Hemodynamic characteristics of proper hepatic artery and portal vein in patients after splenectomy and devascularization / 临床肝胆病杂志

Objective To investigate the characteristics of hemodynamics of proper hepatic artery and portal vein after splenectomy and devascularization. Methods The clinical data of 103 patients with portal hypertension who underwent splenectomy and devascularization in the Capital Medical University-Affiliated You'an Hospital from April 2014 to February 2019 were retrospectively analyzed. Their hemodynamics of the proper hepatic artery and portal vein were recorded before and 1 week-, and 1-, 3-, 6-, 12-, and 24-months after surgery and then statistically analyzed. Continuous data with normal distribution were compared using paired-samples t test. Results Compared with the before surgery data, the portal vein diameter, portal vein flow, maximum velocity, and average velocity of the portal vein were all significantly decreased 1-week-, 1-, 3-, 6-, 12-, and 24-months after splenectomy and devascularization (all P < 0.05). The blood flow and velocity of the proper hepatic artery was significantly increased 1 week and 1 month after surgery (all P < 0.05); however, there was no statistically significant difference at 3-, 6-, 12-, and 24-months after surgery. Conclusion The diameter, flow, and flow velocity of the portal vein after splenectomy and devascularization were significantly lower than those before surgery, whereas the proper hepatic artery flow and flow velocity were increased within 1 month after surgery and then returned back to the pre-surgery levels 3 months after surgery.

Isolation and identification of plague phage from Suncus murinus in Yunnan Province and its epidemiological significance / 中华地方病学杂志

Objective:To study the basic situation of Yunnan Province Suncus murinus carrying plague phage and to explore its epidemiological significance. Methods:From 2015 to 2018, a survey of plague host animals was carried out in 10 investigation sites in the historical plague foci, new plague foci (after 1982) and stubborn plague foci of domestric mouse in Yunnan Province. The plague phage was isolated and cultured from the intestinal specimens of Suncus murinus. The growth of plaque was observed by double-layer plate method, and the morphology and structure of plague phage were observed under electron microscope. At the same time, intestinal samples were taken to detect the structural gene caf1 of F1 antigen of Yersinia pestis. Results:In this study, a total of 157 Suncus murinus were captured and 16 strains of plague phage were isolated, with a total isolation rate of 10.19%. There was no difference in plague phage isolation rate between historical plague foci (10.00%, 1/10) and stubborn plague foci (16.22%, 12/74), new plague foci (4.11%, 3/73, χ 2 = 0.00, P = 0.965; Fisher test, P = 1.000). However, there was a difference in plague phage isolation rate between stubborn plague foci and new plague foci (χ 2 = 5.88, P = 0.015). There was no significant difference in the isolation rate of plague phage among different sex, growth period and habitat ( P > 0.05). The plaque morphology of the isolated plague phage was diverse, of which four strains were myotavirus phages; and all samples were negative for F1 antigen structural gene caf1. Conclusions:Suncus murinus is widely distributed in the domestic mouse plague foci in Yunnan Province, and the animals carry a certain number of plague phage. Regular surveillance of Suncus murinus and their plague phage has a certain guiding significance for the surveillance and early warning of plague in Yunnan Province.

Research progress on the relationship between formyl peptide receptor 1 and plague infection / 中华地方病学杂志

Inflammatory response is an important immune mechanism of the body, formyl peptide receptor (FPR) 1 is a pattern recognition receptor expressed in immune cells, and its binding with ligands is the basis for immune cells to realize various physiological functions in infectious inflammation. FPR1 plays an important role in inflammatory response, and changes in amino acids caused by its gene polymorphism affect a variety of diseases. Plague is an inflammatory disease caused by Yersinia pestis. Yersinia pestis, its pathogen, has a strong ability of immune escape and attacks on host immune cells. In this paper, FPR structural characteristics, expression and distribution, FPR1 gene polymorphism, ligand and its relationship with plague are reviewed, with a view to further understanding the role of FPR1 in the occurrence and development of plague.

Clinical effect of liver transplantation from elderly donors / 国际外科学杂志

Objective:To investigate the clinical effect of liver transplantation from organ donors in elderly patients.Methods:The clinical data of 346 patients who underwent liver transplantation in the general surgery center of Beijing You′an Hospital Affiliated to Capital Medical University from January 2018 to November 2020 were retrospectively analyzed. After screening, they were divided into the elderly donor group (30 cases) aged 60-70 years and the non elderly donor group (60 cases) aged < 60 years. The observation indexes were operation time, anhepatic phase time and operation bleeding. The prognosis indexes were: postoperative ICU stay, length of hospital stay, primary graft nonfunction (PNF), delayed graft function recovery (DGF) and in-hospital mortality. The measurement data in accordance with normal distribution are expressed as ( Mean± SD). The comparison between the two groups was analyzed by t-test. The measurement data that did not conform to the normal distribution were expressed as median (range). Mann Whitney U test was used for comparison between the two groups. The counting data were collected by the computer χ2 test or Fisher′s exact test analysis. Results:The operation time, anhepatic period and blood loss in the elderly group were (444.33±72.44) min, 56.0 (30-170) min, 1 992.1(400-9 000) mL, respectively and the non elderly group were (460.88±91.32) min, 58.45 (35-140) min, 1 885.8(400-12 000) mL, respectively, there were no significant difference between the two groups ( P>0.05); Among the prognostic indicators, the length of stay in ICU, the length of stay in hospital and the in-hospital mortality of the elderly group were 4.9 (2-21) d, 20.4 (3-40) d and 10% respectively, while the length of stay in ICU, the length of stay in hospital and the in-hospital mortality of the non elderly group were 5.3(1-32) d, 22.1(3-61) d and 10% respectively, with no significant difference between the two groups ( P>0.05); No PNF occurred in the two groups, but the incidence rate of DGF in the elderly group was 13.33%(4/30), and the non elderly group was 1.67%(1/60). There was a significant difference between the two groups ( P<0.05). Conclusion:Under strict preoperative donor evaluation and accurate recipient selection, 60-70 years old donors can achieve similar short-term effect as non elderly donors, but the long-term effect needs further observation.

Role of live webcast as a new medium in the propaganda and education of liver transplant recipients / 器官移植

Objective To evaluate the role of live webcast as a new medium in the propaganda and education of liver transplant recipients. Methods According to the contents of live webcast propaganda and education meeting for liver transplant recipients, relevant data of the live webcast meeting were counted and analyzed, including baseline data of participants, participation pattern, viewing frequency and duration, etc. The characteristics between live webcast and traditional propaganda and education meetings were compared. Results By the end of the live webcast meeting, 273 participants were registered, including 2 oversea participants and 271 from China. These domestic participants were from 26 provinces, autonomous regions and municipalities in China. The total number of views was 1 526. Participants attended the meeting by clicking direct link (n=243), WeChat group access (n=22), WeChat chat access (n=7) and Dingding App access (n=1). The viewing duration was (68± 5) min. Compared with the traditional method, the number and places of registers of the live webcast propaganda and education meeting were increased. The questioning methods and filling out follow-up information were more convenient. Participants could attend the meeting free from charge anywhere, and saved more time. The live webcast propaganda and education meeting was not affected by the COVID-19 pandemic, and data statistical method was optimized. Conclusions Live webcast as a new medium, has a wide range of advantages, which provides a novel form of propaganda and education for the recipients after liver transplantation. It is of significance to improve the long-term survival rate and to enhance the quality of life of recipients after liver transplantation.

blaIMP-45 and armA co-carrying multidrug resistance Pseudomonas isolates and characterization of their genetic environment / 中华检验医学杂志

Objective The primary goal of this work is to discuss the molecular mechanism of multi-drug resistant Pseudomonas spp. resistance to carbapenam and aminoglycoside antibiotics. Methods From June 2012 to March 2013, six strains of P. aeruginosa and P. putida producing carbapenemasefrom 4 different district were collected. Species identification was performed using VITEK-2 compact system and by sequencing of 16S rDNA amplicons. Minimum inhibitory concentrations were determined by E-test method. Production of carbapenemase were detected by Carba NP method. Carbapenemase genes and aminoglycoside 16s rRNAmethylase genes were screened by PCR, and their subtypes combined with their immediate genetic context were worked out by assemble the sequence of overlapped PCR amplicons. SpeI-PFGE (Pulse field gel electrophoresis after SpeI enzyme digestion) were conducted to evaluate their clonal relatedness. S1-PFGE (Pulse field gel electrophoresis after S1 enzyme digestion) were conducted to conform the relatedness of plasmids they carried. Results Three multidrug resistant P. aeruginosa and three P. putida, were all positive for Carba NP test and conformed producing class B carbapenemase. PCR screening followed by sequencing confirmed carriage of blaIMP-45 and armA, which confer resistance to β-lactams (except aztreonam) and aminoglycosides. These two genes co-located in a Tn1548-associatedregion. SpeI-PFGE disclosed that these isolates were not clonal closely related to each other, except two P. aeruginosa isolates were clonal related. S1-PFGE results showed that these isolates all carried plasmids of large size (300-600 kb). Conclusions This study showed that Pseudomonas spp. isolates co-carried blaIMP-45 and armA were disseminated in clinical settings. Spread of these genes may attribute to horizontal gene transfer of related entities.

Experience in diagnosis and treatment of acute graft-versus-host disease after liver transplantation of 8 cases / 临床肝胆病杂志

ObjectiveTo investigate the diagnosis and treatment of acute graft-versus-host disease (aGVHD) after liver transplantation. MethodsThis report included 8 patients treated with liver transplantation who were admitted to the Liver Transplantation Center of Beijing YouAn Hospital from April 2011 to August 2016. The key points in the diagnosis of aGVHD and the experience in the treatment of this disease were summarized. ResultsThe key points in the diagnosis of aGVHD after liver transplantation were as follows: (1) aGVHD usually occur at two weeks to two months after liver transplantation; (2) fever, rash, diarrhea, and reduced whole blood cell count are typical clinical symptoms; (3) the percentage of donor T lymphocytes in peripheral blood is more than 10%; (4) there are typical histopathological manifestations. The experience in the treatment of aGVHD after liver transplantation were as follows: the overall steroid response rate is 20%-50%, and methylprednisolone (1.5 mg·kg-1·d-1, one week) is recommended; high-dose glucocorticoids are not recommended, thus avoiding increased infection risk; high-dose immunosuppressant is one of the causes of aGVHD, and excessive application of immunosuppressant should be avoided in clinical practice; the prevention of respiratory infection and digestive tract infection was very important; enteral nutrition should be considered; second-line therapies such as siplizumab, antithymocyte globulin, and tumor necrosis factor-alpha inhibitor may play a certain therapeutic role; blood purification can be used to effectively eliminate cytokines and inflammatory mediators, which is helpful to the treatment of aGVHD. ConclusionThe diagnostic criteria for aGVHD after liver transplantation are mainly based on time of onset, clinical symptoms, peripheral blood T lymphocyte chimerism rate, and histopathology. Hormone shock and reducing the dose of immunosuppressant may be effective treatments.

Risk factors for variceal rebleeding after esophagogastric devascularization and splenectomy in patients with portal hypertension / 临床肝胆病杂志

ObjectiveTo investigate the risk factors for variceal rebleeding after esophagogastric devascularization and splenectomy in patients with portal hypertension. MethodsA retrospective analysis was performed for the clinical data of 244 patients with portal hypertension who were admitted to Beijing YouAn Hospital from April 2010 to September 2015 and underwent esophagogastric devascularization and splenectomy. According to the presence or absence of variceal rebleeding, these patients were divided into non-rebleeding group and rebleeding group. Preoperative, intraoperative, and postoperative clinical data were compared between the two groups. The t-test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed data between groups; the chi-square test was used for comparison of categorical data between groups. A multivariate logistic regression analysis was performed for statistically significant variables identified by the univariate analysis. ResultsOf all 244 patients, 38 (15.6%) experienced variceal rebleeding. The univariate analysis showed that there were significant differences between the two groups in the history of variceal bleeding, preoperative ascites, total bilirubin after surgery, portal venous pressure after devascularization, portal venous pressure before and after splenectomy, and preoperative international normalized ratio (χ2=5530、4120，t=3591、4098、2516、2622、4278，P=0.016, 0.026, 0.008, 0.002, 0022, 0.012, and 0.003). The multivariate logistic regression analysis showed that variceal rebleeding after esophagogastric devascularization and splenectomy was associated with the history of variceal bleeding (95%CI:1113-13704，P=0.033), preoperative ascites (95%CI:1257-5437,P=0.010), and portal venous pressure after devascularization (95%CI:1022-1172,P=0.010). ConclusionHistory of variceal bleeding, preoperative ascites, and portal venous pressure after devascularization are independent risk factors for variceal rebleeding after esophagogastric devascularization and splenectomy.

Dissemination of insertion sequence common regions 1 and int1 gene and drug resistance of 483 Escherichia coli and Klebsiella pneumonia broiler isolates / 中华预防医学杂志

Objective@#To investigate and analyze distribution characteristics of two multidrug resistance related genes in broiler isolates in Shandong province.@*Methods@#The pre slaughter broilers were chosen from Shandong province in this study in June, 2014. A total of 400 fecal samples from five different zones (east, south, west, north and middle) of the hen house were collected. 373(77.2%) Escherichia coli and 110 (22.8%) Klebsiella pneumonia strains were isolated, and ISCR1 and int1 gene were detected by PCR assay and sequencing. The resistance to 10 drugs belonging to 8 classes antimicrobial drugs were obtained by using minimal broth dilution method and data analysis. The difference between isolates and drug resistance profiles was analyzed.@*Results@#Among 483 isolates, 440 isolates (91.1%), 126 isolates (26.1%) and 126 isolates (26.1%) were detected as int1, ISCR1 and both two gene carriers, respectively. The rate of 37 E. coli isolates not carried ISCR1 or int1 gene resistant to 0 to 2, 3 to 5, 6 to 8 classes antimicrobial agents was 13.5% (n=5), 78.4% (n=29), and 8.1% (n=3), respectively; the rate of 288 only int1 gene E. coli carriers resistant to 0 to 2, 3 to 5, 6 to 8 groups antimicrobial agents was 2.4% (n=7), 74.7% (n=215), and 22.9% (n=6), respectively. The data above showed significant difference (P<0.001). The rate of 26 only int1 gene K. pneumonia carriers resistant to 0 to 2, 3 to 5, 6 to 8 classes antimicrobial agents was 11.5% (n=3), 76.9% (n=20), and 11.5% (n=3), respectively; the rate of 78 both two gene K. pneumonia carriers resistant to0 to 2, 3 to 5, 6 to 8 groups antimicrobial agents was 0, 35.9% (n=28), and 64.1% (n=50), respectively. The data above showed significant difference (P<0.001).@*Conclusion@#Gene int1 and ISCR1 showed high prevalence in E. coli and K. pneumonia isolates. High level multi-drug resistance profile could be mediated by int1 and ISCR1 gene co-existence.

Drug resistance and dissemination of New Delhi metallo-β-lactamase 1 positive bacteria in a patient / 中华预防医学杂志

Objective@#The aim of this work was to report the surveillance and dissemination of NDM-1 positive bacteria in a patient and ward environment.@*Methods@#In 2010, during the therapy for a 51 years old patient, clinical and environmental samples were collected for carbapenem resistant bacterial culture, according to the clinical microbiological examination. Strains identification and antibiotic susceptibility were tested by VITEK Compact 2 system and E-test. The blaNDM-1 was detected by PCR and analyzed by sequencing. Plasmids containing blaNDM-1 were submitted to PFGE-S1 and Southern hybridization.@*Results@#During hospitalization from October 1st to November 4th, nine strains were isolated from blood, sputum, urine, fecal, and ward ground samples. The Klebsiella oxytoca, Raoultella planticola, and Acinetobacter baumannii were isolated from blood sample. The Klebsiella pneumonia and Acinetobacter baumannii were isolated from sputum sample. An Acinetobacter lwoffii was isolated from urine sample. An Escherichia coli was isolated from fecal sample. And the Acinetobacter lwoffii and Acinetobacter spp. were isolated from ward ground. Four strains were NDM-1 positive, which were Raoultella planticola (RpNDM1) isolated from blood, Escherichia coli (EcNDM1) isolated from fecal, Acinetobacter lwoffii (AlDNM1) and Acinetobacter spp. (AsNDM1) isolated from ward ground. Four NDM-1 positive strains were resistant to Piperacillin, Piperacillin tazobactam, Cefepime, Ceftriaxone, Ceftazidime, Imipenem, Meropenem, and Ertapenem. Southern hybridization revealed that blaNDM-1 were all located on plasmids in the four positive strains.@*Conclusion@#blaNDM-1 can transfer rapidly among different species, resulting in difficult to control and prevent. While isolating patient who is carrying NDM-1 positive strains, more attention should be paid to the disposal of patient's excreta, especially stool, should be paid more attention.

Posterior enlargement of spinal canal for the treatment of multi-segmental cervical diseases without cervical lordosis / 中华骨科杂志

Objective To evaluate the feasibility and efficacy of posterior enlargement of spinal canal for the treatment of multi-segmental cervical diseases without cervical lordosis.Methods From January 2013 to June 2017,a retrospective study was conducted with 21 patients of multi-segmental cervical diseases accompanied cervical lordosis loss,and the complete followup data was obtained.There were 14 males and 7 females,with an average age of 53.9±7.3 years (range,42-65 years).There were 14 multi-segmental cervical spondylotic myelopathy,5 ossification of posterior longitudinal ligament,and 2 congenital cervical stenosis included in this study.The cervical lordotic angle and cervical curvature index were measured preoperatively and 1 year postoperatively.To access the enlargement of spinal canal and spinal cord,the anteroposterior diameter and cross section area of spinal canal or spinal cord were measured on MRI preoperatively and 1 year postoperatively.The Japanese Orthopaedic Association Scores (JOA) was applied to evaluate the neurological function at preoperation and postoperation.Visual Analogue Scales (VAS) was applied to evaluate the pain degree at preoperation and postoperation.Frankel classification was used to assess the severity of spinal cord injury at preoperation and postoperation.Results The follow-up time was 12-26 months,with an average of 16.4 months.The cervical lordosis angle was 3.1°±2.3° preoperatively,and 4.2°±1.6° 1 year postoperatively with a significant difference.The cervical curvature index was 4.4％ ± 1.7 ％ preoperatively and 5.0％ ± 1.5 ％ 1 year postoperatively with no statistically difference.Except for C7T1 level,the preoperative anteroposterior diameter and cross section area of spinal canal at C2.3,C3.4,C4.5,C5.6,and C6.7 level were lower than that at 1 year after operation with a significant difference.Except for C2,3 and C7T1 and level,the preoperative anteroposterior diameter and cross section area of spinal cord at C3,4,C4,5,C5,6,and C6,7 level were significantly lower than that at 1 year after operation.The average JOA score preoperatively was 8.9±1.7.The average JOA score at 3 months postoperatively was 13.1±2.0,which was significantly higher than that preoperatively.At 3 months postoperatively,the average improvement rate was 52.0％,and the superior rate was 52.3 ％.At 1 year postoperatively,the average JOA score was 13.3±2.1,which improved significantly from that preoperatively.The average improvement rate was 54.3 ％,and the superior rate was 61.9％.The VAS score at preoperatively was 3.0±2.4,and which was 2.7± 1.7 at 1 year postoperatively with no significant differences.At pre-operation,the level of Frankel classification was C level in one (4.8％) case,D level in 8 (38.1％) cases and E level in 12 (57.1％) cases.At 1 year postoperatively,the level of Frankel classification was C level in one (4.8％) case,D level in 6 (28.6％) cases and E level in 14 (66.7％) cases,compared with that at preoperatively,there was no statistically significant difference.One patients suffered from neurologic deterioration at 1 year after surgery and recovered after anterior cervical surgery.No other serious complications were occurred.Conclusion For the patients with multi-segmental cervical diseases accompanied cervical lordosis loss,effective spinal decompression by cervical posterior laminoplasty was feasible,and a good clinical efficacy was achieved.

The impact of splenectomy and esophagogastric devascularization on the nutrition status of patients with cirrhosis and portal hypertension / 中华肝胆外科杂志

Objective To study the impact of splenectomy and esophagogastric devascularization on the nutritional status of patients with cirrhosis and portal hypertension.Methods Sixty consecutive patients with cirrhosis and portal hypertension who underwent splenectomy and esophagogastric devascularization at the Beijing YouAn Hospital from April 5,2015 to January 23,2017 were included in this study.The body mass index (BMI),albumin (Alb),prealbumin (PA) and lymphocyte counts were prospectively collected at the end of 1-week,1-month,3-month,6-month and 1-year after surgery.The postoperative results were compared with the preoperative results in these patients.Results The BMI results obtained at 1-week and 1-month after surgery were significantly lower than the preoperative level [(22.14 ± 3.08)kg/m2 vs.(22.85 ± 3.14) kg/m2,(21.72 ± 3.05) kg/m2 vs.(22.86 ± 3.16) kg/m2,P ＜ 0.05].The BMI result at the end of 1-year after surgery was significantly elevated when compared with the preoperative level [(23.24 ± 3.64) kg/m2 vs.(22.68 ± 3.47) kg/m2,P ＜ 0.05].The ALB levels at 1-month and 3-month after surgery were significantly higher than the preoperative level [(39.87 ± 4.22)g/L vs.(35.35 ±5.15) g/L,(39.35 ± 4.75) g/L vs.(34.82 ± 5.50) g/L,P ＜ 0.05].The PA obtained at 1-week after surgery was significantly lower than the preoperative levels [(79.59 26.52)mg/L vs.(121.77 ±39.96)mg/L,P ＜ 0.05].The lymphocyte counts at all the points after surgery were significantly higher than the preoperative level (P ＜ 0.05).Conclusion Short term and long term nutritional status improved in patients with cirrhosis and portal hypertension after splenectomy and esophagogastric devascularization.

Construction and identification of HSV-1 vector vaccine carrying HIV-1 antigen / 生物工程学报

To construct an HSV-1 vector vaccine carrying HIV-1 antigens, HIV-1 gp160, gag, protease and the expression elements were chained together, and then inserted into the internal inverted repeat sequence region of HSV-1 by bacterial artificial chromosome technology. Firstly, HIV-1 gp160 (including type B and C), gag and protease genes were cloned into pcDNA3 in series to generate the pcDNA/gBgp and pcDNA/gCgp, then the recombinant plasmids were transfected into 293FT cells, and HIV-1 antigen was detected from transfected cells by Western blotting. Then the expression cassettes from pcDNA/gBgp and pcDNA/gCgp, comprising HIV-1 antigen genes and expression elements, were cloned into pKO5/BN to generate the shuttle plasmids pKO5/BN/gBgp and pKO5/BN/gCgp. The shuttle plasmids were electroporated into E. coli cells that harbor an HSV-BAC, the recombinant bacteria were screened, and the recombinant DNA was extracted and transfected into Vero cells. The recombinant virus was purified through picking plaques, the virus' DNAs were identified by Southern blotting; HIV-1 antigen was detected from the recombinant HSV-1 infected cells by Western blotting, and the virus' replication competent was analyzed. As the results, gp160 and gag proteins were detected from 293FT cells transfected with pcDNA/gBgp and pcDNA/gCgp by Western blotting. The recombinant bacteria were generated from the E. coli electroporated with pKO5/BN/gBgp or pKO5/BN/gCgp. The recombinant HSV was purified from the Vero cells transfected with the recombinant DNA, the unique DNA fragment was detected from the genome of recombination HSV by Southern blotting; gp120 and gp41 were detected from the infected cells by Western blotting, and the recombinant HSV retained replication competent in mammalian cells. The results indicate that the recombinant HSV carrying HIV-1 gp160, gag and protease genes was generated, the virus retains replication competent in mammalian cells, and could be used as a replicated viral vector vaccine.

Subchronic Toxicological Assessment of Diosgenin in Kunming Mice / 世界科学技术-中医药现代化

This study was aimed to evaluate the subchronic toxicity of diosgenin in mice. A total of 80 mice were divided into 4 groups, which were 0 (control), 100, 200, and 400 mg·kg-1 by the random number table. Intragastric administration was given once a day for 90 days in the assessment of subchronic toxicity of diosgenin among mice. The observed indexes contained body weight, fur color, diet, feces, and etc. The detected indexes contained blood routine analysis, blood biochemistry and pathological examination. The results showed that compared with the control group, the body weights of mice in the male medication group were slight reduced. There were no significant hematologic and pathologic abnormalities. It was concluded that the subchronic toxicity of diosgenin with no observed adverse effect dose level was more than 400 mg·kg-1. The oral administration was relatively safe.

Biodegradability and biocompatibility of polylactide/glycolide biliary stent / 中国组织工程研究

BACKGROUND:Biliary stent is widely used in different biliary tract surgeries, and there are some defects in the use of biliary stent. OBJECTIVE:To explore the biodegradability and compatibility of polylactide/glycolide biliary stent. METHODS:The polylactide/glycolide biliary stent was prepared, and immersed in the bile. At 1, 2, 3, 4 and 5 weeks after soaking, eight experimental stents were dried and placed under the scanning electron microscope. In the sterile condition, the stent was implanted under the rat skin. At 1, 2, 3, 4, and 5 weeks after implantation, two rats were sacrificed. The stent was taken out. The appearance of the stent and muscle structure of experimental animals was observed. The gross appearance of stent was observed at different time by scanning electron microscopy. The rate of degradation was calculated. The muscle structure of experimental animal and the stent were understood. RESULTS AND CONCLUSION:At 1 week, stent shape remained almost intact, but the texture became soft;surface roughness and cracks gradual y appeared;stent wal col apse was visible. The stent was completely degraded at 5 weeks. Before degradation, the stent presented clear three-dimensional reticular structure observed by scanning electron microscopy. With the time extended, the stent surface and section corrosion became worsened. By gel permeation chromatography detection, at 1 week of implantation, the molecular mass of the stent declined rapidly, and then gradual y declined. At 2 weeks, the relative molecular mass decreased to 15 000. At 4 weeks, stent mass loss was approximately 40%. Al the experimental animals were survived, no poisoning, al ergy or heat source response. The operative wound was healed wel , and no infection occurred. By histological observation, at 5 weeks, the stent was completely degraded, with a degradation rate of 100%. Surrounding muscles recovered to a normal state. These results indicate that the polylactide/glycolide biliary stent has good degradation in vitro and biocompatibility.

Dynamic changes of IL-27, IL-10, IL-17 in serum of collagen-induced arthritis in mice / 中国免疫学杂志

Objective:To observe chicken typeⅡcollagen-induced arthritis( CIA) in serum of mice with the dynamic changes of IL-27,IL-17,IL-10. Methods: 54 DBA1/J mice were randomly divided into control group(n=6) and model group(n=12), according to the progress of CIA mouse course early,middle and late(7,14,and 35 days after booster immunization) ,taking the eyeball for blood and separating the serum under sterile condition. The dynamic levels of cytokines IL-27,IL-17,IL-10 were detected by flow cy-tometry. Results:The level of IL-27 in the model group was significantly declined in the the progress of CIA mouse course early and middle(P 0. 05);the level of IL-17 in the disease early and late was no significant difference(P> 0. 05) compared with the control group,while in the mid course significantly higher than control group(P 0. 05). Conclusion: IL-27,IL-17,IL-10 paticipate in the pathogenesis of CIA and their alterations at different stages of the disease have a relation to the development of arthritis.

A retrospective cohort study regarding the effect of sirolimus-based immunosuppression protocol on the long-term survival of hepatocellular carcinoma patients after liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the influence of sirolimus on the long-term survival of patients after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Clinic data of 165 consecutive patients who underwent OLT for HCC from February 2005 to March 2012 was analyzed retrospectively. Among them, 94 patients were treated with a sirolimus-based immunosuppressive protocol after OLT, while the other 71 patients with a FK506-based protocol. Postoperative survival time, survival, disease-free survival (DFS) and tumor recurrence rates between the two groups were compared.</p><p><b>RESULTS</b>The 2 groups were comparable in all clinicopathologic parameters. The sirolimus-based group had higher patient survival rates than the control group at 1-year (87% vs. 97%, P = 0.03), 2-year (80% vs. 88%), 3-year (76% vs. 85%) and 5-year (63% vs. 75%). The 1-year, 2-year, 3-year and 5-year recurrence rates were 12% vs. 3%, 17% vs. 9%, 21% vs. 9% (P = 0.04) and 31% vs. 16% (P = 0.03). Early and mid-HCC (I - II stage) of 131 cases (control group 61 cases, sirolimus-based group of 70 patients). The 1-year, 2-year, 3-year and 5-year survival rates were 90% vs. 97% , 80% vs. 90%, 78% vs. 86% and 65% vs. 82% (P = 0.04) and recurrence rates were 10% vs. 3%, 16% vs. 8%, 18% vs. 8% and 29% vs. 11% (P = 0.01).</p><p><b>CONCLUSION</b>The sirolimus-based immunosuppressive protocol reduce long-term postoperative recurrence rate and improve the survival rate of patients after OLT for HCC significantly (especially early-mid HCC).</p>

Effect of pre-hospital emergency care for patients with acute cranio-cerebral injury / 中国实用护理杂志

Objective To know the effect of pre-hospital emergency care for patients with acute cranio-cerebral injury. Methods Selected 312 patients with acute cranio-cerebral injury from Jan of 2005 to Jan of 2009 as the emergency group, selected 285 patients with acute cranio-cerebral injury from Jan of 2000 to Dec of 2004 as the control group. Retrospective analized the clinical condition between the two groups to know the effect of pre-hosptial emergency cares. Results There was significant difference of dead rate betweent the two groups, the prognosis of the two groups was also different. Conclusions Effective pre-hospital emergency care is very important for patients with acute eranio-cerebral injury, which can avoid certain complications and reduce dead rate.

Influence of emergency nursing process reengineering on rescue of patients with acute and severe dis-ease / 中国实用护理杂志

ObjectiveTo explore influence of emergency nursing process reengineering on the satisfac-tion degree of patients, quality of rescue, rescue time and success rate of rescue. MethodsEvidence-based nursing method was used for emergency nursing process reengineering. The first 30 types of acute and sever diseases and the first 6 large emergency events in 2008 were chosen as the rescue objectves, and they received new emergency nursing process. Influence of classic emergency nursing process in 2007 was retrieved and revalued. The satisfaction degree of patients, quality of emergency nursing and success rate of emergency before and after process reengineering were compared and analyzed. ResultsCompared with that before process reengineering, the satisfaction degree of experts, doctors and nurses, and patients was higher, the quality of emergency nursing greatly improved, the rescue time was less, and the success rate of rescue was higher after process reengineering. ConclusionsEmergency nursing process reengineering was more hu-man oriented. It can rescue patients with acute and severe diseases with lest time, reduce disputes between nurses and patients. It is worthy of application in clinic and the process should be reengineered and im-proved constantly in the future.

Application study of sequential severity evaluation in emergency nursing for stroke patients / 中国实用护理杂志

Objective To explore the clinic value of sequential severity evaluation in emergency nursing for stroke patients. Methods 138 of stroke patients were enrolled in study group, which completed sequential severity evaluation in emergency medical and nursing provision drawn up according to the results. Another 207 of stroke patients were enrolled in control group, which emergency nursing provision drawn up according to general procedure. Length of time from emergency call to special therapeutic, mortality compared between the two groups respectively. Results In study group, length of time from emergency call to special therapeutic (48.9?34.1) min was significantly shorter than that of control group (73.1?46.7) min; mortality (11.1%) was significantly lower than that of control group (24.3%),cure rate (34.7%) was significantly higher than that of control group (26.9%). Conclusion Sequential severity evaluation in acute nursing may be a worthy procedure for proving reaction ability of nurse reaction ability in emergency medical and nursing, proving outcome for stroke patients and it should be commended.