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It is believed that the basic pathogenesis of oculomotor nerve paralysis （ONP） is qi and blood depletion and channel obstruction. Taking channel pattern differentiation as the core， it is recommended to use acupuncture mainly based on location， syndrome and channel deficiency-excess differentiation. Location and channel tropism differentiation mainly follows the principle of “where the channels and collaterals pass， the main treatment can reach”， and commonly uses acupuncture points on Dumai （督脉）， the hand Shaoyang （少阳） Sanjiao （三焦） channel， the hand Taiyang （太阳） small intestine channel， three yang channels of the foot， the hand Shaoyin （少阴） heart channel， the foot Jueyin （厥阴） liver channel， and others， and combines scalp acupuncture with electro-acupuncture to enhance channel stimulation. Pattern and channel tropism differentiation is to differentiate the entered channel according to clinical symptoms and zang-fu patterns. The differentiation of deficiency-excess should be payed attention to， and the principle of “supplementing the deficiency， and draining the excess” should be followed. The supplementing and draining method should be used rationally by considering the differences in the supplementing and draining acupoints themselves， as well as the actual condition of the patients. Simultaneously， it is suggested to combine manipulation and stimulation amount and effect in clinical practice.
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Objective:To investigate the safety and feasibility of Ivor-Lewis procedure under uniportal video-assisted thoracoscopy(VATS) for esophageal cancer and Siewert type I esophago-gastric junction carcinoma.Methods:The patients with middle-lower segment esophageal cancer or Siewert type I esophago-gastric junction carcinoma received minimally invasive esophagectomy between October 2020 and June 2021, and the clinical data was collected and analyzed.Results:26 patients received Ivor-Lewis procedure underwent uniportal VATS, while 45 patients underwent McKeown surgery under multiport VATS. The average operation time of patients in the two groups were(265±110)min and (235±94)min, and the average intraoperative blood loss were(80±57)ml and(105±60)ml. The mean number of lymph nodes removed in the surgery were (19.3±2.9) and 18.6±2.7 respectively in two groups, and the mean length of hospital stay was(7.5±3.5)days and(8.3±2.7)days. The incidence of perioperative complications were not significantly different in two groups. The VAS score of patients received Ivor-Lewis procedure underwent uniportal VATS was lower than that of patients received McKeown surgery in ostoperative day 1, day 3, day 7 and 1 month. The difference was statistically significant in two groups( P<0.05). Conclusion:The Ivor-Lewis procedure under uniportal VATS for esophageal cancer and Siewert type I esophago-gastric junction carcinoma has the advantage of less postoperative pain, and the procedure is feasible in clinical practice.
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Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.
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Objective:To explore the effect of short-term modularized training mode with clear milestones for case competition of standardized residency training.Methods:Surgical residents, who attended the first case competition of Guangdong Province in 2020, were trained by short-term modularized training mode with clear milestones. This mode contained four modules: SP consultation training, training of disease characteristics and principles of diagnosis and treatment summary, medical documents and case analysis writing training, and comprehensive emergency case training.Results:After the training, they all made great progress in consultation, interpretation of exam results, and first writing of course record, but less in medical documents and case analysis. The satisfaction rate was 100%, and they all considered informed consent writing for operation and formulating principles of diagnosis and treatment summary as difficult tasks.Conclusion:Short-term modularized training mode with clear milestones might improve the level of consultation, interpretation of exam results, and first writing of course record effectively. While, the difficult point is clinical thinking about the surgical treatment, which must be trained more in routine work.
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Objective:To explore the effect of foraging exercise (FE) on the behavior of rats with post-stroke depression (PSD) and the expression of 5-Hydroxytryptamine 1A (5-HT1A) receptor and transforming growth factor β1 (TGF-β1) in their frontal lobes.Methods:Thirty-six healthy male Sprague-Dawley rats were randomly divided into an ischemia-reperfusion (I/R) group, a PSD group and a PSD+ FE (FE) group, each of 12. The right middle cerebral artery of each was occluded using the thread occlusion method with 1.5h of ischemia. In the PSD and FE groups, mild stimulation was administered at unpredictable intervals over 3 weeks beginning 1 week after the successful modeling. The rats in the I/R group were raised in a group. Those in the PSD group were raised in individual cages. Those in the FE group were raised in a single cage and foraged freely for a total of 4 weeks. Four and eight weeks after the modeling, the body weights were measured, and the open field, social interaction (SIT) and sugar preference tests were administered to all of the groups. Four weeks later, all of the rats were sacrificed and their brains were sliced and stained. The expression of 5-HT1A receptor and TGF-β1 in the frontal lobe was detected using western blotting.Results:One week after modeling, there was no significant difference in average body weight or the average behavioral scores among the three groups. After four weeks the PSD and FE groups had significantly lower average body weight than the I/R group, fewer counts of rearing and grid crossing, longer SIT latency, less interaction time and lower average sugar preference (all significant differences). After eight weeks the average body weight had increased in each group. SIT latency had shortened and interaction time had increased in the FE group, and the rearing and grid crossing counts and sugar preference had increased in the PSD and FE groups. At that point the FE group had significantly greater average body weight than the PSD group, more counts of rearing and grid crossing, shorter SIT latency, increased interaction time, and greater sugar preference. The ratio of residual brain volume in the right hemisphere of the PSD and FE groups was significantly lower on average than in the I/R group. However, there was no significant difference in the right residual brain volume ratio between the PSD and FE groups. Staining revealed that the pathological changes in the frontal lobes of the FE group had been significantly relieved compared with the PSD group. Eight weeks after the operation the increases in average 5-HT 1A receptor and TGF-β1 levels in the FE group were significantly greater than in the PSD group.Conclusion:Foraging can relieve the depressive symptoms of rats modeling post-stoke depression. The mechanism may be related to alleviating the pathological damage and increasing the expression of 5-HT1AR and TGF-β1 in the frontal lobe. Early chronic stress may increase the volume of cerebral infarction, at least in rats.
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Objective:To explore the effects of foraging exercise (FE) on depressive-like behaviors and expression of transforming growth factor-β1 (TGF-β1) in hippocampus of rats with ischemic stroke after chronic stress.Methods:The right middle cerebral artery occlusion (MCAO) model was used in 30 male adult clean grade SD rats by suture method.According to the body weight, rats were evenly divided into stroke group ( n=10) and chronic unpredictable mild stimulation (CUMS) group ( n=20). Rats of CUMS group received stress induction 1 week after operation and lasted for 3 weeks. Then, according to random number generator of SPSS 24.0 software, the depression rats were divided into post-stroke depression (PSD) group( n=10) and FE groups ( n=10). The FE group received free FE intervention for 4 weeks. Body weight, water maze test, novelty inhibition feeding test (NSFT) and sucrose preference test (SPT) were performed at the end of the 1st, 4th and 8th week, respectively. The expression of TGF-β1 in hippocampus was detected by Immunohistochemistry (IHC) and Western blot (WB), and the levels of TGF-β1 and TNF-α in serum were detected by ELISA. SPSS 24.0 software was used for statistical analysis. The behavioral data were compared by two factor repeated measurement analysis of variance. One way ANOVA was used for comparison among groups, and LSD test was used for further pairwise comparison. Results:(1) The interaction between group and time had statistical significance on body weight, latency and food intake of NSFT and sucrose preference index(SPI) ( F=2.936-12.098, all P<0.05). After 4 weeks, compared with the stroke group((343.80±19.34)g, (12.10±6.97)s, (0.75±0.09)%), the body weight((307.80±17.23)g, (305.30±24.39)g), and SPI((0.52±0.06)%, (0.53±0.07)%) of PSD group and FE group were lower and the NSFT latency((21.70±7.02)s, (22.40±0.84)s) was longer (all P<0.05). After 8 weeks, SPI in FE group was higher than that in PSD group ( P=0.045). There were significant differences in body weight of three groups, NSFT latency and SPI of PSD group and FE group, and food intake of stroke and FE group ( F=8.478-196.548, all P<0.05). There was no interaction between group and time in the water maze test. Main effect of time ( P=0.034) and main effect of group ( P<0.01) had statistical significance on escape latency. The escape latency after 4 weeks was longer than that after 1 week ( P=0.003). The latency of PSD group was longer than that of stroke group ( P=0.005), and latency of FE group was shorter than that of the PSD group ( P<0.01). The main effect of group had statistical significance in the number of crossing quadrant ( P<0.01). The number of crossing quadrant of FE group was less than that of PSD group ( P<0.01). (2) Immunohistoche mistry staining showed that compared with the stroke group, the expression of TGF-β1 was down-regulated in 3 areas of hippocampus of PSD group (CA1, CA3 and DG) ( t=5.449-9.353, all P<0.01). Compared with stroke group, the expression of TGF-β1 of CA1 ( t=7.433, P<0.01) in FE group was down-regulated, but was up-regulated in CA3 ( t=3.342, P<0.05) of FE group. Compared with the PSD group, the expression of TGF-β1 was up-regulated in CA3 and DG of FE group ( t=7.811, 8.790, both P<0.01). (3) Western blot results: Compared with stroke group, the expression of TGF-β1 in hippocampus of PSD group was down-regulated ( t=3.255, P<0.01). Compared with the PSD group, the expression of TGF-β1 in hippocampus of FE group was up-regulated ( t=2.906, P<0.05). (4) ELISA detection showed that compared with the stroke group, the levels of TGF-β1 decreased ( t=2.224, P<0.05), but TNF-α increased ( t=6.127, P<0.01) in PSD group.Compared with the PSD group, the expression of TGF-β1 in FE group increased significantly ( t=4.417, P<0.01). Conclusion:Foraging exercise can improve the depressive behavior symptoms of ischemic stroke rats after chronic stress, and its mechanism may be related to the increasing expression of TGF-β1, which can alleviate the inflammatory reaction in hippocampus.
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Objective@#To understand sexual orientation and characteristics of sexual behaviors related with HIV infection among HIV positive male college students in Beijing and to provide suggestions for development of sexual health education and HIV prevention strategy for student population.@*Methods@#HIV positive male college students diagnosed from 2016 to June 30, 2019 in Beijing were recruited. Questionnaire was used to retrospectively investigate sexual orientation and characteristics of sexual behaviors before HIV infection. Behaviors related to HIV infection were compared between absolutely homosexual and others sexual orientation.@*Results@#The average age of male students firstly identified to be HIV positive was (22.18±2.70) years old, 61.5%(123) of them were undergraduate, 69.5%(139) were not registered permanent residency in Beijing, 38.5%(77) of their interviewed sexual partners were from online chat and 83.0%(166) had homosexual behaviors. Sexual orientation score analysis showed that 50.0% of the participants self identified as exclusively homosexual. Compared with other sexual oriental group, exclusively homosexual group had lower mean age of their HIV infection firstly identified（ t =2.77， P =0.01）, higher rate of Rush use, firstly insertive sexual behavior with male, firstly insertive sexual behavior before 18 years old, sexual partners more than three persons, having regular partners, nonpersistent use of condom, being diagnosed of sexual transmitted disease and the frequency of homosexual behaviors more than 1 time per month （ χ 2=5.15,28.06,4.16,5.34,5.89,7.39,6.68, P <0.05）. Rush users had higher rate of STD diagnosis than non users in exclusively homosexual group ( χ 2=6.26， P =0.01).@*Conclusion@#Risky sexual behaviors associated with HIV infection were higher in exclusively homosexual group then other sexual orientation groups among HIV positive male college students. Family and school should concern with sexual health education byreinforcing health education via network media to improve college students’ awarenees on HIV/AIDS.
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Objective:To investigate the differentially expressed microRNAs (miRNAs) in human gastric carcinoma SGC-7901 cell-derived exosomes induced by Helicobacter pylori ( H. pylori), providing new clues for further elucidating the carcinogenic mechanism of H. pylori. Methods:Ultracentrifugation and exosome extraction kit were used to extract the exosomes released by the H. pylori-stimulated and negative control group, and transmission electron microscope(TEM), nanoparticle tracking analysis(NTA) and Western blot experiments were employed to identify exosomes. Then, exosomes were labeled with the fluorescent dye PKH67 and co-cultured with THP-1-derived macrophages. The internalization of exosomes by macrophages was observed by laser confocal fluorescent microscopy. Additionally, miRNA microarray chips were performed to detect the differentially expressed miRNAs of exosomes from the two groups of cells. Real-time fluorescence quantitative PCR (qRT-PCR) was used to verify the expression of four differentially expressed miRNAs. Furthermore, the target genes and their functions as well as the possible signal pathways involved of partial differentially expressed miRNAs were predicted and analyzed by bioinformatics software. Differentially expressed miR-382-5p was labeled by Cy3 to observe whether it could be transferred to macrophages through exosomes. The expression of phenotype molecule CD206 and the cytokines TNF-α, IL-6 and IL-10 in miR-382-5p mimic-transfected macrophages were analyzed by qRT-PCR and ELISA, and the proportion of cells expressing CD206 and HLA-DR was analyzed by flow cytometry. Results:The extracted exosomes were consistent with exosome morphology and highly expressed the surface marker proteins CD9, CD63 and TSG101. After co-culturing with THP-1 derived macrophages for 12 h, the exosomes could be internalized by macrophages. Compared with the control group, there were 130 up-regulated miRNAs and 111 down-regulated miRNAs in the H. pylori-stimulated group. Bioinformatic analysis showed that the potential target genes of partial differentially expressed miRNAs were mainly involved in the regulation of PI3K-AKT, NF-κB, JAK-STAT, stem cell pluripotency and other inflammation and tumor-related pathways. miR-382-5p could be transferred to macrophages through exosomes, and induced the expression of M2-type phenotype molecule CD206 and cytokines IL-10 in macrophages, while inhibited the expression of TNF-α and IL-6 and increased the proportion of CD206 high HLA-DR low cells. Conclusions:H. pylori treatment caused a significant change in the expression level of exosome miRNAs in SGC-7901 cells. Bioinformatics analysis demonstrated that the prospective targets of these differentially expressed miRNAs might play an important role in the regulation of inflammation and tumor-related signaling pathways. miR-382-5p might induce the M2-type polarization of macrophages.
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Objective:To investigate the effects and regulation mechanism of lipid-associated membrane proteins (LAMPs) derived from Mycoplasma pneumoniae( Mp) on the expression of quinine oxidoreductase 1 (NQO-1) in human monocyte cell line THP-1 cells, and to know the effect of NQO-1 to interleukin 8 secretion in LAMPs stimulated cells, so as to better understand the regulation mechanism upon Mp infection. Methods:Mp were cultivated and the precipitate was collected to extract LAMPs. The cytotoxicity of LAMPs to THP-1 cells was analyzed by using CCK8 test. THP-1 cells were cultured in vitro with different concentrations of LAMPs for different times, and the expression of NQO-1 protein was detected by Western blot. Nrf2 siRNA was used to investigate the role of Nrf2 in NQO-1 expression in LAMPs induced cells, and NQO-1 inhibitor Diminutol was performed to test whether they blocked interleukin 8 (IL-8) secretion when treated with LAMPs in THP-1 cells. Results:LAMPs extracted from Mp had no cytotoxicity to THP-1 cells. The expression of NQO-1 protein in LAMPs-stimulated THP-1 cells showed a dose-dependent and time-dependent manner. The production of NQO-1 protein reached peaks when treated with 5.0 μg/ml or 7.5 μg/ml of LAMPs for 12 h. Silencing of Nrf2 by siRNA significantly decreased NQO-1 production, and blocking NQO-1 by Dim increased the level of IL-8 in LAMPs-stimulated cells. Conclusions:LAMPs derived from Mp induced the expression of NQO-1 protein in THP-1 cells via Nrf2, and NQO-1 can inhibit IL-8 secretion in LAMPs stimulated monocytes.
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Objective:To explore the efficacy of total sternotomy or partial sternotomy for the treatment of isolated plasmacytoma of the sternum, and the feasibility of the chest wall reconstruction using 3D printed polyether ether ketone(PEEK) implants.Methods:In this study, a total of 6 patients with isolated plasmacytoma of sternum was enrolled, including 5 males and 1 female, aged (57.7±9.4) years old (42-71 years old). All patients received total sternotomy or partial sternotomy, and the chest wall was reconstructed using 3D-printed PEEK implant. The perioperative data and demographic characteristics of the patients were collected for statistical analysis.Results:All patients in this study had isolated plasmacytoma of sternum. Chest wall defects with mean area of (102.7±18.8)cm 2 were anatomically repaired using 3D-printed PEEK implants. No postoperative complications such as abnormal respiration was found. All 6 patients were discharged from hospital successfully, and no complications during the perioperative period were found. During the average follow-up period of(31.2±15.4)months, no implant fracture, displacement, rejection and other phenomena occurred, and no recurrence, metastasis or death occurred in postoperative patients. Conclusion:Total or partial sternotomy was an effective treatment for isolated sternum plasmocytoma . The chest wall reconstruction using 3D-printed PEEK implant was a reliable clinical treatment method.
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Objective:To analyze the changes in biological characteristics including infectivity, growth and pathogenicity of Chlamydia muridarum ( Cm) after serial passage in vitro in special conditions in order to provide reference for screening attenuated live vaccines and virulence-related genes. Methods:Wild-type Cm strain (G0) was cultured for several passages using conventional cell culture method under alternate unassisted and assisted culture conditions. Then, the 28th generation (G28) of Cm was selected and compared with the parental G0 strain in terms of centrifugation dependence, attaching ability, intracellular growth curve, plaque size and fallopian tube lesions after genital tract infection in a mouse model. Results:Compared with the parental G0 strain, the G28 strain showed significantly decreased dependence on centrifugation during cell infection ( P<0.05) and increased attachment capacity to cells ( P<0.05). No significant differences were observed in the growth curves 32 h after cell infection or in the plaque sizes between the parental G0 and G28 strains. In the in vivo virulence test, fallopian tube lesions were observed in 87.5% of G0-infected mice and 37.5% of G28-infected mice ( P<0.05). Conclusions:Compared with the parental G0 strain, the G28 strain showed significantly enhanced in vitro infection ability, but decreased in vivo pathogenicity, which brought hope for further identification of virulence genes, isolation of attenuated strains with single genotype and development of live attenuated Chlamydia vaccines.
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Objective:To analyze relationship between 13q14 deletion and prognosis in initial-treatment patients with multiple myeloma (MM).Methods:The follow-up data of 121 patients with newly diagnosed MM admitted to the First People's Hospital of Xiangtan City from January 2012 to December 2016 were collected and divided into deletion group ( n=39) and non deletion group ( n=82) according to the deletion of 13q14.The prognosis situations were compared among patients with different 13q14 deletion. Univariate analysis was performed for 3-year overall survival (OS) and progression free survival (PFS) in patients with MM. Results:As of the follow-up time, the 3-year OS rate, 3-year OS, 3-year PFS rate, 3-year PFS and median PFS were 71.90%(87/121), 5.8-36 months, 47.93%(58/121), 2.3-36 months and 34.8 months, respectively. The age, hypoproteinemia, high lactic dehydrogenase (LDH) and 13q14 deletion were independent influencing factors of OS ( P<0.05). The age, high LDH and 13q14 deletion were independent influencing factors of PFS ( P<0.05). The 3-year OS rate and 3-year PFS rate in 13q14 deletion group were 61.54%(24/39) and 25.64%(10/39), lower than those in non-deletion group ( P<0.05). Conclusions:The short-term prognosis is poor in initial-treatment MM patients with 13q14 deletion. Conducting risk stratified treatment for patients based on common influencing factors of OS and PFS is conducive to improving their prognosis.
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@#Objective To evaluate the clinical outcomes of larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction for the treatment of cervical esophageal squamous cell carcinoma (ESCC) without tumor involvement of the larynx and hypopharynx compared with the upper thoracic ESCC. Methods Retrospective and comparative analysis of consecutive patients with cervical and upper thoracic ESCC who underwent R0 surgical resection from 2006 to 2011 in our center was performed. Kaplan-Meier method was used to calculate the patients’ survival. Results In total, 44 pairs of patients, including 71 males and 17 females with an average age of 60.66±8.49 years were enrolled in the study after propensity score matching. The baseline characteristics of the two groups of patients were well balanced. There was no statistical difference in the operation time (P=0.100), blood loss (P=0.685), mortality rate in 30 days (P=1.000), total complication rate (P=0.829), cervical anastomosis leakage (P=0.816), mechanical ventilation (P=1.000), normal oral diet within 15 days (P=0.822) and anastomosis recurrence rate (P=0.676) between the two groups. Survival analysis showed that there was no statistical difference in survival time between the cervical group [31.83 (95%CI 8.65-55.02) months] and upper thoracic group [37.73 (95%CI 25.29-50.18) months, P=0.533]. The 5-year survival rates were 32.6% and 42.1%, respectively. Conclusion Larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction for the treatment of cervical ESCC without involvement of the larynx and hypopharynx may result in a similar clinical outcome to upper thoracic ESCC.
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Objective:To investigate the teaching mode of laparoscopic surgery skills for medical interns and its effect.Method:s New interns were randomly divided into experimental group and control group. The experimental group received the laparoscopic surgery skill training by learning Pick and Place (PP), Scrip Shear (SS), Suture and Knot tying (SK) and Tissue Isolation (TI), and they also received additional training of basic surgery skills before the training of laparoscopic surgery skills, while the control group did not receive the pre-training. Examines and questionnaires were conducted after the training.Result:s There were no significant differences in laparoscopic skills between the two groups at the beginning of the training, but they all had obvious improvement after training ( P<0.01). Compared with the control group, the experimental group did better in PP and SK ( P<0.01), but no differences in SS and TI. The satisfaction rate of training model and skill improvement was 95% and 85% in the experimental group and control group. Conclusion:Short-term program of laparoscopic surgery skill training could effectively improve intern's laparoscopic surgery skills, and the master of basic surgery skills is conducive to the learning of laparoscopic surgery skills.
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@#Objective To explore the safety and effectiveness of a precise marking method based on body surface mesh and three-dimensional (3D) image reconstruction. Methods We retrospectively analyzed the clinical data of 22 patients in our hospital from October 2018 to October 2019. There were 13 males and 9 females aged 58.5 (37-72) years. All patients underwent a precise marking of pulmonary nodules based on body surface mesh and 3D image reconstruction. Then, video-assisted thoracoscopic surgery (VATS) was performed to resect the nodules. The clinical data, including positioning success rate and operation time were analyzed. Results A total of 22 small pulmonary nodules were removed. The average diameter of small nodules was 12±3 mm, and the average distance from the visceral pleura was 17±6 mm. The localization success rate was 86.4%. The operation time was 110±43 min, and there was no surgery-related complication. Conclusion The method of marking pulmonary nodules based on body surface mesh and 3D image reconstruction is a safe and reliable technology, which reduces the risk of hemopneumothorax caused by CT-guided lung puncture.
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Objective To investigate the influences of antibiotic-induced gut microbiota dysbiosis on Mycoplasma pneumoniae (Mp) airway infection. Methods C57BL/6J mice were treated with vancomy-cin and gentamicin for 21 d by oral delivery and then intranasally infected with Mp. Quantitative real-time PCR ( qPCR) was performed to detect five major phyla of gut microbiota in mouse fecal specimens before and after antibiotic treatment and the loads of Mp in lung tissues on 3 d and 7 d after infection. Pathological changes in lung tissues were evaluated with HE staining. IFN-γ and IL-4 secreted by spleen CD4+ T cells and CD8+ T cells were analyzed by flow cytometry. Mp-specific IgM and IgG in mouse serum samples were measured by indirect enzyme-linked immunosorbent assay (ELISA). Results Vancomycin and gentamicin treatment significantly reduced the number of Bacteroidetes in mouse feces, but increased the amount of Fir-micutes. Meanwhile, the numbers of δ, γ-Proteobacteria, Actinomycetes and Tenericutes also changed. These antibiotic-induced gut microbiota alterations in mice with Mp infection increased the loads of Mp in lung tissues and the pathological scores of lung tissue inflammation on 3 d and 7 d after infection, and re-duced the number of IFN-γ-secreting spleen CD4+T lymphocytes on 7 d. Conclusions Antibiotic-induced gut microbiota dysbiosis aggravated Mp airway infection.
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Objective@#To investigate the influences of antibiotic-induced gut microbiota dysbiosis on Mycoplasma pneumoniae (Mp) airway infection.@*Methods@#C57BL/6J mice were treated with vancomycin and gentamicin for 21 d by oral delivery and then intranasally infected with Mp. Quantitative real-time PCR (qPCR) was performed to detect five major phyla of gut microbiota in mouse fecal specimens before and after antibiotic treatment and the loads of Mp in lung tissues on 3 d and 7 d after infection. Pathological changes in lung tissues were evaluated with HE staining. IFN-γ and IL-4 secreted by spleen CD4+ T cells and CD8+ T cells were analyzed by flow cytometry. Mp-specific IgM and IgG in mouse serum samples were measured by indirect enzyme-linked immunosorbent assay (ELISA).@*Results@#Vancomycin and gentamicin treatment significantly reduced the number of Bacteroidetes in mouse feces, but increased the amount of Firmicutes. Meanwhile, the numbers of δ, γ-Proteobacteria, Actinomycetes and Tenericutes also changed. These antibiotic-induced gut microbiota alterations in mice with Mp infection increased the loads of Mp in lung tissues and the pathological scores of lung tissue inflammation on 3 d and 7 d after infection, and reduced the number of IFN-γ-secreting spleen CD4+ T lymphocytes on 7 d.@*Conclusions@#Antibiotic-induced gut microbiota dysbiosis aggravated Mp airway infection.
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Objective To verify the analytical performance of Hitachi 7600-210automatic biochemical analyzer detection system.Methods The precision, accuracy, linearity and clinical reportable range, limit of quantitative detection and anti-interference capability were validated according to Clinical and Laboratory Standards Institute (CLSI) documents (EP15-A3and EP17-A2) and Clinical Laboratory Improvement Amendment 1988 (CLIA′88) standards.Results The within precisions of high and low two concentrations were both less than1/4CLIA′88TEa (laboratory permissible total error), the day precisions were less than 1/3CLIA′88TEa, the pass rates of three external quality assessments in 2017 were all not less than 80％and range from 0.02mmol/L to 401.80mmol/L.The clinical reportable was ranged from 0.02to 401.80mmol/L with a linear relationship.The LoB, LoD and LoQ of glucose (GLU) detection were 0.01 mmol/L, 0.03 mmol/L and 0.08mmol/L respectively.The anti-interference capability to hemoglobin (Hb), vitamin C (VitC), bilirubin (BIL) and triglyceride (TG) in the detection system to GLU measurement were in accordance with the manufacturer′s statement.Conclusion Performance verification of Hitachi 7600-210automatic biochemical analyzer detection system to GLU detection is consistent with the manufacturer statement also in accordance with CLIA′88standards, which can meet the expectant use of clinical test.
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Thirty patients with gastric cancer,ASA Ⅱ or Ⅲ,scheduled for selective radical gastrectomy under tracheal intubation general anesthesia in Zhejiang Provincial People's Hospital from November 2016 to February 2017 were enrolled in the study.The gastric tubes were placed by a nurse before operation.The position of gastric tube was judged under gastric ultrasonography by a sonographer and anesthesiologist respectively;and confirmed by the surgeon during the operation.With the position judged by the surgeon as gold standard,the sensitivity,specificity,positive predictive value,negative predictive value of the judgment of ultrasonographer were 96％,80％,96％,50％,respectively with the Kappa value 0.760 of (P ＜0.001),those of the judgment of anesthesiologist were 92％,40％,92％ and 60％,respectively with a Kappa value of 0.280 (P =0.125);those of the judgment of nurse were 92％,0％,100％ and 71.4％,with a Kappa value of-0.105 (P =0.513).The results suggest that ultrasound examination is a simple,reliable and sensitive method for confirming correct gastric tube placement.
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OBJECTIVE@#To investigate the prognostic value of preoperative serum tumor markers combined with peripheral blood routine indexes in colorectal cancer patients.@*METHODS@#From January 2010 to March 2013, clinicopathological data of colorectal cancer patients receiving surgery treatment at the Third Affiliated Hospital of Sun Yat-sen University were collected.@*INCLUSION CRITERIA@#(1) histologically confirmed adenocarcinoma; (2) primary cancer resected; (3) intact clinical data; (4) no signs of clinical infection. Patients with intestinal perforation or obstruction, hematological diseases or other malignant tumors were excluded. Informations were recorded containing sex, age, tumor location, degree of differentiation, tumor size, vascular tumor thrombus, nerve invasion, depth of infiltration, lymph node metastasis, distant metastasis, TNM stage, peripheral serum CEA, CA199, number of neutrophil, monocyte, platelet and lymphocyte. Positive CEA was defined as ≥5 μg/L, CA199 as ≥35 U/L; while NLR (neutrophil-to-lymphocyte ratio), MLR (monocyte-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio) greater than their cut-off values were defined as positive. ROC curve was used to determine the cut-off values (with greatest area under curve) of NLR, MLR and PLR. The prognostic values of these indexes were analyzed using Kaplan-Meier regression and log-rank test. COX regression was used to perform risk factor analysis.@*RESULTS@#A total of 312 colorectal cancer patients were enrolled, including 192 males and 120 females with median age of 61 (15-85) years. Till March 11, 2018, during median follow-up period of 65 months(2-96), the follow-up rate was 90.4% with loss of 30 cases and the mortality was 37.2% with 116 death. Univariate analysis found that colorectal cancer patients with positive CEA, CA199, NLR (>2.32), MLR (>0.24) and PLR (>164.1) had poor prognosis (all P<0.01). When combining CEA, CA199 with NLR, MLR, PLR, the survival analysis showed that patients with both negative indexes had the best prognosis, one positive the worse and both positive were the worst (all P<0.01). COX regression revealed that CEA(HR= 1.702,95%CI:1.148-2.522, P<0.01), combination of CA199 and MLR (HR=2.292, 95%CI:1.426-3.683, P<0.01) were independent risk factors for colorectal cancer.@*CONCLUSION@#Combination of preoperative serum tumor markers and peripheral blood routine indexes can provide prognostic information for the patients with colorectal cancer.