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Several studies have shown that glutamine (Gln) may play an important role in energy metabolism, inflammatory reactions, and immune processes in patients with severe acute pancreatitis (SAP). Nevertheless, the results of individual randomized controlled trials (RCTs) on Gln nutrition support for SAP are contradictory. This systematic review and meta-analysis evaluated the clinical benefit of Gln-supported early enteral nutrition (G+EEN) in patients with SAP.Cochrane Library, PubMed, Embase, CNKI, Wan Fang, and Chinese Biomedical Literature Database were searched for relevant studies published before December 2018. RCTs of G+EEN versus standard early enteral nutrition (EEN) for SAP were selected, with both started within 48 h of admission.Seven clinical RCTs including a total of 433 patients (EEN group: 218 patients; G+EEN group: 215 patients) were included. Compared with EEN, G+EEN increased serum albumin (standard mean difference [SMD]=0.74; 95% confidence interval [CI], 0.33-1.15; p0.01), reduced serum hypersensitive C-reactive protein (SMD=-1.62; 95% CI, -1.98 to -1.26; p0.01) and risks of mortality risk (risk ratio= 0.38; 95% CI, 0.16-0.90; p=0.03) and multiple organ dysfunction syndrome (MODS)(risk ratio=0.37; 95% CI, 0.15-0.94; p0.01), and shortened length of hospital stay (SMD=-1.19; 95% CI, -1.88 to 0.49; p0.01); moreover, it did not significantly increase the incidence of infection-related complications, operative interventions, or APACHE II scores.G+EEN is beneficial in SAP management.

Objective To explore the difference in level of first-aid capability and consciousness of the masses in different regions of China. Methods The survey was performed by filling the questionnaire on the "National Day of Emergency Platinum Ten Minutes" over the country China on October 10, 2014. The data were analyzed by SPSS 13.0 software. Results A total of 1580 questionnaires were returned from 16 cities, and among them 1422 were valid. The highest age of the subjects involved in the investigation was 83 years, the youngest 14 years, with the mean age 40.2 years. There were 483 men and 703 women, of whom 767(64.7%) had heard of the "platinum ten minutes" project. 57.8% people believed that the "platinum ten minutes" was their own affair. 52.0% of them offered that they would call the emergency system when met an emergency; 83.8% did not have the experience of dealing with an accident; only 53.2% of them had actively learned first aid knowledge from TV, training schools, newspapers, extracurricular training etc. 27.2% of the people thought that they were not able to deal with accident or emergency of their families. On the scene of an injury, only 30.4% of the people would be willing to deal with the accident only when they were asked to. The scores of the middle, northeast, coastal and northwest regions were 80, 70, 60 and 50 (P60 year were 90, 80, 70 and 50 (P

The International Association of Water Quality (IAWQ) Activated Sludge Model No.2 (ASM2) was applied to troubleshoot an existing underperforming full-scale wastewater treatment plant (WWTP) built for biological nutrient removal. The WWTP is operated in a 3-stage pho-redox process configuration (A 2 O). This study was undertaken with the aim of finding optimal operating conditions that will meet TP and TN concentration requirements in the effluent of the WWTP under study without the use of either chemical or external carbon sources and also to verify the applicability, capability and predictability of ASM2 as implemented in STOAT software. ASM2 was successfully used to troubleshoot bottle neck areas and to define the operational schedule for optimal performance of the wastewater treatment plant. Consequently, the costs of chemical and external carbon sources were eliminated and the effect of residual chemicals on the environment reduced.

According to the second economic census data of Jiangsu Province, this paper firstly uses PCA-HCA model based on provincial cities data to classify economic regions. And then, it uses BLR-HCA model to reclassify the economic regions based on counties data. Finally, it comes to the conclusion that the past regional classification ways of Jiangsu Province need to be updated. The research on regional economy is dynamic and timely, while deepening the division of labor and finance is an effective way to develop Jiangsu’s regional economy.

In this paper, we present a framework of orientation analysis for rotated human face detection. A novel orientation histogram is constructed for statistical analysis of face images, which can show a proper symmetry with respect to the orientation of the principal axis and a local peak at its orthogonal orientation. By analyzing the orientation histogram, we can easily find the principal axis' orientation of the rotated face. Then an upright frontal face detector based on orientation analysis and other knowledge is designed to verify the given face. The experimental results illustrate the effectiveness of our framework.

To investigate protective effects of pyruvate-enriched peritoneal dialysis solution (P-PDS), compared with lactate-PDS (L-PDS), on the intestinal mucosal barrier in peritoneal resuscitation (PR) from severe hemorrhagic shock (HS) in rats.Fifty male SD rats were randomly divided into five groups (n = 10): group sham, group control (HS without fluid resuscitation), group intravenous resuscitation (IVR) (HS with IVR only), group L-PDS (HS with i.v. infusion plus PR with L-PDS), and group P-PDS (HS with i.v. infusion plus PR with P-PDS). HS was induced by hemorrhage with mean arterial pressure 40 mm Hg for 60 min. In three groups with fluid rehydration, IVR included shed blood and dl-lactate Ringer solution equal to two times the volume of shed blood during 60 min; in two groups with PR, 20 mL of L-PDS, or P-PDS were infused when i.v. infusion started after HS into the peritoneal cavity in 20 min, respectively. Blood samples were taken for determinations of pH, base excess, PaCO2, PaO2, and D-LA 60 min post fluid resuscitation. After rats were sacrificed, a segment of intestine was harvested for the detection of expressions of intestinal barrier proteins: zonula occludens-1 (ZO-1) and phosphorylated vasodilator-stimulated phosphoprotein (p-VASP) by Western blot and immunohistochemistry. Intestinal morphologic alterations were also observed.Blood pH, base excess, and PaO2 were higher, whereas PaCO2 and D-LA were lower in group P-PDS than in other three HS groups (P0.05 and P0.01, respectively). Severe acidosis was nearly corrected in group P-PDS. Intestinal barrier proteins ZO-1 and p-VASP were significantly preserved in group P-PDS than in group L-PDS (P0.05) although they were improved in group L-PDS in comparison with other two HS groups (P0.05 or P0.01). Expressions of barrier proteins by Western blotting in group P-PDS were reversed to normal. The score of intestinal epithelial damage index was reduced in group L-PDS, compared with other two HS groups (P0.05), however, it was significantly lower in group P-PDS than in group L-PDS (P0.05).Pyruvate was superior to lactate in PDS in the correction of severe acidosis with PR. P-PDS was more preservative of expressions of intestinal ZO-1 and p-VASP and mucosal barrier function, compared with L-PDS in PR from severe HS in rats.

Background To investigate the effects of treatment with Multi component Chinese Medicine Jinzhida (JZD) on behavioral deficits in diabetes-associated cognitive decline (DACD) rats and verify our hypothesis that JZD treatment improves cognitive function by suppressing the endoplasmic reticulum stress (ERS) and improving insulin signaling transduction in the rats’ hippocampus. Methods A rat model of type 2 diabetes mellitus (T2DM) was established using high fat diet and streptozotocin (30 mg/kg, ip). Insulin sensitivity was evaluated by the oral glucose tolerance test and the insulin tolerance test. After 7 weeks, the T2DM rats were treated with JZD. The step-down test and Morris water maze were used to evaluate behavior in T2DM rats after 5 weeks of treatment with JZD. Levels of phosphorylated proteins involved in the ERS and in insulin signaling transduction pathways were assessed by Western blot for T2DM rats’ hippocampus. Results Compared to healthy control rats, T2DM rats initially showed insulin resistance and had declines in acquisition and retrieval processes in the step-down test and in spatial memory in the Morris water maze after 12 weeks. Performance on both the step-down test and Morris water maze tasks improved after JZD treatment. In T2DM rats, the ERS was activated, and then inhibited the insulin signal transduction pathways through the Jun NH2-terminal kinases (JNK) mediated. JZD treatment suppressed the ERS, increased insulin signal transduction, and improved insulin resistance in the rats’ hippocampus. Conclusions Treatment with JZD improved cognitive function in the T2DM rat model. The possible mechanism for DACD was related with ERS inducing the insulin signal transduction dysfunction in T2DM rats’ hippocampus. The JZD could reduce ERS and improve insulin signal transduction and insulin resistance in T2DM rats’ hippocampus and as a result improved the cognitive function.

In protein coding regions prediction works, the predicted non-coding percentile (PNCP) is usually used as the threshold to separate the DNA sequences into two kinds of regions, i.e. protein coding regions and non-coding regions. In this paper, a new protein coding regions prediction algorithm based on the hybrid threshold is presented. First, the normalized power spectral density (PSD) of a DNA sequence is calculated using the prediction algorithm based on narrow pass-band filters (NPBF), and the maximum PSD value of the DNA sequence is used as the normalization standard in the NPBF algorithm. Second, the coding regions' PSD curve is set up as a trapezoid model characterized by its slope and height. Third, the method for calculating the hybrid threshold which taking the slope and the height both into consideration is presented. Finally, the algorithm is performed on DNA dataset HMR195. Using the approximate correlation (AC) as the evaluation measure of prediction accuracy, the prediction results of the proposed algorithm reach to 0.48 for the dataset, which is much better than the modified Gabor wavelet transform algorithm. The prediction results are also presented in the form of q9 proposed by Chun-Ting Zhang in 2002.

The paper uses cloud model, and proposes a multi-attribute cloud decision method based on linguistic assessment. It includes mainly several parts as follows. First, the described rank cloud and the evaluated rank cloud respectively are presented to measure attribute rank and rank certainty degree. On the basis, cloud normalizing algorithm is presented to fuse several values of an attribute given by experts. Then, cloud aggregation algorithm is presented to integrate different attribute information and get every alternative value, and the most desirable alternative is selected according to their values. Cloud model can express the relationship between randomness and fuzziness, so the method is more effective to measure linguistic assessment information. Finally, an example with linguistic assessment information shows that the method is simple and feasible.

To observe the efficacy of Dahuang Fuzi decoction in patients with severe acute pancreatitis (SAP), and to provide valuable medical evidences for a treatment of SAP with combined traditional Chinese and western medicine.A prospective, multi-center, randomized, controlled clinical trial was designed. Two hundred and six adult patients with SAP admitted to intensive care unit (ICU) in three tertiary university teaching hospitals in Dalian from January 2007 to February 2010 were randomly divided into two groups: soapsuds enema control group (control group, n=101) and Dahuang Fuzi decoction enema study group (study group, n=105). The levels of serum amylase, albumin (Alb), D-lactic acid, endotoxin and diamine oxidase (DAO), high-sensitive C-reactive protein (hs-CRP), immunoglobulin (IgG, IgA, IgM), complements (C3, C4), tumour necrosis factor-α (TNF-α), interleukins (IL-6, IL-8) were determined before and after treatment for 2, 4, 7 days. The bowel sound, gastrointestinal function score, the acute physiology and chronic health evaluation II (APACHEII) score and the length of mechanical ventilation (MV), the length of stay in ICU, the mortality rate and average hospital expenses within 28 days were compared.Compared with control group, in the study group the levels of serum amylase, DAO, D-lactic acid and endotoxin were lowered, the Alb was increased, the levels of TNF-α, IL-6, IL-8, hs-CRP were decreased, the function of body immunity was enhanced, intestinal peristalsis was enhanced, gastrointestinal function score and APACHEII score were improved, the length of MV was reduced, the length of stay in ICU was diminished, the 28-day mortality and average hospital expenses were lowered [4 days amylase (U/L): 357.35±137.54 vs. 492.95±189.42, 2 days DAO (kU/L) : 5.20±0.59 vs. 5.45±0.72, 4 days D-lactic acid (mmol/L): 3.31±0.48 vs. 4.15±0.55, 2 days endotoxin (kEU/L): 0.29±0.11 vs. 0.34±0.14, 4 days Alb (g/L): 34.75±3.56 vs. 32.53±3.44, 2 days TNF-α (ng/L): 3.08±0.45 vs. 3.36±1.11, 2 days IL-6 (ng/L): 298.54±67.82 vs. 313.56±73.91, 4 days IL-8 (ng/L): 30.48±8.56 vs. 45.16±10.81, 2 days hs-CRP (mg/L): 32.56±11.83 vs. 40.42±15.10, 4 days IgG (g/L): 7.05±2.56 vs. 9.53±2.94, 2 days IgA (mg/L): 1 600±170 vs. 1 400±140, 4 days IgM (mg/L): 1 310±280 vs. 1 650±290, 4 days C3 (g/L): 1.11±0.09 vs. 1.50±0.15, 4 days C4 (g/L) : 0.32±0.11 vs. 0.41±0.10, 2 days bowel sound (times/min): 1.26±0.45 vs. 1.15±0.41, 2 days gastrointestinal function score: 2.24±0.98 vs. 2.42±1.05, 4 days APACHEII score: 16.4±6.8 vs. 20.1±7.1, the length of MV (days): 6.5±3.1 vs. 10.1±4.6, the length of stay in ICU (days): 11.3±6.3 vs. 13.8±7.5, mortality: 8.6% vs. 16.8%, average hospital expenses (yuan): 72 thousands vs. 86 thousands, P0.05 or P0.01].Dahuang Fuzi decoction may enhance the intestinal peristalsis, protect the gastrointestinal barrier function, reduce the bacteria and endotoxin translocation and the releasing of inflammation mediators, protect the function of body immunity, reduce the length of MV, the length of stay in ICU, and lower the 28-day mortality and average hospital expenses, and it can improve the prognosis of patients with SAP.

To determine the influencing factors and life quality of patients undergoing maintaining hemodialysis (MHD).One hundred and two MHD patients in hemodialysis center were enrolled, and a questionnaire investigation using KDQOL-SF(TM) 1.3 was employed. This questionnaire was disease-specific for chronic kidney disease. The object was to evaluate the quality of life, in relation with the patients' kidney disease and dialysis (KDTA) and the patients' general health (SF-36), and to analyze the influencing factors.Among the influencing factors revealed in questionnaire investigation, the items such as encouragement from medical staff, social support, symptoms, cognitive function, quality of social relationship and satisfaction degree of patients won higher scores, while the items such as sex function, difficulties in daily activity due to kidney disease, expectation of general health and self-evaluation of health won lower scores. Among the influencing factors, the scores of physical functions and body pain were much lower in female than male patients (63.52±17.96 vs. 71.65±18.66, 64.33±21.23 vs. 76.58±19.20, both P0.05). Patients of age60 won higher scores than patients of age≤40 and 40-60 in respect to work condition and sex function (61.98±13.63 vs. 52.27±7.54 and 55.23±19.97, 68.33±4.04 vs. 5.45±9.34 and 15.81±26.92, all P0.05); patients of 60 years old or older won higher scores in respect of satisfaction degree of patients but lower scores in respect of physical functions. Among primary diseases, only patients with diabetes won much encouragement from medical staff (93.57±11.29). Patients whose serum albumin was lower than 3.5 g/L won much lower scores than those with serum albumin higher than 3.5 g/L in respect of scoring of KDTA, influence to daily life due to kidney disease, cognitive function, physical functions, expectation of general health, and scores obtained previously (53.62±8.87 vs. 61.26±9.42, 44.58±12.52 vs. 57.47±17.15, 65.56±20.60 vs. 78.18±15.73, 54.38±19.73 vs. 68.87±17.57, 31.11±10.23 vs. 41.19±66.27, 44.44±27.06 vs. 68.57±26.94, all P0.05). Patients who had undergone hemodialysis for longer than 6 years won higher scores in respect to symptoms, body pain, vigour and expectation of general health (86.92±6.67, 85.08±57.34, 78.40±13.04, 53.33±24.22, respectively), while patients who had hemodialysis for as long as 3 to 6 years won highest scores in respect to social support (94.23±10.96, all P0.05). The level of hemoglobin and urea clearance index showed no obvious influence to MHD patients' daily life.MHD patients have poor self-confidence and they usually lose self-confidence. Nutritional status greatly influences patients' daily life. So it is important to improve the quality of daily life in MHD patients, especially in respect of nutritional support, and this aspect should form our focus of medical support.

To investigate the expression and significance of phosphatidylinositol 3-kinase/protein kinase B (PI3K/PKB) signal transduction pathway in severe acute pancreatitis-associated lung injury.Twenty-four healthy male Changbai pigs were randomized into four groups: sham operation group (n = 6), ALI group (n = 6), ALI plus LPS (lipopolysaccharide) group (n = 6) and ALI plus Wortmannin group (n = 6). The expression levels of PI3K and PKB were determined by both RT-PCR and Western blot. Activity changes of NF-kappaB were detected by electrophoretic mobility shift assay (EMSA). Contents of TNF-alpha and IL-1beta in bronchoalveolar lavage fluid (BALF) were examined by ELISA. The histopathological changes of lung were observed.The expressions of mRNA and protein PI3K and PKB, NF-kappaB activity and TNF-alpha, IL-1beta in BALF in ALI group were higher than those in sham operation group (P0.05 or P0.01). In ALI plus LPS group, they increased significantly in comparison with ALI group and sham operation group after injection of LPS (P0.05 or P0.01). In ALI plus Wortmannin group, these parameters were significantly inhibited by Wortmannin in comparisons with ALI group and ALI plus LPS group (P0.05 or P0.01).The phosphatidylinositol 3-kinase/protein kinase B signal transduction pathway is found to participate in the pathological process of severe acute pancreatitis-associated lung injury through the up-regulations of NF-kappaB activity, TNF-alpha and IL-1beta.

Spine-associated Rap guanosine triphosphatase-activating protein (SPAR) is an important regulator of activity-dependent remodeling of synapses. It is also critically involved in both mature dendritic spine formation and the maintenance of spine maturity. Glutamate is a major neurotransmitter of the brain, and is involved in all aspects of cognitive function, as it is the primary transmitter utilized by the cortical and hippocampal pyramidal neurons. Glutamate has also been associated with neuronal dendritic spine damage. The precise molecular mechanisms underlying dendritic spine damage following glutamate-induced neurotoxicity remain unknown. In the current study, we measured mRNA and protein expression levels of SPAR and serum-inducible kinase (SNK) in primary hippocampal neurons following glutamate treatment. Expression of SPAR and SNK was altered by glutamate treatment, indicating that the SPAR and SNK signaling pathways may be involved in the damage to dendritic spines in hippocampal neurons following excitotoxicity induced by glutamate.

To investigate the relationship between the excitotoxicity and serum-inducible kinase (SNK) and spine-associated Rap GTPase-activating protein (SPAR) pathway in primary hippocampal neuron injury induced by glutamate and furthermore, to explore the molecular mechanism of neuroprotection of Zibu Piyin Recipe (ZBPYR) and the relationship between ZBPYR and the morphological regulation of dendritic spines.The serum containing ZBPYR was prepared by seropharmacology. Reverse transcription and polymerase chain reaction (RT-PCR) was used to detect the expression of mRNA for SNK, SPAR, postsynaptic density protein 95 (PSD-95) and N-methyl-D-aspartate (NMDA) receptor subunits (NR1, NR2A and NR2B) in primary rat hippocampal neuron cultures after pretreatment with 10 micromol/L glutamate and ZBPYR serum.ZBPYR serum pretreatment resulted in a significant down-regulation of glutamate-induced SNK mRNA expression (P0.05). Significant up-regulation was seen on the mRNA expression of SPAR and PSD-95 (P0.05). All these changes were dose-dependent. The mRNA expression of NR1, NR2A and NR2B was down-regulated to different degrees (P0.05).The mechanism of effect of ZBPYR on glutamate-induced excitotoxicity may be related to the regulation of SNK-SPAR signal pathway. ZBPYR may play a role in protecting and maintaining the normal morphology and structure of dendritic spines, which may be achieved by inhibiting the excessive activation of NMDA receptors.

To investigate the apoptosis effect induced by D-limonene on BGC-823 gastric cancer cells.The expression of p53, bc1-2 in BGC-823 cells and qualitative, quantitative index of cell apoptosis were detected with MTT, electron microscopy, flow cytometry and immunohistochemical method.D-limonene could induce the formation of apoptotic bodies in a dose- and time-dependent manner. The expression of bcl-2 protein decreased and p53 protein increased in BGC-823 cells treated with D-limonene, compared with the control cells.D-limonene exerts its cytotoxic effect on BGC-823 gastric cancer cells by inducing apoptosis.

ObjectiveIncreasing evidence shows that TGF-β1 is a key mediator in diabetic nephropathy (DN) and induces renal fibrosis positively by Smad3 but negatively by Smad7. However, treatment of DN by blocking the TGF-β/Smad pathway remains limited. The present study investigated the anti-fibrotic effect of a traditional Chinese medicine, Chaihuang-Yishen granule (CHYS), on DN.Research design and methodsProtective role of CHYS in DN was examined in an accelerated type 1 DN induced by streptozotocin in uninephrectomized Wistar rats. CHYS, at a dose of 0.56 g/kg body weight, was administered by a daily gastric gavage for 20 weeks and the therapeutic effect and potential mechanisms of CHYS on diabetic kidney injury were examined.ResultsTreatment with CHYS attenuated diabetic kidney injury by significantly inhibiting 24-h proteinuria and progressive renal fibrosis including glomerulosclerotic index, tubulointerstitial fibrosis index, and upregulation of extracellular matrix (collagen I, IV, and fibronectin), despite the same levels of blood glucose. Further studies revealed that inhibition of renal fibrosis in CHYS-treated diabetic rats was associated with inhibition of TGF-β1/Smad3 signaling as demonstrated by upregulation of Smad7 but downregulation of TGF-β1, TGF-β receptors, activation of Smad3, and expression of miRNA-21.ConclusionsCHYS may be a therapeutic agent for DN. CHYS attenuates DN by blocking TGF-β/Smad3-mediated renal fibrosis.

To investigate the effects and mechanism of d-limonene on the growth and metastasis of gastric cancer in vivo.Metastatic model simulating human gastric cancer was established by orthotopic implantation of histologically intact human tumor tissue into gastric wall of nude mice. One percent d-limonene was orally administered at dose of 15 ml/kg every other day for seven weeks. Eight weeks after implantation, tumor weight, inhibition rate, apoptotic index (AI), microvessel density (MVD), vascular endothelial growth factor (VEGF), variation of ultrastructure, and the presence of metastasis were evaluated, respectively, after the mice were sacrificed.The tumor weight was significantly reduced in 5-FU group (2.55+/-0.28 g), d-limonene group (1.49+/-0.09 g) and combined treatment group (1.48+/-0.21 g) compared with the control group(2.73+/-0.23 g, P0.05). In 5-FU group, d-limonene group, combined treatment group, the inhibition rates were 2.60%,47.58% and 46.84% and 0, respectively; AI was (3.31+/-0.33)%, (8.26+/-1.21)%, (20.99+/-1.84)% and (19.34+/-2.19)%, respectively; MVD was (8.64+/-2.81), (16.77+/-1.39), (5.32+/-4.26) and (5.86+/-2.27), respectively; VEGF expression was (45.77+/-4.79), (41.34+/-5.41), (29.71+/-8.92) and (28.24+/-8.55), respectively. The incidences of peritoneal metastasis also decreased significantly in 5-FU group(77.8%), d-limonene group (20.0%) and combined group (22.2%) compared with control group (100%) versus 62.5%,30% and 22.2%) (P0.05). Liver metastasis was also inhibited and the incidences decreased significantly in 5-FU group, d-limonene group and combined group than that in control group (87.5% vs 55.5%, 20.0% and 22.2% respectively)(P0.05). The incidence of ascites in control group, 5-FU group, d-limonene group and combined group was 25.0%, 22.2%, 0, 0, respectively and 12.5%, 11.1% 0, 0, with respect to the metastasis rate to other organs.d-limonene has antiangiogenic and proapoptotic effects on gastric cancer, thereby inhibits tumor growth and metastasis. Combination of d-limonene with cytotoxic agents may be more effective.