Synchronous biopsy followed by radiofrequency ablation in lung tumors: A clinical analysis of a single center / 中国胸心血管外科临床杂志

@#Objective    To explore the application value of synchronous CT-guided percutaneous biopsy followed by radiofrequency ablation in the diagnosis and treatment of lung tumors. Methods    The clinical data of 21 patients with lung tumors were retrospectively analyzed. There were 8 males and 13 females aged 68 (51, 73) years. A total of 24 lesions underwent CT-guided percutaneous biopsy and concurrent radiofrequency ablation. The effectiveness and safety of this protocol were analyzed. Results    All 21 patients successfully completed the procedures. The diameter of 24 lesions was 17.0 (13.3, 19.0) mm. Biopsy specimens met the requirements of pathological diagnosis, and the effectiveness of specimens was 100.0%. The incidence of small amount of pneumothorax/pleural shrinkage after procedures was 19.0% (4/21) and the incidence of tension pneumothorax was 4.7% (1/21). There was no obvious bleeding or other complications. Conclusion    Synchronous CT-guided percutaneous biopsy followed by radiofrequency ablation combines two interventional techniques, which is safe and effective in the diagnosis and treatment of lung tumors, and it is worthy of popularization and application in clinic.

Correlation between intestinal mucosal permeability and prognosis in patients with liver cirrhosis / 中华肝脏病杂志

Objective@#To investigate the correlation between changes in intestinal mucosal permeability and prognosis of patients with liver cirrhosis.@*Methods@#Data of 89 cases with liver cirrhosis who were hospitalized in the Hepatology Department of Shanxi Provincial Hospital of Traditional Chinese Medicine from January 2017 to August 2017 were collected as the liver cirrhosis experimental group, and 40 healthy subjects were randomly selected as the healthy control group. JY-DLT, the Intestinal Mucosal Barrier Biochemical Index Analysis System was used to measure the levels of serum diamine oxidase (DAO), D-lactic acid, and endotoxin (ETX) in two groups to evaluate intestinal mucosal barrier function. Spearman’s rank correlation test was used to evaluate the correlation between liver cirrhosis prognosis and intestinal mucosal permeability. The results of the two groups were compared by Mann-Whitney H test of two independent samples. One-way Anova was used for intergroup comparison. The pairwise comparison between groups was performed using the LSD or SNK test.@*Results@#The level of ETX in patients with decompensated cirrhosis was significantly higher than that in the compensated phase, and the difference was statistically significant (P < 0.05). The levels of DAO, D-lactic acid and ETX in the liver cirrhosis group were significantly higher than those in the healthy control group, and the differences were statistically significant (P < 0.01). The plasma levels of DAO, D-lactic acid and ETX in the Child-Pugh grade groups of patients with liver cirrhosis were significantly higher than those in the healthy control group, and the differences were statistically significant (P < 0.05). The results of intergroup comparison showed that there were statistically significant differences in DAO, D-lactic acid and ETX levels between Child-Pugh grade A and grade B groups (t = -4.255, 2.527, -2.179, P < 0.05). Furthermore, there were statistically significant differences in the levels of D-lactic acid and ETX between the Child-Pugh grade A and grade C groups (t = -2.693, -4.248, P < 0.01).The plasma levels of DAO, D-lactic acid and ETX levels were positively correlated (r = 0.205, 0.372, 0.342, P < 0.01). D-lactic acid and ETX levels were positively correlated with CTP score, Forns’ index, RPR index, APRI score, FIB-4 index and FibroScan score(P < 0.01).@*Conclusion@#The three indices (plasma DAO, D-lactic acid, and ETX) can accurately detect the changes in intestinal mucosal permeability. Moreover, the higher index of intestinal mucosal permeability causes the more severe degree of liver cirrhosis and the correlation between the intestinal mucosal permeability and the prognosis score of liver cirrhosis provides a reference for a new evaluation system and new ideas for the treatment of liver cirrhosis.

Role of adenosine A2b receptors in pulmonary microvascular endothelial inflammation induced by lipopolysaccharide / 中华危重病急救医学

Objective To explore the role of the low-affinity A2b adenosine receptors (Adora2b) in pulmonary microvascular endothelial inflammation induced by lipopolysaccharide and its mechanism. Methods Rat pulmonary microvascular endothelial cells (PMVECs) were isolated and cultured in vitro. After serum deprivation for 24 hours, cells were pretreated with Adora2b specific agonist BAY60-6583 (0.1, 1, 10 μmol/L) or Adora2b specific antagonist PSB1115 (1 μmol/L) for 1 hour, respectively, and then challenged with LPS (100 μg/L). Cells without treatment were served as the control group, and those treated with LPS, BAY60-6583 or PSB1115 alone were served as single challenge groups. After incubation with specific drugs for 24 hours, the apoptosis of PMVECs was analyzed by flow cytometry using Annexin V/propidium iodide (PI) technique. The levels of early inflammatory factors in cultured medium were measured using enzyme linked immunosorbent assay (ELISA). The mRNA expressions of chemotactic factors and adhesion molecules were determined by real-time quantitative-polymerase chain reaction (RT-qPCR). Polymorph nuclear neutrophils (PMNs) from venous blood of healthy rats were isolated, and PMN migration through PMVECs monolayer under stimulation of drugs was observed in transwell inserts. The monolayer permeability of PMVECs after adhesion of PMNs was determined by fluorescein isothiocyanate (FITC)-albumin assay. Oxidative stress was detected by DCFH-DA assay. Results Compared with the control group, more cells entered into the apoptosis stage after LPS challenge. Meanwhile, the levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in cultured medium were significantly increased, as well as the mRNA expressions of chemotactic factors [C-X-C motif chemokine ligand 1 (CXCL-1), CXCL-3 and monocyte chemoattractant protein-1 (MCP-1)] and adhesion molecules [E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)]. More PMNs migrated through PMVECs following adhesion and the monolayer permeability of PMVECs was rapidly enhanced. The oxidative stress was upregulated. Compared with LPS group, BAY60-6583 pretreatment could dose-dependently decrease the rate of apoptosis, attenuate trans-endothelial migration of PMNs and decrease the endothelial cell barrier leakage. There were significant differences even after incubation of 0.1 μmol/L BAY60-6583 [apoptosis rate: (21.12±2.12)％vs. (27.66±3.57)％, number of migrated PMNs/HP: 260.60±18.24 vs. 290.20±16.48, permeability coefficient (Pd, ×10-6 cm/s): 28.28±2.04 vs. 32.55±2.13, all P < 0.05]. Meanwhile, BAY60-6583 pretreatment also downregulated the levels of early proinflammatory factors in a dose-dependent manner as well as the mRNA expressions of chemotactic factors and adhesion molecules. The statistic difference was significant while treated with 1 μmol/L BAY60-6583 [IL-1β(ng/L): 475.75±63.15 vs. 755.25±67.42, TNF-α (ng/L): 560.25±69.96 vs. 818.75±60.92, CXCL-1 mRNA (2-ΔΔCt):3.57±0.28 vs. 5.27±0.69, CXCL-3 mRNA (2-ΔΔCt): 4.56±0.48 vs. 7.32±0.54, MCP-1 mRNA (2-ΔΔCt): 2.21±0.31 vs. 3.35±0.21, E-selectin mRNA (2-ΔΔCt): 4.64±0.09 vs. 7.28±0.73, ICAM-1 mRNA (2-ΔΔCt): 4.14±0.30 vs. 5.89±0.25, VCAM-1 mRNA (2-ΔΔCt): 2.23±0.19 vs. 2.92±0.33, all P < 0.05]. Furthermore, pretreatment of 10 μmol/L BAY60-6583 could decrease the oxidative stress [reactive oxygen species (RFU): 629.05±33.10 vs. 781.45±64.59, P < 0.05]. Contrast, PSB1115 pretreatment aggravated apoptosis of PMVECs after LPS incubation [(34.36±4.57)％ vs. (27.66±3.57)％], upregulated expressions of proinflammatory and chemotactic factors as well as adhesion molecules [IL-1β (ng/L): 889.00±63.11 vs. 755.25±67.42, TNF-α (ng/L): 939.00±43.44 vs. 818.75±60.92, CXCL-1 mRNA (2-ΔΔCt): 6.66±0.65 vs. 5.27±0.69, CXCL-3 mRNA (2-ΔΔCt): 10.42±0.51 vs. 7.32±0.54, MCP-1 mRNA (2-ΔΔCt):4.85±0.34 vs. 3.35±0.21, E-selectin mRNA (2-ΔΔCt): 8.42±0.47 vs. 7.28±0.73, ICAM-1 mRNA (2-ΔΔCt): 7.46±0.72 vs. 5.89±0.25, VCAM-1 mRNA (2-ΔΔCt): 4.35±0.26 vs. 2.92±0.33], aggravated trans-endothelial migration of PMNs (cells/HP: 348.40±22.68 vs. 290.20±16.48), enhanced the leakage of PMVECs monolayer [Pd (×10-6 cm/s):39.65±2.69 vs. 32.55±2.13] and increased oxidative stress in PMVECs [reactive oxygen species (RFU): 847.04±29.26 vs. 781.45±64.59], with statistically significant difference (all P < 0.05). Conclusion Activation of endothelial Adora2b attenuates LPS-induced pulmonary microvascular inflammation by decreasing the release of early inflammatory factors, downregulating expressions of chemotactic factors and adhesion molecules, attenuating trans-endothelial migration of PMNs and oxidative stress in PMVECs, which suggest endothelial Adora2b is apotential anti-inflammatory target in the treatment of LPS-induced acute lung injury.

Role of adenosine A2b receptors in pulmonary microvascular endothelial inflammation induced by lipopolysaccharide / 中华危重病急救医学

Objective@#To explore the role of the low-affinity A2b adenosine receptors (Adora2b) in pulmonary microvascular endothelial inflammation induced by lipopolysaccharide and its mechanism.@*Methods@#Rat pulmonary microvascular endothelial cells (PMVECs) were isolated and cultured in vitro. After serum deprivation for 24 hours, cells were pretreated with Adora2b specific agonist BAY60-6583 (0.1, 1, 10 μmol/L) or Adora2b specific antagonist PSB1115 (1 μmol/L) for 1 hour, respectively, and then challenged with LPS (100 μg/L). Cells without treatment were served as the control group, and those treated with LPS, BAY60-6583 or PSB1115 alone were served as single challenge groups. After incubation with specific drugs for 24 hours, the apoptosis of PMVECs was analyzed by flow cytometry using Annexin V/propidium iodide (PI) technique. The levels of early inflammatory factors in cultured medium were measured using enzyme linked immunosorbent assay (ELISA). The mRNA expressions of chemotactic factors and adhesion molecules were determined by real-time quantitative-polymerase chain reaction (RT-qPCR). Polymorph nuclear neutrophils (PMNs) from venous blood of healthy rats were isolated, and PMN migration through PMVECs monolayer under stimulation of drugs was observed in transwell inserts. The monolayer permeability of PMVECs after adhesion of PMNs was determined by fluorescein isothiocyanate (FITC)-albumin assay. Oxidative stress was detected by DCFH-DA assay.@*Results@#Compared with the control group, more cells entered into the apoptosis stage after LPS challenge. Meanwhile, the levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in cultured medium were significantly increased, as well as the mRNA expressions of chemotactic factors [C-X-C motif chemokine ligand 1 (CXCL-1), CXCL-3 and monocyte chemoattractant protein-1 (MCP-1)] and adhesion molecules [E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)]. More PMNs migrated through PMVECs following adhesion and the monolayer permeability of PMVECs was rapidly enhanced. The oxidative stress was upregulated. Compared with LPS group, BAY60-6583 pretreatment could dose-dependently decrease the rate of apoptosis, attenuate trans-endothelial migration of PMNs and decrease the endothelial cell barrier leakage. There were significant differences even after incubation of 0.1 μmol/L BAY60-6583 [apoptosis rate: (21.12±2.12)% vs. (27.66±3.57)%, number of migrated PMNs/HP: 260.60±18.24 vs. 290.20±16.48, permeability coefficient (Pd, ×10-6 cm/s): 28.28±2.04 vs. 32.55±2.13, all P < 0.05]. Meanwhile, BAY60-6583 pretreatment also downregulated the levels of early proinflammatory factors in a dose-dependent manner as well as the mRNA expressions of chemotactic factors and adhesion molecules. The statistic difference was significant while treated with 1 μmol/L BAY60-6583 [IL-1β (ng/L): 475.75±63.15 vs. 755.25±67.42, TNF-α (ng/L): 560.25±69.96 vs. 818.75±60.92, CXCL-1 mRNA (2-ΔΔCt): 3.57±0.28 vs. 5.27±0.69, CXCL-3 mRNA (2-ΔΔCt): 4.56±0.48 vs. 7.32±0.54, MCP-1 mRNA (2-ΔΔCt): 2.21±0.31 vs. 3.35±0.21, E-selectin mRNA (2-ΔΔCt): 4.64±0.09 vs. 7.28±0.73, ICAM-1 mRNA (2-ΔΔCt): 4.14±0.30 vs. 5.89±0.25, VCAM-1 mRNA (2-ΔΔCt): 2.23±0.19 vs. 2.92±0.33, all P < 0.05]. Furthermore, pretreatment of 10 μmol/L BAY60-6583 could decrease the oxidative stress [reactive oxygen species (RFU): 629.05±33.10 vs. 781.45±64.59, P < 0.05]. Contrast, PSB1115 pretreatment aggravated apoptosis of PMVECs after LPS incubation [(34.36±4.57)% vs. (27.66±3.57)%], upregulated expressions of proinflammatory and chemotactic factors as well as adhesion molecules [IL-1β (ng/L): 889.00±63.11 vs. 755.25±67.42, TNF-α (ng/L): 939.00±43.44 vs. 818.75±60.92, CXCL-1 mRNA (2-ΔΔCt): 6.66±0.65 vs. 5.27±0.69, CXCL-3 mRNA (2-ΔΔCt): 10.42±0.51 vs. 7.32±0.54, MCP-1 mRNA (2-ΔΔCt): 4.85±0.34 vs. 3.35±0.21, E-selectin mRNA (2-ΔΔCt): 8.42±0.47 vs. 7.28±0.73, ICAM-1 mRNA (2-ΔΔCt): 7.46±0.72 vs. 5.89±0.25, VCAM-1 mRNA (2-ΔΔCt): 4.35±0.26 vs. 2.92±0.33], aggravated trans-endothelial migration of PMNs (cells/HP: 348.40±22.68 vs. 290.20±16.48), enhanced the leakage of PMVECs monolayer [Pd (×10-6 cm/s): 39.65±2.69 vs. 32.55±2.13] and increased oxidative stress in PMVECs [reactive oxygen species (RFU): 847.04±29.26 vs. 781.45±64.59], with statistically significant difference (all P < 0.05).@*Conclusion@#Activation of endothelial Adora2b attenuates LPS-induced pulmonary microvascular inflammation by decreasing the release of early inflammatory factors, downregulating expressions of chemotactic factors and adhesion molecules, attenuating trans-endothelial migration of PMNs and oxidative stress in PMVECs, which suggest endothelial Adora2b is apotential anti-inflammatory target in the treatment of LPS-induced acute lung injury.

Effects of different medication time of cefuroxime sodium on nosocomial infections of surgical incision and C-reactive protein in patients of Department of Obstetrics and Gynecology / 中国基层医药

Objective To study the effect of different medication time of cefuroxime sodium on nosocomial infections of surgical incision and C-reactive protein (CRP) in patients of Department of Obstetrics and Gynecology.Methods A total of 158 surgery patients in Department of Obstetrics and Gynecology who were treated in the People ~ Hospital of Qing County from July 2015 to November 2017 were enrolled in the study.According to random number method,they were randomly divided into control group and observation group,with 79 cases in each group.The observation group received the treatment of cefuroxime sodium in the perioperative period,the control group was given cefuroxime sodium treatment after surgery.The differences of the probability of a nosocomial infection and CRP between the two groups who chose different medication time were compared.Results The observation group had 45 patients appearing abnormal temperature after surgery,and the temperature restoring normal time was (40.17 ± 10.35)h.The control group had 59 patients appearing abnormal temperature after surgery,and the temperature restoring normal time was (56.35 ±9.87)h,which of the observation group were less than that of the control group,the differences were statistically significant (x2 =5.513,P =0.019;t =8.163,P =0.000).The levels of CRP and procalcitonin of the observation group after surgery were (2.34 ± 0.66) mg/L,(2.48 ± 0.79) mg/L,respectively,which were lower than those of the control group [(3.46 ± 0.84) mg/L,(3.19 ± 0.96) mg/L],the differences were statistically significant (t =9.260,P =0.000;t =5.104,P =0.000).The observation group had 2 patients appeared incision infection after surgery,the control group had 9 patients appeared incision infection after surgery,there was statistically significant difference between the two groups(x2 =4.788,P =0.029).The hospitalization time of the observation group was (6.70 ± 1.04) d,which was shorter than (8.26 ± 1.25)d of the control group,there was statistically significant difference between the two groups(t =8.513,P =0.000).The quality of life score of the observation group after surgery was (85.63 ± 15.30) points,which was higher than (71.29 ± 11.07) points of the control group,there was statistically significant difference between the two groups (t =-6.748,P =0.000).Conclusion Using cefuroxime sodium in the perioperative period can reduce the probability of nosocomial infection in surgical patients,improve the level of inflammation in vivo,shorten the hospital stay and improve the quality of life of patients.

Activation of A2b adenosine receptor decreases lipopolysaccharide-induced pulmonary microvascular permeability / 中华危重病急救医学

Objective To explore the role of the A2b adenosine receptor (Adora2b) in lipopolysaccharide (LPS)-induced injury of human pulmonary microvascular endothelial cells (HPMECs), and its mechanism. Methods HPMECs were cultured in vitro. The LPS dose-effect experiment, time-effect experiment and the Adora2b agonist/antagonist intervention experiment were performed respectively. ① Dose-effect and time-effect experiments: HPMECs were stimulated with 1, 10, 100, 1 000 μg/L LPS for 24 hours, or 100 μg/L LPS for 4, 8, 12, 16, 24 hours. Cell viability was measured by cell counting kit-8 (CCK8). The protein and mRNA expressions of Adora2b were determined by Western Blot and real-time reverse transcription-polymerase chain reaction (RT-PCR) respectively. ② Adora2b agonist/antagonist intervention experiment: serum-starved HPMECs were pretreated with Adora2b specific agonist BAY60-6583 (0.1, 1, 10 μmol/L) or Adora2b specific antagonist PSB1115 (1 μmol/L) for 1 hour, respectively, and then incubated with 100 μg/L of LPS for 24 hours. The HPMECs without treatment were served as blank control group, and those treated with LPS, BAY60-6583 or PSB1115 alone were served as single challenge groups. The monolayer permeability of HPMECs was determined by fluorescein isothiocyanate (FITC)-dextran. Cell cycle was analyzed by flow cytometry. The mRNA expressions of VE-cadherin, occludin, vascular endothelial growth factor (VEGF) and angiopoietin-1 (ANGPT1) were determined by RT-PCR. Results ① Dose-effect and time-effect experiments: LPS induced the decreased cell viability of HPMECs in dose and time-dependent manner. Compared with the control group, the protein expression of Adora2b was sharply up-regulated after 100 μg/L or 1 000 μg/L LPS stimulation. Meanwhile, LPS was shown to cause a dose and time-dependent induction of Adora2b transcript level. ② Adora2b agonist/antagonist intervention experiments: compared with the control group, the monolayer permeability of HPMECs was rapidly enhanced after LPS treatment, and lower cell viability and proliferation, as well as the expression of cell junction and angiogenic factors were downregulated. Compared with LPS group, 0.1, 1, 10 μmol/L BAY 60-6583 pretreatment could decrease the endothelial cell barrier leakage in a dose-dependent manner [Pd: (203.06±15.24)%, (164.15± 17.82)%, (125.69±10.38)% vs. (218.53±12.05)%], and promote cell proliferation of HPMECs [the proportion of S and G2 phases: (24.36±1.40)%, (32.37±0.95)%, (40.05±2.99)% vs. (18.83±0.73)%]. Pretreatment of 10 μmol/L BAY60-6583 also upregulated the mRNA expressions of cell junction and angiogenic factors [VE-cadherin (2-ΔΔCt):2.17±0.23 vs. 0.56±0.10, occludin (2-ΔΔCt): 5.32±0.28 vs. 0.48±0.11, VEGF (2-ΔΔCt): 4.44±0.34 vs. 0.58±0.09, ANGPT-1 (2-ΔΔCt): 5.98±0.73 vs. 0.66±0.10, all P < 0.01]. PSB1115 pretreatment aggravated injury of microvascular endothelial cells after LPS incubation, with lower cell viability, slower proliferation and less expression of VEGF and ANGPT1. There was no influence of BAY 60-6583 or PSB1115 single treatment on cell viability, cell cycle and the expression of angiogenic factors in HPMECs. Conclusions In vitro studies of cultured HPMECs exposed to LPS are identified as dose and time-dependent induction of Adora2b transcript and corresponding protein induction. Activation of Adora2b attenuates LPS-induced pulmonary microvascular endothelial cell barrier enhancement by regulating intercellular junction and promoting angiogenesis, suggesting Adora2b as potential therapeutic target in the treatment of LPS-induced forms of acute lung injury.

Clinical effect of probiotics in treatment of liver cirrhosis: a Meta-analysis / 临床肝胆病杂志

Objective To investigate the clinical effect of probiotics in the treatment of liver cirrhosis through a systematic review. Methods PubMed, Embase, Cochrane Library, Chinese Scientific Journal Full-Text Database, VIP, and Wanfang Data were searched for randomized controlled trials (RCTs) of probiotics for the treatment of liver cirrhosis. Rev Man 5. 3 software was used for the meta-analysis of the articles screened out. Rate difference (RD) and its 95％ confidence interval (95％ CI) were used as effect size indicators for binary variables; weighted mean difference (WMD) was used for evaluating continuous variables with the same unit, and standardized mean difference (SMD) and its 95％ CI were used for evaluating continuous variables with different units. Funnel plots were used to analyze publication bias.Results A total of 15 RCTs which met the inclusion criteria were included, and there were 1411 patients with liver cirrhosis in total (726 in treatment group and 685 in control group) . Compared with the control group, the treatment group had significant improvements in overall response rate (RD = 0. 28, 95％ CI: 0. 22-0. 34, P ＜ 0. 001) and biochemical parameters for liver function including alanine aminotransferase (SMD =-0. 90, 95％ CI:-1. 14 to-0. 66, P ＜ 0. 001), total bilirubin (WMD =-15. 99, 95％ CI:-26. 42 to-5. 57, P ＜0. 001), albumin (SMD = 0. 66, 95％ CI: 0. 40-0. 93, P ＜ 0. 001), endotoxin (SMD =-1. 13, 95％ CI:-2. 11 to-0. 15, P ＜0. 001), and blood ammonia (WMD =-15. 86, 95％ CI:-21. 54 to-10. 18, P ＜ 0. 001) . Conclusion Probiotics can significantly improve liver function in patients with liver cirrhosis, effectively inhibit the progression of liver cirrhosis, reduce the risk of complications including hepatic encephalopathy, and increase overall response rate and have good tolerability.

Dental pulp stem cells in regenerative medicine:application and development / 中国组织工程研究

BACKGROUND:Dental pulp stem cel s are characterized by multi-lineage differentiation and proliferation abilities and are easy to obtain, so they are becoming an issue of concern in regenerative medicine. OBJECTIVE:To provide clues and direction for further study by analyzing progress of domestic and overseas research on dental pulp stem cel s, and summarizing their application in regenerative medicine. METHODS:The“dental pulp stem cel , regenerative medicine, tissue engineering”in Chinese and English served as the search terms to search articles related to dental pulp stem cel s and regenerative medicine, published from 2000 to 2015 in Medline, PubMed, CNKI, Wanfang and Cqvip databases. Total y 46 articles were selected for overview. RESULTS AND CONCLUSION:Dental pulp stem cel s, which hold the capacity of self-renewal and multi-lineage differentiation, are relatively easy to obtain, and exhibit a great potential in regenerative medicine. The research of dental pulp stem cel s in repairing bone defects has entered the clinical trial phase, but the research of cel differentiation into other tissues is stil in basic trial phase and needs further development.

The relationship between prehospital endotracheal intubation and the postoperative pulmonary infection in patients with traumatic brain injury / 中华急诊医学杂志

Objective To investigate the impacts of prehospital endotracheal intubation on postoperative pulmonary infection in the patients with severe traumatic brain injury.Methods Retrospectively, the clinical data of 284 patients with severe traumatic brain injury admitted in the 97th Hospital of PLA from July 2007 to December 2012 were analyzed.The patients were classified into two groups according to the timing of endotracheal intubation, namely, prehospital intubation group and admission intubation group.The postoperative pulmonary infection incidence, occurrence time, and the duration of treatment of the two groups were studied.Results The incidences of postoperative pulmonary infection in patients intubated before and after admission were 38.0％ and 25.2％ respectively.Pulmonary infection occurred in the prehospital intubation group was at the (9.9 ± 0.6) d after admission, and in the admission intubation group was at the (11.6 ± 0.3) d after admission.The duration of treatment for postoperative pulmonary infection was (21.2 ± 7.2) days and (14.5 ± 9.0) days respectively.Compared with the patients intubated after admission, patients intubated before admission suffered higher incidence (P ＜ 0.05), earlier onset (P ＜ 0.05), and longer treatment duration of pulmonary infection (P ＜ 0.01).Conclusions Severe traumatic brain injury patients with prehospital endotracheal intubation are more susceptible to pulmonary infection.Avoiding the tracheal injury and bacterial contamination in the procedure could reduce the incidence of pulmonary infection.

Evaluation on drill method to prepare for healthcare-associated infection outbreak / 中国感染控制杂志

Objective To evaluate the drill method to prepare for healthcare-associated infection (HAI)outbreak, and strengthen the control of HAI outbreak.Methods According to two cases of surgical site infection (SSI)re-ported by a neurosurgical department on January 16,2014,HAI outbreak emergency drill was started,SSI occurred from January 2012 to January 2014 were analyzed,specimens of air,object surface and hands of health care workers (HCWs)in the SSI-related operating room and neurosurgical intensive care unit(NSICU)were taken and analyzed. Results In July 2013,3 cases of SSI occurred in neurosurgical department (1 case was suspected of SSI,and didn’t per-form cerebrospinal fluid culture),SSI didn’t exceed 2 cases in the other months,and SSI outbreak couldn’t be confirmed. 16 specimens of air,object surface and hands of HCWs in operating room were taken,microbial detection results were all qualified.13 specimens of air,object surface and hands of HCWs in NSICU were taken,qualified rate was 61.54%;and mould was detected from 2 air specimens.24 disposable objects of neurosurgical department were performed bacterial cul-ture,3 were positive,and all were qualified after repeated detection.Conclusion HAI outbreak drill is helpful for HAI management professional personnel to grasp the method of HAI outbreak investigation method,improve the correct hand washing of surgeons and nurses,strengthen the standard operating procedure,and ensure the safety of pa-tients.

Hysteroscopic resection in the treatment of submucous myoma / 中国基层医药

Objective To explore the clinical effect of hysteroscopic resection in the treatment of submucous myoma.Methods The clinical data of 78 submucosal myoma patients with hysteroscopic resection which were diagnosed by B ultrasound and hysteroscopy were retrospectively analyzed,including 35 cases of type O,23 cases of type Ⅰ,20 cases of type Ⅱ.Results Application of hysteroscopic resection in the treatment of type O and type Ⅰ submucosal myoma,the rate of postoperative satisfaction was 100.0％.There were 3 cases of multiple myoma in 20 cases of type Ⅱ,which were not one time of resection,and were taken the second times of resection 4 months after operation.In all operation,there was on complications,and the rate of postoperative satisfaction was 96.2％.Conclusion Hysteroscopic resection in the treatment of submucous myoma for the preservation of reproductive function and not affecting ovarian function has the advantage of less bleeding,short operation time,rapid postoperative recovery,shorter hospitalization time,and greatly improve the quality of life of patients,and has good clinical application value,it provides the effective treatment for clinical,and is worthy of clinical popularization.

Reason analysis of catheter-related infections in ICU patients and the countermeasures / 中国实用护理杂志

[Objective] To explore the reasons of catheter-related infections in ICU critical pa-tients and raise up the countermeasures.[Methods] The clinical data of 46 patients with catheter-related infections were surveyed and analyzed from May 2010 to March 2011 in our hospital.[Results] Elderly patients occupied the majority of ICU patients with catheter-related infections.The main infection sites included the respiratory system,urinary system and gastrointestinal system.Establishment of artificial airway was the main cause of infection,indwelling catheter came next.[Conclusions] ICU patients has a high incidence of catheter-related infections.We should handle the ICU management appropriately,strengthen the control and prevention of factors of catheter-related infections,strictly enforce disinfection and segregation regulation,cut off infection way,enhances the resistance of patients,limit antibiotic use and various invasive operation in order to reduce the incidence of catheter-related infections.

Expression of neurokinin B in hypertensive disorder complicating pregnancy / 中华围产医学杂志

Objective To investigate the relationship between the genesis of hypertensive disorder complicating pregnancy and neurokinin B (NKB).Methods The serum NKB levels of 229 women including non-pregnant women (n = 62),normal pregnant women (n = 80) and pregnant women with preeclampsia (n=37) or gestational hypertension (n= 50) were examined by enzyme linked immunosorbent assay.The umbilical blood levels of NKB and the NKB mRNA expression in the pregnant women were also tested by fluorescent quantitative reverse transcription-polymerase chain reaction technique.ANOVA and paired t-test were applied.Results (1)The maternal plasma NKB levels of normal pregnant women,patients with gestational hypertension or preeclampsia were significantly higher than that of non-pregnant women,respectively [(28.2±6.6)μg/L,(31.5±5.2)μg/L,(70.5±8.9)μg/L vs(3.2±1.8)μg/L,P＜ 0.01].In preeclampsia,gestational hypertension and normal pregnancy group,the NKB level in umbilical blood [(121.4±9.3)μg/L,(60.5±7.2)μg/L,(40.8±6.3)μg/L] were significantly higher than that of maternal plasma(P＜0.01).(2) The maternal plasma NKB level in gestational hypertension group was higher than that in normal pregnancy group,while the difference had no statistical significance (P＞0.05).The maternal plasma NKB level in preeclampsia group was higher than that in gestational hypertension group and normal pregnancy group (P＜0.01).Forty-eight hours after delivery,the maternal plasma NKB levels significantly decreased in the normal pregnant,gestational hypertension and preeclampsia group [ (14.1±4.2) μg/L,(16.4±3.8) μg/L,(25.4±5.2) μg/L],compared to the values before delivery (P＜0.01).(3) The expression of NKB mRNA in placenta of preeclampsia group was significantly higher than that of gestational hypertension group and normal pregnancy group [(3.8±0.6) × 10-3 vs(1.7±0.4) × 10-3 and (1.6±0.3) × 10-3,P＜0.01].No statistical difference was found in the expression of NKB mRNA in placenta between gestational hypertension group and normal pregnancy group (P＞0.05).Conclusions Elevated NKB level in placenta and maternal or umbilical blood might play an important role in the development of hypertensive disorder complicating pregnancy.

Combined hepatectomy in radical resection for hilar cholangiocarinoma / 中国医师杂志

Objective To evaluate the value of combined hepatectomy in radical resection for hilar cholangiocarinoma. Methods The clinical data and follow-up data of 67 patients of resection for hilar cholangiocarinoma in Henan Tumor Hospital from June 2005 to october 2008 were retrospectively analyzed. Results According to intraoperative exploration situation and bismuth types, tumor resection was combined performed with hepatectomy (n＝38)or non-hepatectomy (n＝29). The rate of R0 resection was 55.3% in hepatectomy group(n＝21) and 34.5% in non-hepatectomy group(n＝10), and the difference was significant（P＝0.024）. The incidence of complications were 39.5% in hepatectomy group(n＝15) and 13.4% in non-hepatectomy group(n＝4), and one patient with liver and kidney failure died in hospital. The 1, 3, 5 years of survival rate were 89.3%,53.6% and 32.1% respectively in R0 group (n＝31) and 69.7%,30% and 10% respectively in R1～R2 group(n＝36), there were significant differences in the postoperative survival rate between both groups（P＝0.018). The 1, 3, 5 years of survival rate were 81.8%,48.5% and 24.2% in hepatectomy group and 75%,32% and 16% in non-hepatectomy group respectively, and the differences were significant（P＝0.037). Conclusions Aggressive resection including combined hepatectomy for hilar cholangiocarcinoma can play an important role for curative effect and long term survival rate.

Separation and Drug Resistance Anaiysis of Pseudomonas Aeruginosa in Patients With Lower Respiratory Trace Infection / 医学研究杂志

Objective To understand Present condition of separation of Pseudomonas aeruginosa and its drug-resistant tendercy in patients with lower respiratory trace infection in our hospital.Methods To make a statistical analysis of durg sensitive tests of 182 strains of Pseudomonas aeruginosa form thos samples of patients with lower respiratory trace infection detected from October 2005 to August 2007.Results 1031 strains of pathogenic bacteria were separated from 1409 sample of lower respiratory trace tract,and pseudomonas aeruginosa 182 strains and 17.65% of them are PA,results of drug sensitive test indicate that Paare resistant to gentamycin CN SMZ CTX GAT etc.Conclusion The infection and drug resistance of pare wery severe now,it isbeneficial to rational use of drugs to keep abreast of current drug-resistant condition.

The association of S447X and Hind III polymorphism in the lipoprotein lipase gene with dyslipidemia of the metabolic syndrome in patients with essential hypertension / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of S447X mutation and Hind III polymorphism in the lipoprotein lipase gene with dyslipidemia of the metabolic syndrome in patients with essential hypertension.</p><p><b>METHODS</b>A total of 983 patients were randomly selected from those with hypertension (diagnosed in the Community-based Comprehensive Studies on Prevention and Control of Hypertension Project in China) and those not treated with anti-hypertensive medications for at least in 2 weeks immediately before blood collection. Among them were 389 subjects with dyslipidemia and 594 subjects without dyslipidemia. The definition of dyslipidemia in patients with hypertension was used only when triglyceride or HDL-cholesterol was at abnormal level. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine Ser447stop mutation and Hind III polymorphism in LPL gene.</p><p><b>RESULTS</b>Linkage disequilibrium between the two sites was observed, with three major haplotypes identified: H+S, H-S, and H-X. The LPL gene S447X mutation and H-X haplotype were significantly associated with dyslipidemia (OR=0.547, 95%CI: 0.348-0.859 for S447X mutation; OR=0.537, 95%CI: 0.328-0.880 for H-X haplotype) in male, both by themselves and after adjustment for age, body mass index, smoking, alcohol intake, systolic blood pressure, diastolic blood pressure, education and serum glucose. The LPL H- carriers and H-S haplotype were significantly associated with dyslipidemia (OR=0.575, 95%CI: 0.358-0.923) in female after multivariate adjustment. Moreover, compared with the H+S haplotype, the H-X haplotypes were associated with significantly lower TG and Log (TG/HDL-C) levels in both men and women, and with higher HDL-C levels in women; whereas no significant difference was observed between the H-S and H+S haplotype. Compared with the H-S haplotype, the H-X haplotypes had significant effect on the HDL-C levels in women.</p><p><b>CONCLUSION</b>The LPL H-X haplotype was one of the protective factors of dyslipidemia of metabolic syndrome in hypertensive patients. It is significantly associated with low triglyceride, log triglyceride-to-HDL-cholesterol ratio and high HDL-cholesterol levels. S447X mutation does not explain all the effect associated with the Hind III polymorphism, although the effect on serum lipids associated with the H-X haplotype appeared to be mainly mediated by the S447X mutation. It is possible that some functional mutations in the LPL gene besides the S447X mutation are in linkage disequilibrium with the Hind III polymorphism.</p>

A study on ways of intrauterine infection of chlamydia trachomatis / 中华妇产科杂志

Objective To study the route of intrauterine infection of chlamydia trachomatis (CT) Methods Seven hundred and seventy two cervical samples from in women and 105 matched maternal labom neonatal samples composed of cervical samples,cord blood, amniotic fluid, conjunctival and nasopharyngeal samples of neonate were detected by PCR SSCP and DNA sequencing technique Results CT were detected in 87 of 772 (11 3%) cervical samples In the 81 matched maternal infant samples from pregnant women with cervical CT positive, CT were not detected in all of the cord blood samples In the 30 CT positive neonatal samples, 26 were from cases of vaginal delivery and 4 from cases of caesarean section Statistical analysis showed a significant difference between the groups of caesarean section and the vaginal delivery ( P

Expression of endometrial leukaemia inhibitory factor gene in patients with unexplained infertility / 中华妇产科杂志

Objective　To investigate the expression of endometrial leukaemia inhibitory factor（LIF） gene in patients with unexplained infertility. Methods　 By a quantitative reverse transcription-polymerase chain reaction (RT-PCR)，the expression of LIF gene on endometrium during mid-luteal phase was detected in 35 unexplained infertility (infertility group) cases and 20 infertile cases due to tubal obstruction or male factor (control group). Results　The level of LIF mRNA expression on endometrium during mid-luteal phase in infertility group was 0.448±0.239，significantly lower than those in the control group （1.093±0.761，P<0.01). Conclusions　Our findings suggested LIF might play an important role in the process of implantation. The decreased expression of LIF gene might be one of the major causes of unexplained infertility.