Correlation analysis of thromboelastogram and routine coagulation test in the detection of cerebrovascular diseases / 中国输血杂志

【Objective】 To explore the changes of parameters of thromboelastogram (TEG) detection in patients with cerebral infarction and cerebral hemorrhage, and their correlation with routine coagulation indicators, and compare the two methods in detecting coagulation function and status in patients with cerebrovascular disease. 【Methods】 The detection data of 34 cases of cerebral infarction and 102 cases of cerebral hemorrhage, who underwent TEG and routine coagulation test in parallel, in Department of Neurosurgery of our hospital from January 1, 2018 to March 26, 2019 were collected. Fifty healthy subjects, who underwent TEG and routine coagulation tests in the same period, served as the control. The results of TEG and routine coagulation test of the 3 groups were compared and analyzed. 【Results】 Compared with cerebral hemorrhage (group) and the control, R value of cerebral infarction group decreased significantly, while the Angle angle, MA distance, CI value, Fib and D-D levels increased significantly(P<0.05); the K value, Fib, TT, and D-D of cerebral hemorrhage group increased significantly while Angle angle and MA distance decreased significantly compared with other two groups(P<0.05). The R value, K time (min), TT (s), D-D (mg/L), Angle angle (°), MA distance, CI value, and Fib (mmg/L) of cerebral infarction and cerebral hemorrhage group were 5.06±1.71 vs 6.95±4.34, 1.19±0.68 vs 3.43±1.46, 13.89±1.05 vs 18.63±1.25, 1.93±0.25 vs 2.63±0.45, 69.34±10.37 vs 56.54±10.48, 68.34±9.37 vs 54.35±7.48, 2.20±0.31 vs 0.78±0.41, and 380±70.02 vs 354±71.56 (P<0.05). In cerebral infarction group, the R value, APTT, Angle angle, MA, and CI values were positively correlated with Fib (P<0.05); while K time was negatively correlated with Fib ; MA distance with PT/TT; CI value with PT/APTT(P<0.05). In the cerebral hemorrhage group, the R value was positively correlated with PT/APTT; K time with TT; Angle with Fib (P<0.05); R value/K time were negatively correlated with Fib; Angle with TT; CI value with PT (P<0.05). 【Conclusion】 For patients with cerebrovascular disease, there is no correlation between TEG indicators and the D-D level of routine coagulation tests; the Angle angle of patients with cerebrovascular disease is positively correlated with the elevated Fib; and MA distance is more useful for diagnosing cerebral infarction than cerebral hemorrhage. TEG is complementary to routine coagulation test, and can be used as a laboratory index for assessing the severity of cerebrovascular disease.

Construction of recombinant house dust mite group 1 allergen vaccine and study on immune response induced by nasal immunization / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the preparation of recombinant house dust mite group 1 allergen vaccine (chitosan-pVAX1-Derp1 nanoparticles, pVAX1-Derp1/CS) and to investigate the efficacy and mechanism of intranasally given chitosan-pVAX1-Derp1 nanoparticles on mouse model with allergic rhinitis (AR).</p><p><b>METHODS</b>The chitosan-pVAX1-Derp1 nanoparticles was prepared by complex coacervation, and its nature was identified and analysed. A total of 40 BALB/c rats were randomly divided into 5 groups: the normal group (group A), the AR model group (group B), the chitosan (CS) prevention group (group C), the pVAX1-Derp1 prevention group (group D), and the pVAX1-Derp1/CS prevention group (group E). The nasal cavity of rats in the group B, C, D and E were dripped with phosphate buffered saline (20 µl), CS (20 µl), pVAX1-Der p1 (20 µl), pVAX1-Derp1/CS nanoparticles (20 µl) on the first day and day 8, once daily. Rats in the latter 4 group were sensitized with Der p1 and Al(OH)3 in day 15 and day 22, and challenged with Der p1 to establish AR model from day 36 to day 43, while rats in group A were treated with PBS. Then the level of cytokines in serum was assayed by ELISA, inflammatory reactions in nasal mucosa were analyzed by haematoxylin and eosin staining.</p><p><b>RESULTS</b>pVAX1-Derp1/CS nanoparticles was successfully constructed, the mean grain size of pVAX1-Derp1/CS was (205.3 ± 12.8) nm, and the zeta potential was (30.5 ± 5.6) mV. In nasal mucosa tissue, group B and C showed significant allergic inflammation, while group D and E showed lighter allergic inflammation. Compared with the group B, the group D and E could effectively reduced serum IgE level and IL-4 level [group B: (120.0 ± 8.8) ng/ml, (248.7 ± 10.6) pg/ml; group D: (109.6 ± 14.5) ng/ml, (192.5 ± 10.2) pg/ml; group E: (88.1 ± 8.3) ng/ml, (165.7 ± 9.7) pg/ml; IgE: t value were 3.5, 6.9, all P < 0.01; IL-4: t value were 10.0, 15.2, all P < 0.01], and increased IFN-γ level [group B: (709.0 ± 26.5) pg/ml; group D: (856.3 ± 37.4) pg/ml; group E: (904.8 ± 37.7) pg/ml; t value were 8.2, 10.8, all P < 0.01)]. IL-10 level of group D [(129.9 ± 16.1) pg/ml] and E [(107.1 ± 11.8) pg/ml] was lower than IL-10 level of group B [(160.6 ± 24.2) pg/ml]. The difference were significantly (t value were 2.9, 5.5, all P < 0.05).</p><p><b>CONCLUSIONS</b>Chitosan can effectively encapsulate pVAX1-Derp 1 and inhibit nuclease degradation of the plasmid, the DNA vaccine has some preventive effect on AR animal model by nasal immunization.</p>

Practice and thoughts on the social responsibility of private hospitals / 中华医院管理杂志

The paper introduced the organization culture building of a private hospital, in creating the Aikang hospital as your home culture and Aikang values for building a harmonious workplace for the hospital. The management system reform features the separation between regulations and management,building of the supporting system and operating system, for better quality of care with advanced management practice. The social rewards feature great efforts in supporting the disadvantageous population, and undertaking public health service and charity activities. These care and love to the community help the hospital to fulfill its social responsibilities.

Laparoscopic versus open wedge resection for gastrointestinal stromal tumors of the stomach: a clinical controlled study / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the surgical outcomes between laparoscopic and open wedge resection for gastrointestinal stromal tumors of the stomach.</p><p><b>METHODS</b>Clinical data of 18 cases undergoing laparoscopic wedge resection from June 2000 to August 2009 at the Zhejiang Provincial People's Hospital were compared with 30 patients treated by open surgery. The perioperative parameters and prognosis data of the two groups were compared.</p><p><b>RESULTS</b>Compared to the open group, laparoscopic group was found with longer operative time, less blood loss, less requirement of postoperative analgesia, earlier resumption of oral intake, earlier return of first flatus, and shorter postoperative hospital stay(all P<0.05). There were no postoperative deaths in both groups. Postoperative complication rate was significantly lower in the laparoscopic group(5.5% vs. 33.3%, P<0.05). The postoperative recurrence rates were 11.8%(2/17) and 10.7%(3/28); the 5-year survival rates were 78% and 63%, respectively, and the difference was not statistically significant(P>0.05).</p><p><b>CONCLUSION</b>Laparoscopic wedge resection is a feasible treatment option for GISTs of the stomach.</p>

Oral glucose tolerance test and insulin response in Beagle dogs after subtotal distal gastrectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the impact of reconstruction techniques after subtotal gastrectomy on postoperative glucose and insulin levels after oral glucose tolerance test (OGTT).</p><p><b>METHODS</b>Distal gastrectomy was performed in 38 Beagle dogs. Reconstruction techniques used included integral continual jejunal interposition (n=9), Billroth I( (n=6), Billroth II( (n=7), and isolated jejunal interposition (n=8). Eight controls were used. OGTT was conducted to examine the changes in glucose and insulin levels.</p><p><b>RESULTS</b>Compared to controls, glucose significantly increased in all the 4 operative groups and peaked at 60 min. Billroth II( was associated with the most significant increase. Insulin level significantly increased in all the experimental groups in response to food stimulus and peaked at 60 min. However, the increase of insulin in Billroth II( group was not as prominent as in other groups.</p><p><b>CONCLUSIONS</b>Fluctuation of blood glucose after gastrectomy may be mitigated and insulin elevated if duodenal passage is preserved. Continual jejunal interposition should be given priority when Billroth I( reconstruction is not feasible.</p>

Experimental research of integral continuous jejunal interposition after subtotal distal gastrectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate nutritional status, myoelectrical activity, and gastrointestinal tract emptying capacity after integral continuous jejunal interposition following subtotal gastrectomy.</p><p><b>METHODS</b>According to different re-construction techniques, 30 Beagle dogs were divided into four groups after subtotal distal gastrectomy: group 1(n=9, integral continuous jejunal interposition), group 2(n=6, Billroth I(), group 3(n=7, Billroth II(), group 4(n=8, isolated jejunal interposition). Blood cell counts, liver function, myoelectrical activity and the rate of gastrointestinal tract emptying were compared among the four groups.</p><p><b>RESULTS</b>At week 12 after operation, the body weight in group 1 [(9.65±1.54) kg] was significantly higher than that in group 2[(9.25±1.76)kg], group 3[(9.31±1.54)kg] and group 4[(7.77±1.46)kg]. At week 4, the prognostic nutritional index in group 1(2671.9±49.9) was significantly higher than that in group 3(2555.9±54.7) and group 4(2440.9±54.3), but similar to that in group 2(2791.8±54.3). At week 6, the fasting and postprandial frequency of jejunal pacesetter potentials in group 1 were higher than those in group 3 and group 4(P<0.05) but comparable with those in group 2. The emptying rate of food in the four groups were 95.4%, 91.3%, 93.1% and 94.2%, respectively and there were no significant differences(P>0.05). However, as compared with group 2 and group 3, group 1 had longer operative time and later regular diet resumption, more severe abdominal adhesion(P<0.05).</p><p><b>CONCLUSION</b>Continuous jejunal interposition should be considered when Billroth I( is not feasible after subtotal gastrectomy.</p>

Meta-analysis of study on risk factors of female breast cancer / 中华疾病控制杂志

50 years (ORs=1.39,95% CI:1.22～1.57) and oral contraceptive use (Adjusted ORs=2.12,95% CI:1.24～3.62) were associated with increase in breast cancer risk while the summary OR based on number of full-term pregnancy ≥1 (Adjusted ORs=0.63,95% CI:0.60～0.68) and breastfed (ORs=0.76,95% CI:0.64～0.90) indicated no association with breast cancer risk. Conclusions Decreasing benign breast disease, advocating breastfed and examining high risk population will be the effective measures to control breast cancer in women.