the TLR pathway. Therefore, SOCS1 is expected to be a new target for the repair of DN renal injury.

The parallel surface contact between a template and a wafer is of critical importance for pattern fidelity in step imprint lithography. The passive compliant stage, which has a much simpler structure than an active control one, is an effective orientation-adjusting mechanism. For a perfect passive compliant stage, the orientation-adjusting process should bring about the smallest possible additional lateral motion to maintain the overlay precision. In the present paper, based on the analysis of a compliant wafer stage and the influence of the rotation axis on position shift, a monolithic template orientation stage with four groups of passive compliant mechanisms is proposed to satisfy the above requirements. This compliant template orientation stage can be regarded as two four-bar linkages that interfere with each other, with the connecting line of two flexible hinges in each group passing through the centre of the template, ensuring that the rotation axis is located in the centre of the template during the whole orientation-adjusting process. The performance of the designed compliant template orientation stage is researched using the finite element analysis method and experiments. The results indicate that this compliant template stage can ensure the parallel surface contact between a template and a wafer while minimizing relative lateral motion during the imprinting process.

Low efficiency is the key factor restricting the development of EV wireless charging systems in recent years. In order to improve the efficiency, the main circuit of the system is simplified by removing the DC/DC circuit and replacing full bridge inverter with half bridge inverter. And the output power control strategy is optimized by changing the duty cycle of PWM that controls the inverter. Besides, the peaks are reduced by changing the frequency of the system, and the output power can also be controlled by changing frequency. The performance of two most common magnetic couplers is compared and a direction of how to select couplers is given. The methods are all verified by simulations and experiments. By optimizing of the circuit and control strategy, the efficiency and the safety of the system are all improved.

In water-flooding petroleum reservoir, microbial populations in injected water are expected to migrate into oil-bearing strata and reach production wells. To demonstrate this, we firstly investigated microbial compositions in a homogeneous sandstone reservoir. The results indicated that the injected water harbored more microbial cells than produced water, and the shared populations and their abundance accounted for a minor fraction in injected water, while dominated in produced water, suggesting that most populations in injected water did hardly reach production wells in this reservoir. We further investigated microbial communities in water samples collected from wellhead and downhole of injection wells and production wells in a heterogeneous conglomerate reservoir. The results indicated that, except for the community reconstruction mainly resulted from dissolved oxygen, most populations were simultaneously detected in the wellhead and downhole of injection wells and production wells, suggesting that most microbial populations in injected water reached the production wells. This study suggest that microbial populations in injected water can pass through reservoir strata and reach production wells, but the reservoir heterogeneity, interwell spacing, sieve effect of strata and dissolved oxygen exert significant influence on microbial migration and distribution in reservoirs.

This study was performed to investigate: (1) the role of gut-derived endotoxin/bacterial translocation in the pathogenesis of sepsis, and (2) the possible effects of selective decontamination of the digestive tract (SDD) on mortality in rats following 40 per cent full-thickness scald injury. In the SDD-treated group, Enterobacteriaceae and yeasts were eradicated from the caecal mucosa, while the mucosal flora consisting of mainly anaerobes was well preserved, within 3 days. The incidence of bacterial translocation to the mesenteric lymph nodes (MLN) and viscerae was significantly lowered on postburn days 1, 3 and 5 (P < 0.05−0.01). Meanwhile, pretreatment with SDD resulted in reductions of the faecal endotoxin levels in different segments of intestinal tract to less than 0.5 per cent (0.04 – 0.45 per cent) of the untreated control; there was also a significant attenuation of the elevation of endotoxin concentrations in both portal and systemic blood. Intestinal diamine oxidase (DAO) activity returned to baseline on day 5 in rats receiving SDD but not in controls. The 5-day survival rate in the SDD-treated group was elevated by 26.7 per cent as compared with controls (P < 0.05). These data suggested that endotoxin/bacterial translocation took place early and commonly, which in turn contributed to postburn sepsis and mortality. SDD was effective in preventing gut origin endotoxaemia and bacterial translocation, and improving the survival rate in rats following severe thermal injuries.

The present study was conducted to determine the relationship between levels of neopterin and endotoxin in the circulation, and whether the neopterin level was related to the development of severe sepsis after extensive burns. This prospective study included 35 patients with burn size greater than 30% (30-98%), and 22 healthy volunteers who served as a comparison group. Neopterin levels increased in most patients on day 3 post-burn, but they were not significantly correlated with the extent of the burn surface (P > 0 center dot 05). A high serum neopterin level was found in patients with sepsis (n = 15), and a marked elevation persisted throughout the observation period. The difference between septic and non-septic patients (n = 20) became significant on 14 and 28 days post-burn. Although the presence of early endotoxaemia did not influence the alterations in serum neopterin, patients with endotoxaemia had much higher neopterin values than those who showed no endotoxaemia from the second week onward (P < 0 center dot 05-0 center dot 01). In addition, circulating endotoxin and neopterin levels were positively correlated in patients who developed endotoxaemia on day 14 (r = 0 center dot 368, P < 0 center dot 05) and day 21 (r = 0 center dot 439, P < 0 center dot 01) after major burns. These results suggest that thermal injury can lead to an elevation of serum neopterin independent of the burn surface area. The initial increase in the neopterin level may be a part of the acute-phase response to tissue injury itself, whereas the endotoxin release in the circulation may be responsible for the continuous induction of neopterin during the late stage. In addition, the presence of a constant high neopterin level is associated with a critical event in the development of severe burn sepsis.

In this study, we examined the relationship of plasma endotoxin levels to the development of multiple organ failure (MOF), and the outcome in patients with thermal injury. A prospective cohort study of 17 patients admitted with burns covering more than 70 per cent of body surface area was undertaken. Circulating endotoxin concentrations were measured by modified limulus amoebocyte lysate assay in serial samples of plasma. Seven out of 17 burned patients developed MOF according to multiple criteria. The plasma endotoxin concentrations of patients with MOF were 0.512-1.127 EU/ml, which were significantly higher than that of 10 patients without MOF (0.216-0.553 EU/ml), on 3, 14, 21 and 28 days postburn (p0.05-0.01). A significantly higher incidence of positive endotoxin tests (or = 0.120 EU/ml) was found in patients who developed MOF as compared to those patients who did not develop MOF during the observation period (p0.05). As the mean endotoxin levels increased, the incidence of MOF and death rate also increased, and persistent endotoxemia carried a poor prognosis. The present investigation provides further evidence that endotoxemia in severely burned patients commonly occurs. Circulating endotoxin has also been found to be strongly associated with the development of MOF and mortality following major burn injury.

This study examines the possible beneficial effect of Re-LPS (F515) antiserum on experimental multiple system organ failure (MSOF) in rabbits. The results showed that the plasma LPS level was significantly decreased, and it took a shorter period to clear up LPS in experimental than in control rabbits after receiving Re-LPS antiserum. Pretreatment with antiserum can markedly improve the function of the liver, lungs, kidneys, blood and gastrointestinal tract. The MSOF incidence in the group of rabbits receiving immune sera was only 11.2% and the survival rate was raised by about 40.0%. The results suggest that early passive immunotherapy may neutralize gut-derived endotoxin, inhibit endotoxin-induced mediators release and prevent development of severe complications due to sepsis. It is therefore postulated that LPS core antiserum may provide a prophylactic effect on the development of experimental MSOF.

According to the difference of light reflection of tissue with different degree of viability, spectacles were made from glass permitting light of certain wavelength to pass to help distinguish viable from nonviable tissue. They were used in debridement of wounds in 300 patients. The results showed that the quality of debridement was improved as evidenced by better healing and shorter healing time. These spectacles were helpful, especially for young and unexperienced operators to distinguish viable from nonviable tissue. They were also used to predict flap viability in plastic surgery.

We reported the clinical results in 13 cases of hypercortisolism treated with amino-glutethimide (AG), which was developed by Tiantsin Research Institute of Medical Industry. Of the thirteen cases nine were confirmed by surgery and histology, and the others were diagnosed clinically. Clinical improvements have been achieved in ten of the thirteen cases over a therapeutic course of 8 to 12 wk with a daily dosage of 1.0 to 2.0 g of AG. Plasma and urinary corticosteroids, as well as plasma testosterone levels were significantly decreased after one-month treatment followed, however, by somewhat return and fluctuation. The high levels of blood glucose and serum insulin were declined after therapy consistent with the decrement of corticoids. Serum potassium levels in hypokalemic patients returned to normal after one month of therapy. Radial bone mineral contents in patients with low bone density returned or closed to normal after three-month treatment. The main side effects of AG are anorexia, nausea, drowsy, tierdness, skin rashes, etc, which are mild and transient. Adrenal hypofunction was seen in one case after treatment.

Forty-four dogs were used. In experimental animals, Serratia marcescens inoculated cloth were placed on the entrance or exist side before shooting, while in control animals no inoculated cloth was placed. Bullet wounding was carried out to both hind legs from a distance of 20 metres. 5.56 mm calibre bullet was used. The impact velocity was 919 m/s or 716 m/s. Bacteriological examination was made immediately or 6 hrs after the shot. The experimental studies showed that primary bacterial contamination of bullet wounds could be resulted immediately after the shot. And it has been verified that the main mechanisms of primary bacterial contamination were two: (1) The bacteria were sucked into the wound by negative pressure of the temporary cavity at both entrance and exit sides. (2) At entrance side, in addition, bacteria could be further carried into the wound tract by contaminated bullet itself.