Current progress on lesion classification of hepatic alveolar echinococcosis / 中华肝胆外科杂志

Human alveolar echinococcosis is a chronic infectious disease caused by Echinococcus multilocularis infection. It predominantly injuries the liver and grows like the malignant tumor. The therapeutic options and prognosis depend on types of human alveolar echinococcosis, clinical stages, biological activity, vascular invasion, pathological characteristics, and patient's immune status. However, despite of multiple classification methods, there are still lacking of comprehensive typing schemes. which leads to inappropriate diagnosis and therapy. This research systematically reviewed the recent studies on human alveolar echinococcosis at home and abroad and analyzed the classifications based on ultrasound, computer tomography, magnetic resonance imaging, positron emission computed tomography, serology and pathology, and some novel technologies and summarized the individual advantage and disadvantage for each classification Relationships and their advantages plus disadvantages have been assessed comprehensively. Meanwhile, the possible reference factors or theoretical basis for optimized future classification are proposed, in order to establish a unified classification system to provide guidance for clinical diagnosis and treatment.

Noninvasive indicators of indications for antiviral therapy in HBeAg-negative chronic HBV infection patients with alanine aminotransferase ≤40 U/L / 临床肝胆病杂志

Objective To investigate the noninvasive indicators of indications for antiviral therapy in HBeAg-negative chronic hepatitis B virus (HBV) infection patients with alanine aminotransferase (ALT) ≤40 U/L under the guidance of liver pathology. MethodsA retrospective analysis was performed for the clinical data of 377 HBeAg-negative chronic HBV infection patients with ALT ≤40 U/L who were hospitalized in Affiliated Hospital of Yan’an University, from October 2013 to August 2018 and underwent liver biopsy, among whom the patients with inflammatory activity ＜A2 and fibrosis stage ＜F2 were enrolled as non-antiviral therapy group(n=266), and the patients with inflammatory activity ≥A2 or fibrosis stage ≥F2 were enrolled as antiviral therapy group(n=111). The chi-square test was used for comparison of categorical data between two groups; the t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; univariate and multivariate binary logistic regression analyses were used to screen out the influencing factors for the initiation of antiviral therapy; the receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency of each indicator in determining the need for antiviral therapy in HBeAg-negative chronic HBV infection patients with ALT ≤40 U/L. ResultsOf all 377 patients, 266 (70.6%) did not need antiviral therapy for the time being, and 111 (29.4%) had marked liver damage and thus needed active antiviral therapy. The multivariate analysis showed that liver stiffness measurement (LSM) (odds ratio ［HR］=2.003, 95% confidence interval ［CI］: 1.647-2.437, P＜005), HBsAg (HR=1.563, 95% CI: 1.110-2.200, P＜0.05), HBV DNA (HR=1.519, 95% CI: 1173-1.966, P＜0.05), and albumin (HR=0.939, 95% CI: 0.884-0.998, P＜0.05) were independent influencing factors for the initiation of antiviral therapy. The ROC curve analysis showed that the area under the ROC curve (AUC) was 0.749 (95% CI: 0.699-0799) for LSM, 0642 (95% CI: 0.586-0.699) for HBV DNA, and 0.565 (95% CI: 0.507-0.623) for HBsAg, and the combination of LSM, HBV DNA, and HBsAg had a larger AUC of 0.779 (95% CI: 0.732-0.827). ConclusionThe levels of LSM, HBV DNA, and HBsAg have a reference value in determining the initiation of antiviral therapy in HBeAg-negative chronic HBV infection patients with ALT≤40 U/L.

Pathogen spectrum of viral encephalitis in children living in Hebei province, China from May to December 2017 / 中华实验和临床病毒学杂志

Objective@#To investigate the pathogenic characteristics of viral encephalitis in children living in Hebei province.@*Methods@#We randomly collected cerebrospinal fluid specimens from a total of 399 children diagnosed with viral encephalitis in Hebei Children′s Hospital from May to December 2017. Real-time fluorescence quantitative PCR and Sanger sequencing were used to detect viral nucleic acids in cerebrospinal fluid by an automatic laboratory station. Statistical analysis was performed on the experimental data using SPSS 21.0 software and the clinical data were analyzed. Comparison of infection rates of EV encephalitis in different months, using line × column chi-square test. The MRI and EEG positive rates of different viral encephalitis and viral encephalitis patients not infected with the virus were analyzed by Fisher′s exact probability test. The positive rate of infection with different viruses and non-virus agents was analyzed by Fisher′s exact probability test.@*Results@#The result showed that 80 of 399 samples were positive, and the positive rate was 20.05%. It included 22 cases of enterovirus, 4 cases of influenza A virus, 3 cases of mumps virus, 2 cases of herpes simplex virus type 1, 1 case of herpes simplex virus type 2, 4 cases of EB virus, 7 cases of cytomegalovirus, 7 cases of herpes zoster virus, 8 cases of adenovirus, 14 cases of human herpesvirus type 6. Eight cases had combined viral infection. Eight cases had concurrent infections: 3 cases had enterovirus and herpesvirus type 6 concurrent infection, 1 case had enterovirus and Japanese encephalitis virus concurrent infection and 1 case had herpes simplex virus type 2 and adenovirus, 1 case had influenza A virus herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had herpes simplex virus type 1 and herpes zoster virus concurrent infections. Children with EV viral encephalitis in Hebei Province were highly prevalent in May and June (P=0.016). HHV6 virus encephalitis was more susceptible to infection than non-HHV6 virus (P=0.016); The rate of MRI positive findings in patients with different viral encephalitis was not statistically significant (P>0.05). The result of EEG of different viral encephalitis were P>0.05, which was not statistically significant.@*Conclusions@#EV was the most common pathogen of children with viral encephalitis in Hebei province. Encephalitis caused by influenza A virus cannot be ignored in clinical practice.

Prevalence of hospital acquired Burkholderia cepacia infection and its antimicrobial susceptibility in a Chinese hospital

This study aimed to investigate antimicrobial susceptibility of hospital acquired Burkholderia cepacia infection in Shanxi [China] during August 2009 and December 2012. To characterize an emerging nocosomial infection. The medical records of 112 patients that were tested positive for B. cepacia were retrospectively analyzed. The K-B disk diffusion method was used to determine the drug susceptibility of the isolated strains. A hundred and fifty strains of B. cepacia were isolated from 112 patients. The sensitivity rates of B. cepacia to meropenem, imipenem, cotrimoxazole, minocycline and ceftazidime were 65.7%, 14.3%, 76.0%, 68.1% and 74.1%, respectively. All patients suffered from more than two underlying diseases, 89 [79.5%] from another bacterial infection and 92 [82.1%] with indwelling catheter. All patients were given antibiotics, including 62 patients that received carbapenem antibiotics. The average duration of hospitalization before detection of B. cepacia was 31+/-24 days, after which 65 patients [58.0%] improved, 22 [19.0%] died, 8 [7.1%] quit the therapy, and 17 [15.2%] were discharged after full recovery. The prevalence of hospital acquired B. cepacia infection and drug-resistance in the hospital is reported and risk factor exploration requires further study

Effects of cannabinoid HU210 on experimental acute pancreatitis and possible relationship with Toll-like receptor 4 signaling pathway / 中国病理生理杂志

AIM:Using Toll-like receptor 4 gene knockout (tlr4-/-) mice and the wild-type (WT) mice with the same C57BL/10J genetic background, the effects of HU210, a cannabis preparation, on caerulein (CAE)-induced acute pancreatitis (AP) and the potential mechanisms were investigated.METHODS:WT or tlr4-/-mice were randomly divided into AP group, AP+HU210 group and control group.AP was induced by intraperitoneal injection of CAE (50 μg·kg-1·h-1) for a total of 6 times and lipopolysaccharide (LPS) at 10 mg/kg 6 h after the first injection of CAE.HU210 (50 μg/kg) was given 30 min before and 4 h after the first injection of CAE in AP+HU210 group.The animals in control group were given normal saline instead of CAE and LPS in the same way.The mice were sacrificed 3 h after the last injection.The blood, the pancreas, the lungs and the intestinal Peyer's patches were harvested.RESULTS:Compared with control group, the pancreatic pathological score and P38 protein expression, plasma amylase activity and inflammatory mediator levels, and lung MPO activity were significant increased (P<0.05) in both WT and tlr4-/-mice with AP.Compared with the WT mice with AP, the tlr4-/-mice with AP showed significantly low levels of IL-6, TNF-α and MCP-1 in the plasma, low expression levels of pancreatic P38 and p-P38 protein (P<0.05), and mild alterations of CD3+ T-lymphocytes, CD4+ T-lymphocytes and the ratio of CD4+/CD8+ (P<0.05).The administration of HU210 attenuated the pancreatic pathological changes and the lung MPO activity in both stains of mice with AP (P<0.05).However, the inhi-bitory effects of HU210 on the increased amylase activity in the plasma and the increased protein levels of pancreatic P38 and p-P38 were remarkable (P<0.05) in WT mice instead of in tlr4-/-mice.CONCLUSION:TLR4 is mainly involved in AP-related systemic inflammatory response and its mechanism may be dependent on TLR4-P38 MAPK signaling pathway.The intervention of HU210 in AP plays a protective role mainly by inhibiting the infiltration of inflammatory cells, and the relationship with TLR4 signaling pathway is not obvious.

Toxoplasma gondii infection among HBV patients / 中国人兽共患病学报

To investigate the prevalence of Toxoplasma gondii infection among hepatitis B virus (HBV) patients in northern Shaanxi Province,139 patients and 43 healthy controls were recruited.All the plasma was screened for IgG antibody of Toxoplasma gondii.Then,the association between Toxoplasma gondii infection and HBV were analyzed.Results showed that the prevalence of Toxoplasma gondii infection was relative low with just 5.04％ in HBV patients but zero in healthy control.Most of those infected with toxoplasma gondii were male,HBeAg positive or with higher HBV viral load.However,no significant relationship was found between Toxoplasma gondii infection and gender,HBeAg status or viral load in univariate analyses.This study indicated the relative low infection rate of Toxoplasma gondii,which had no association with HBV infection in northern Shaanxi Province.

Chinese herbal preparation Qing Yi TangⅡgranule protects against ex-perimental acute pancreatitis in mice / 中国病理生理杂志

[ ABSTRACT ] AIM: To investigate the protect effect of Chinese herbal preparation, Qing Yi TangⅡgranule (QYT), on acute pancreatitis (AP) mice and its mechanism.METHODS:Adult male and female C57BL/6 mice (n=24) were randomly divided into control group, AP group and AP+QYT group.Severe AP was induced by combined intra-peritoneal injection of caerulein (50μg/kg) and lipopolysaccharide (LPS;10 mg/kg).Drinking water or 24%QYT solu-tion was given to the mice in AP group or AP+QYT group by oral gavage.The mice in control group were intraperitoneally injected with equivalent volume of normal saline and gavaged with water.The mice were sacrificed 3 h after the last injec-tion.Severity of AP was assessed by biochemical markers and histology.The plasma level of IL-6 and MCP-1, and lung myeloperoxidase ( MPO) levels were determined for assessing the extent of systemic inflammatory response.The intestinal microflora, T lymphocytes and T-lymphocyte subgroups were examined for assessing the function of the intestinal barrier. RESULTS:Compared with control group, the mice in AP group presented significant increases in pathological histological scores, plasma amylase activity and IL-6 and MCP-1 levels, as well as the MPO activity in the lung and pancreatic tissues. QYT attenuated these changes to some extent.Furthermore, the increased intestinal microflora was significantly reversed by QYT.No difference of the numbers of Peyer’ s patches in small intestine in the 3 groups was observed, but the percentage of CD3 +T lymphocytes decreased significantly in AP group, and increased percentage of CD4 +and CD4 +/CD8 +ratio were found in AP group and AP+QYT group.CONCLUSION: QYT protects against cearulein and LPS-induced acute pancreatitis in mice.The mechanisms may be related to the suppression of the inflammatory response, promoting intestinal bacteria removal, and regulating the functions of T lymphocytes in the intestinal barrier.

Clinical observation of intranasal dexmedetomidine on thyroid surgery / 中国医师进修杂志

Objective To observe the effect of intranasal dexmedetomidine on total intravenous anesthesia for thyroid surgery postoperative analgesia.Methods Sixty female patients who were undergoing elective thyroid surgery were enrolled.Patients by total intravenous anesthesia were randomized in mechanical sampling method to receive intranasal dexmedetomidine 1 μ g/kg (group Ⅰ,30 cases),or the same volume sodium chloride (group Ⅱ,30 cases) before anesthesia induction,then flurbiprofen 100 mg intravenous 10 min before surgery.The postoperative surgical pain was assessed utilizing visual analogue scale (VAS),and the postoperative pain of cough was assessed by comfort score (BCS) at 1,2,4,6,8,12,24 h after surgery,in addition,the adverse reactions were recorded.Results The VAS scores at 1,2,4,6,8,12 h in group Ⅰ were lower than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The BCS scores at 1,2,4,6,8 h in group Ⅰ were higher than those in group Ⅱ,and there were statistically significant (P ＜ 0.05).The nausea and dizziness morbidity in group Ⅰ were lower than those in group Ⅱ (8 cases vs.14 cases,6 cases vs.14 cases),and there were statistically significant (P ＜ 0.05).Eight patients were required supplemental analgesic within 12 h after surgery in group Ⅱ,which was more than that in group Ⅰ (0 case),and there was statistically significant (P ＜ 0.05).Conclusion Receive total intravenous anesthesia for thyroid surgery,the patients who are given intranasal dexmedetomidine 1 μ g/kg combined with flurbipmfen can reach satisfactory postoperative analgesia,decrease the nausea and dizziness morbidity,increase the comfortable degree.

Training clinical skills and scientific thinking for postgraduates of anesthesiology / 中华医学教育探索杂志

Training anesthesiology postgraduates should be started with clinical skill and scien-tific thinking. This article advocated setting up a multi-level and multi-mode training strategy based on theoretical study ,clinical skill training and scientific ability development according to the features of anesthesiology. Meanwhile,the training should have focus and orientation for postgraduates at different grades. This study solved the problems of training for postgraduates of anesthesiology and made a feasible training strategy to develop the clinical and scientific ability of postgraduates.

The teaching experiences in improving the cooperation skills of operating room nurses with anesthesiologists / 中华医学教育探索杂志

The good cooperation between the operating room nurses and anesthesiologists is benefitial to improving working efficiency and can make the patients uneventful during operating period.As an anesthesiologist,the author taught the basic anesthesia knowledge such as the commonly used anesthesia methods,the prevention and treatment of complications and gave advice to the nurses of the nursing trainning group.The cooperations before anesthesia,during anesthesia,after anesthesia were analyzed and the significance of nursing cooperation with anesthesiologist was discussed.

Effects of HIF-1α expression regulated by Tet-on gone expression system on hepatoma cell proliferation and cell cycle in vitro / 中华普通外科杂志

Objective To investigate the effects of HIF-1α expression regulated by Tet-on gene expression system on cell proliferation and cell cycle of hepatoma cells in vitro. Methods The change of human hepatocellular carcinoma cell lines HepG2 cell cycle and cell proliferation was measured after HIF-1 α expression of HepG2 in vitro was regulated by Tet-on expression system. Results Amplified products were confirmed as the cDNA of HIF-1α by DNA sequencing, and pTRE-HIF-1α obtained by edonuclease digestion,capable of expression in HepG2 Tet-on cells. After being incubated under different concentrations of doxycycline for 48 h, MTT assays showed that up-regulation of HIF-1α expression increased HepG2 cell proliferation activities. The cell index of S and G2/M phase was significantly higher and that of G0/G1 phase reduced with the increasing concentrations of doxycycline. The mRNA expression of Cyclin A increased with the increasing concentrations of doxycycline ( P ＜ 0. 001 ), CyclinD1 and CyclinE did not change ( P ＞0. 05). Conclusion HIF-1 α gene promotes cell proliferation and cell cycle of hcpatoma cells in vitro, and this effects increased with the increasing of HIF-1α expression possibly through influencing the expression of CyclinA.

Pathogens Causing Nosocomial Infection and Characteristics of Antimicrobial Resistance 2004-2006 / 中华医院感染学杂志

15.0%.CONCLUSIONS The most common pathogens causing nosocomial infection are Gram-negative bacteria.The resistance rates are high.Antibiotics policy is urgently needed in order to delay the resistance onset development.

Effects of pulmonary surfactant containing ketamine on respiratory failure induced with lung lavage in rats / 中华麻醉学杂志

Objective To evaluate effects of pulmonary surfactant (PS) containing ketamine on respiratory failure induced with lung-lavage in rats Methods Twenty Wistar rats were anesthetized with intraperitoneal pentobarbital sodium and were ventilated with the peak inspiratory pressure(PIP) being 1 47 kPa and E:I at 1:1 following intubation through tracheotomy In all rats whole double lung lavage were performed with normal saline (37℃, 40 ml?kg -1 ) 8 10 times after PIP and PEEP were adjusted to 1 96 kPa and 0 49 kPa respectively The rats were randomly divided into A and B groups after PaO 2 decreased to less than 12 kPa In group A (n=10): PS (25mg, 0 5ml) was injected intratracheally to lungs; in group B (n=10): PS (25mg, 0 5ml) containing ketamine 2 5 mg was injected At 120th min after PS injection, PIP and PEEP were gradually adjusted to 1 47 kPa and 0 kpa (ZPEEP), respectively Results PaO 2 in both groups decreased significantly from 59 3 kPa to 10 3 kPa after lung lavage(P0 05 vs pre-lavage) All rats in group B and 4 of 10 rats in group A survived at the end of experiment Conclusions Intratracheal administration with PS containing ketamine not only reverses hypoxemia , but also maintains the respiratory function under low airway pressure without PEEP after respiratory failure induced with lung lavage,

Effects of antibiotics on the function of pulmonary surfactant / 中华麻醉学杂志

0.05). After the injection, PaO 2 in group A, B and C increased significantly, whereas PaO 2 in group D did not change and was kept at low level below 13.3kPa (P