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Malignant hyperthermia (MH) is an autosomal dominant genetic condition of the skeletal muscle triggered by inhaled general anesthetic agents or succinylcholine and associated with a hypermetabolic state and skeletal muscle rigidity. Tachycardia, increased carbon dioxide production, hypercarbia, hyperthermia, acidosis, hyperkalemia, cardiac arrhythmias, muscle rigidity, and rhabdomyolysis are common symptoms of MH. As the progression of the syndrome could be rapid or less evident, even experienced physicians have difficulty in diagnosing MH, which can lead to delays in treatment and increased mortality. We report a rare case of a 36-year-old man, who underwent open reduction and internal fixation of the left clavicle after inhaled anesthetics. The patient developed dyspnea, hypotension, unremitting hyperthermia, tachycardia, and elevated serum myoglobin, and finally died of pyemia and disseminated intravascular coagulation. We reviewed the process of disease development, summarized the steps of diagnosis, and improved genetic testing. Exome sequencing revealed a new mutation c.8519G>A (p.arg2840 GLN) in the RYR1 gene that could be associated with MH. The gene mutation was also found in his daughter’s genetic test. This case emphasized the importance of the awareness of MH and its atypical clinical symptoms. The presence of dyspnea, hypotension, unremitting hyperthermia, tachycardia, and raised myoglobin in serum might further strengthen the clinical diagnosis of suspected MH.

Background. Dahuang Zhechong pills (DHZCP) is a classic Chinese medicinal prescription in “Treatise on Cold Pathogenic and Miscellaneous Diseases (Shanghan Zabing Lun),” and it has the function of tonifying blood, nourishing Yin, and removing blood stasis. Previous studies have shown that DHZCP could alleviate SiO2 induced pulmonary fibrosis in mice. This study aims to further explore the preventive and therapeutic effects of DHZCP against silicosis fibrosis and the underlying mechanisms in vitro. Methods. We used the experimental model of SiO2-induced MH-S cells to evaluate the therapeutic potential of DHZCP. MH-S cells induced by SiO2 were intervened with the drug-containing serum of DHZCP, and the effects of drug-containing serum of DHZCP on the MH-S cells were detected by CCK8, ELISA, flow cytometry, western blot, and immunofluorescence. Results. DHZCP improved cell viability by reducing apoptosis. It also decreased the levels of TNF-α, IL-1β, IL-6 in the supernatant of MH-S cells induced by SiO2, inhibited the expression of p38 MAPK, blocked the activation of NF-κB, and controlled the upstream inflammatory response by multiple targeting. Concomitantly, we observed upregulation of Smad7 and a marked decline in TGF-β1, α-SMA, Smad2, Smad3 expression in MH-S cells treated with DHZCP. Conclusion. To sum up, we conclude that DHZCP protects against SiO2-induced silicosis by reducing the persistent irritation of inflammation, regulating the p38 MAPK/TGF-β1/Smad pathway.

Objectives Since DHZCP had significant inhibitory effects on liver and kidney fibrosis, we hypothesize that DHZCP could also inhibit pulmonary fibrosis. Therefore, the aim of this study is to examine the effect of DHZCP on silicosis, a type of pulmonary fibrosis caused by silica dust, and its underlying mechanism. Methods Pulmonary fibrosis was induced by inhalation of silica (SiO2) dust in mice which were then randomly divided into 5 groups: pulmonary fibrosis model group, high-dose DHZCP group, medium-dose DHZCP group, low-dose DHZCP group and Tetrandrine group. The normal control group mice were not exposed to SiO2 dust. After 28 days of continuous intragastric administration of DHZCP, the mice were sacrificed. The histopathology of lungs, the levels of tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β) and hydroxyproline (HYP) in serum. Besides, the expression of transforming growth factor‑β1 (TGF-β1), α-smooth muscle actin (α-SMA), Smad2, Smad3 and Smad7 in lung tissue were examined. Results The mice with silicosis was generated with an observed inflamed lung tissues and elevated inflammatory cytokines. DHZCP significantly reduced serum levels of TNF-α, IL-6, IL-1β and HYP in mice with lung fibrosis. DHZCP treatment remarkably downregulated mRNA and protein levels of TGF-β1, α-SMA, Smad2 and Smad3 in lung tissue, while increased the protein level of Smad7. Conclusions These results demonstrated that DHZCP could alleviate pulmonary fibrosis induced by SiO2. The anti-fibrotic effects of DHZCP are conferred by decreasing inflammation and pulmonary fibrosis, which may be related to the TGF-β1/Smad pathway.

The magnesium alloy has a unique advantage in 3C fields due to its high specific strength and excellent electromagnetic shielding characteristic. However, it is difficult to deform homogeneously because of hexagonal close-packed structure. In the present work, the microstructure, mechanical properties and stretch formability of magnesium alloy sheets with different alloying elements were investigated. It was indicated that a trace addition of Zn or/and Er made a key role in modifying texture, activating shear bands formation and precipitating nanoscale second phases, respectively, which resulted in an obvious improvement in both stretch formability and mechanical properties. The results suggested that the Mg–0.5Zn–0.5Er alloy sheet exhibited higher tensile strength along the rolling direction, i.e., yield strength of 180 MPa and ultimate tensile strength of 201 MPa, accompanying with superior Erichsen value of 7.0 mm at room temperature. The good performances of the sheet were ascribed to weakening basal texture intensity, formation of shear bands and precipitation of nanoscale W-phase (Mg3Zn3Er2). The microstructure, mechanical properties and stretch formability of magnesium alloy sheets with different alloying elements were investigated in the present investigation. It was indicated that a trace addition of Zn or/and Er made a key role in modifying texture (Fig. 1), activating shear bands formation and precipitating nanoscale secondary phases (Fig. 2), respectively, which resulted in an obvious improvement in both stretch formability and mechanical properties (Fig. 3).

Background Dahuang Zhechong pills (DHZCP) is a classic Chinese medicinal prescription in “Treatise on Cold Pathogenic and Miscellaneous Diseases (Shanghan Zabing Lun),” and it has the function of tonifying blood, nourishing Yin, and removing blood stasis. Previous studies have shown that DHZCP could alleviate SiO2 induced pulmonary fibrosis in mice. This study aims to further explore the preventive and therapeutic effects of DHZCP against silicosis fibrosis and the underlying mechanisms in vitro. Methods We used the experimental model of SiO2-induced MH-S cells to evaluate the therapeutic potential of DHZCP. MH-S cells induced by SiO2 were intervened with the drug-containing serum of DHZCP, and the effects of drug-containing serum of DHZCP on the MH-S cells were detected by CCK8, ELISA, flow cytometry, western blot, and immunofluorescence. Results DHZCP improved cell viability by reducing apoptosis. It also decreased the levels of TNF-α, IL-1β, IL-6 in the supernatant of MH-S cells induced by SiO2, inhibited the expression of p38 MAPK, blocked the activation of NF-κB, and controlled the upstream inflammatory response by multiple targeting. Concomitantly, we observed upregulation of Smad7 and a marked decline in TGF-β1, α-SMA, Smad2, Smad3 expression in MH-S cells treated with DHZCP. Conclusion To sum up, we conclude that DHZCP protects against SiO2-induced silicosis by reducing the persistent irritation of inflammation, regulating the p38 MAPK/TGF-β1/Smad pathway.

Background. There is no effective therapy for silicosis, and Dahuang Zhechong pill (DHZCP), an ancient Chinese medicine prescription, may have a therapeutic effect on silicosis. This study aims to verify the efficacy and safety of DHZCP in silicosis. Methods. This is a randomized controlled clinical trial done at Panzhihua Second People’s Hospital (Panzhihua City, Sichuan Province, China). Participants diagnosed with silicosis were recruited and randomized to the conventional treatment group (CG) or DHZCP combined with the conventional treatment group (DG). Forced vital capacity % predicted (FVC%), diffusing capacity of the lung for carbon monoxide % predicted (DLCO%), six-minute walk distance (6MWD), peripheral oxygen (SpO2), King’s Brief Interstitial Lung Disease Questionnaire (K-BILD), and safety outcomes were measured at baseline and 9 weeks. Results. Fifty-six participants (28 in each group) completed the study, and 53 of them (26 in DG and 27 in CG) completed pulmonary function. At 9 weeks, compared with no DHZCP, DHZCP treatment was associated with significant improvements in FVC% (mean ± SD, 95%CI) (8.2 ± 3.9, 0.3 to 16.0), DLCO% (8.6 ± 3.5, 1.5 to 15.7), SpO2 (3.8 ± 0.7, 2.3 to 5.2), and K-BILD total score (6.0 ± 2.3, 1.4 to 10.7). And, there were no statistical differences of safety outcomes between the two groups. Eight patients accepting DHZCP developed mild diarrhea during the first week, which subsequently resolved on its own. Conclusion. DHZCP could improve the pulmonary function, the quality of life, and the exercise capacity of silicosis patients.

Background and Objectives: This study was to characterize the association of cumulative exposure to increased high-sensitivity C-reactive protein (hs-CRP) with chronic kidney diseases (CKD). Methods: We included 35,194 participants with hs-CRP measured at three examinations in 2006, 2008, 2010. Participants were classified into nonexposed group (hs-CRP 2 or urinary protein positive. Results: The study showed the risk of CKD as the number of years of exposure to hs-CRP increases. Participants in 3-exposed group had significantly increased CKD risk with hazard ratio (HR) (95% confidence interval, CI) of 1.70 (1.49–1.93), in comparison with 1.47 (1.34–1.62) for participants in the 2-exposed group, and 1.08 (1.00–1.16) for those in the 1-exposed group (p < 0.01); meanwhile, the similar and significant associations were also observed for eGFR 2, proteinuria positive, in participants of the 3-exposed group in comparison with the nonexposed group, with respective HRs (95% CI) of 1.27 (1.01–1.58) and 2.27 (1.87–2.76). Conclusions: Cumulative exposure to hs-CRP was associated with a subsequent increased risk of CKD and was of great value to risk prediction.

Electrode configuration is an important issue in the continuous measurement of respiration using impedance pneumography (IP). The robust configuration is usually confirmed by comparing the amplitude of the IP signals acquired with different electrode configurations, while the relative change in waveform and the effects of body posture and respiratory pattern are ignored. In this study, the IP signals and respiratory volume are simultaneously acquired from 8 healthy subjects in supine, left lying, right lying and prone postures, and the subjects are asked to perform four respiratory patterns including free breathing, thoracic breathing, abdominal breathing and apnea. The IP signals are acquired with four different chest electrode configurations, and the volume are measured using pneumotachograph (PNT). Differences in correlation and absolute deviation between the IP-derived and PNT-derived respiratory volume are assessed. The influences of noise, respiratory pattern and body posture on the IP signals of different configurations have significant difference (p < 0.05). The robust electrode configuration is found on the axillary midline, which is suitable for long term respiration monitoring.

Zhengzhou-Luoyang area is one of the cradles of ancient Chinese civilization and contains more than 1000 settlements of the Neolithic Age. To study the spatial distribution of the Neolithic settlements in the region, this paper applied the Geographic Information Systems (GIS) to investigate the relationship between site locations and environmental variables. The results of GIS analysis show that the settlement distribution of each culture period has a clustered pattern and obvious spatial features. Most of the settlements tend to be located in flat areas with low elevation and close to rivers and arable soils. Based on the environment variables, a Neolithic settlement site predictive model was generated to predict the archaeological probability of any given area in Zhengzhou-Luoyang area. The predictive model and distribution characteristics obtained here can help better understand the Neolithic man-land relationship and provide guidance for future field archaeology.

To assess the effect of mechanical ventilation on prone position for the treatment of acute respiratory distress syndrome (ARDS) originating from pulmonary disease and extra-pulmonary disease.From January 2001 to February 2004 in intensive care unit (ICU), 42 patients with ARDS were divided into pulmonary disease group and extra-pulmonary disease group. All the patients were mechanically ventilated on prone position. Arterial blood gases, respiratory rate (RR), fraction of inspired oxygen (FiO(2)), pulmonary compliance (C), tidal volume (V(T)), airway resistance (Raw) were measured before prone position and 2 hours and 4 hours after prone position. Lung-CT was measured in supine position and prone position.When patients were turned to prone position, SaO(2) and RR were decreased markedly in two groups. V(T) was increased in extra-pulmonary disease groups compared with pulmonary disease group at the same time. Oxygen index, hemoglobin oxygen saturation and Raw were increased markedly when patients were turned to prone position, and oxygen index of pulmonary disease group was higher than that of extra-pulmonary disease group at the same time. No change was found in blood pH and partial pressure of carbon dioxide in artery (PaCO(2)), but oxygenation was improved markedly in two groups. The effective rate of improved oxygenation was 65% in pulmonary disease group and 68% in extrapulmonary disease group, but no significant difference was found. Lung CT revealed that when the patients were in prone position, the degree of lung infiltration in the dorsal part of lung decreased while that in the ventral part increased.Oxygenation is improved markedly in prone position in two groups. Mechanical ventilation on prone position was an effective method in the treatment of ARDS patients.