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【Objective】 To investigate the situation of carbapenem-resistant Enterobacteriaceae(CRE) colonization in patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT). 【Methods】 A total of 241 consecutive patients who underwent haplo-HSCT in the First Affiliated Hospital of Soochow University from June 1, 2021 to June 1, 2022 were enrolled. Anal swab screening was performed within 48 hours of admission and blood cultures were taken when the patient developed fever. Univariate and multivariate analysis were used to analyze the colonization rate, distribution, risk factors and the correlation between CRE colonization and post-transplant bloodstream infection(BSI). 【Results】 Among 241 patients with haplo-HSCT, there were 90 cases in CRE colonization positive group, with a colonization rate of 37.3% (90/241). Multivariate logistic regression analysis showed that sex (OR 2.42, 95% CI 1.38-4.22, P<0.05) and history of infection within 30 days before transplantation (OR 3.37, 95% CI 1.59-7.17, P<0.05) may be independent risk factors for CRE intestinal colonization. Of the 95 CRE strains, the top five species were carbapenem-resistant Klebsiella pneumoniae (38/95, 40.0%), carbapenem-resistant Escherichia coli (29/95, 30.5%), carbapenem-resistant Enterobacter cloacae (13/95, 13.6%), carbapenem-resistant Klebsiella acidophilus (6/95, 6.3%) and carbapenem-resistant Proteus mirabilis (3/95, 3.1%). The incidence of post-transplant BSI was 12.0% (29/241) in the CRE-colonized group and 3.3% (8/241) in the non-colonized group. In the colonization group, 100% of the pathogens of BSI were identical with those of CRE colonization. 【Conclusion】 Bacterial culture of anal swab during haplo-HSCT is helpful for detection of CRE colonization in intestinal tract, which provides some clinical basis for active monitoring of key flora, prevention and control of infection.
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Objective:To explore the clinical correlation between peripheral blood basophil levels and chronic sinusitis （CRS） subtypes. Methods:One hundred and twenty-six patients with CRS and 103 healthy cases from physical examination admitted to the First Affiliated Hospital of Soochow University from January 2021 to October 2022 were retrospectively analyzed. According to the histopathological classification, CRS patients were divided into eosinophilic chronic sinusitis （eCRS） group （47 cases） and non eosinophilic chronic sinusitis （non-eCRS） group （79 cases）. The differences among the three groups in peripheral blood inflammation cell counts, eosinophils-to-basophils ratio（bEBR）, basophils-to-neutrophils ratio（BNR）, basophils-to-lymphocytes ratio（BLR）, basophils-to-monocytes ratio（BMR） were compared, and study the correlation between each index and Lund-Mackay score, and the correlation between basophils in peripheral blood and other inflammatory cells. Results:The counts of basophils in the peripheral blood of the healthy control group, eCRS group and non-eCRS group were 0.03±0.01, 0.04±0.02, 0.03±0.02, respectively, the eosinophils-to-basophils ratio（bEBR） were 5.64±4.22, 8.38±5.95, 4.55±3.90, the basophils-to-neutrophils ratio（BNR） were 0.01±0, 0.01±0.01, 0.01±0.01, and the basophils-to-lymphocytes ratio（BLR） were 0.01±0.01, 0.02±0.01, and 0.02±0.01, respectively, the basophils-to-monocytes ratio（BMR） were 0.08±0.04, 0.11±0.06, and 0.08 ±0.04 respectively. There was a statistically significant difference between eCRS group and healthy control group, non-eCRS group（P<0.01）, while there was no statistically significant difference between non-eCRS group and healthy control group（P>0.05）. Basophil counts （r=0.185 5, P<0.05）, BLR（r=0.226 9, P<0.05）, BMR（r=0.228 1, P<0.01） in patients with CRS were positively correlated with Lund Makey score. In addition, basophils were also positively correlated with eosinophils（r=0.479 2, P<0.01）, lymphocytes（r=0.259 4, P<0.01）, and monocytes（r=0.256 4, P<0.01） in patients with CRS. Conclusion:The peripheral blood basophil count, BLR and BMR were significantly increased in eCRS, and were significantly positively correlated with Lund -Makey score. It has the potential to develop into disease biomarkers and new therapeutic targets of eCRS.
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Humans , Basophils , Retrospective Studies , Rhinitis/surgery , Eosinophils , Sinusitis/surgery , Chronic Disease , Nasal Polyps/pathologyABSTRACT
Objective@#To compare laparoscopic cholecystectomy (LC) with or without percutaneous transhepatic gallbladder drainage (PTGD) for acute severe cholecystitis.@*Methods@#According to the predefined inclusion and exclusion criteria, 23 articles were selected for this meta-analysis. All patients were treated with LC with or without PTGD. A meta-analysis was used to analyze the clinical efficacy.@*Results@#Compared with LC, all the surgical indicators of LC with PTGD were significantly better than LC alone (all P≤0.05), including the operation time: 95%CI(-27.24, -9.27); intraoperative blood loss: 95%CI(-50.25, -40.19); postoperative hospital stay: 95%CI(-3.63, -0.64); rates of conversion to open abdomen: OR=0.48, 95%CI(0.32, 0.74); rates of incision infection: OR=0.49, 95%CI(0.25, 0.99); drainage tube indwelling time: 95%CI(-2.07, -1.19); gastrointestinal function recovery time: 95%CI(-1.73, -0.77); rates of bile leakage: OR=0.23, 95%CI(0.12, 0.44); and rates of complications: OR=0.36, 95%CI(0.27, 0.48).@*Conclusion@#Compared with LC alone, PTGD+ LC is the preferred treatment for acute severe cholecystitis.
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0bjective To compare laparoscopic cholecystectomy(LC)with or without percutane-ous transhepatic gallbladder drainage(PTGD)for acute severe ch01ecystitis.Methods According to the predefined inclusion and exclusion criteria.23 articles were selected for this meta.analysis.A1l patients were treated with LC with or without PTGD.A meta-analysis was used to analyze the clinical efficacy.Results Compared with LC.a11 the surgical indicators of LC with PIGD were significantly better than LC alone(all P≤0.05),including the operation time:95％CI(-27.24,-9.27);intraoperative blood loss:95％CI(-50.25,-40.19);postoperative hospital stay:95％CI(-3.63,-O.64);rates of conversion to open abdomen:OR=0.48,95％CI(0.32.0.74);rates of incision infection:OR=0.49,95％CI(0.25,O.99);drainage tube indwelling time:95％CI(-2.07,-1.19);gastrointestinal function recovery time:95％CI(-1.73,-0.77);rates of bile leakage:OR=0.23,95％CI(0.12,0.44);and rates of compli-cations:OR=0.36.95％CI(0.27,0.48).Conclusion Compared with LC alone,PTGD+LC is the preferred treatment for acute severe cholecystitis.
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Objective: to compare the immediate effects of electroacupuncture (EA) on electrocardiogram and cardiac function in patients with stable angina pectoris by comparing the anti-myocardial ischemia effects of the EA and pericardial meridians (PC) with heart, the heart meridians (HS) and heart. To explore the correlations and differences between cardio, pericardial and cardiac, and to provide some clinical basis for the clinical treatment of this disease.Methods: 45 patients who met the criteria were divided into three groups by single blind randomized reference method:15 cases of pericardial therapy group, 15 cases of pericardial therapy group, and 15 cases of non-acupoint control group.The heart group, according to the meridians following the direction of acupuncture polar spring, Shaohai, Lingdao, Shimen; Heart bag group, according to the direction of the meridians needle Tianquan, Quze, Neiguan, Daling; Non-nonpoint group acupuncture is not non-point F1, F2, F3, F4. Compare the changes in heart rate and the value of the heart rate and the value of the heart rate of the 15 min electrocardiogram, and the value of the body Doppler Tei in the group before and immediately after the acupuncture and the end of the acupuncture. Results: Compared with the preacupuncture, there was no significant change in the cardiac and pericardial groups in the 15 minutes immediately after the acupuncture and the end of the acupuncture (P＞ 0.05), and the heart rate was significantly slower (P＞ 0.05) . The value of was significantly increased (P ＜ 0.05), and the tissue Doppler Tei index was significantly reduced (P ＜ 0.05) .There was no significant change before and after the non-point group indicators (P＞ 0.05) . Compared with the pericardial group, the two groups had the same effect on electrocardiogram and cardiac function (P＞ 0.05) . Compared with the immediate after the end of acupuncture, the 15 min, cardio group and pericardial group after the end of acupuncture slowed the heart rate, increased the T value and reduced the tissue Doppler Tei index (P ＜ 0.05) .Conclusion: Electroacupuncture and pericardial points can specifically slow the heart rate of patients with stable angina pectoris, restore the changes of T wave ischemia, and reduce the tissue Doppler Tei index, indicating that acupuncture of both acupuncture points has an immediate effect against myocardial ischemia. The effects of electroacupuncture and pericardial meridians on heart rate and T and tissue Doppler Tei indices are quite similar, suggesting that the immediate effects of acupuncture and pericardial meridians against myocardial ischemic injury are comparable. Electroacupuncture heart meridians and pericardial meridians have a certain post-acupuncture effect.
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Objective To study the impact of weight loss surgery after 3 months of stable condition through intervention on patients with obese hyperlipidemic acute pancreatitis (HLAP).Methods Ten patients with obese HLAP who underwent laparoscopic sleeve gastrectomy (LSG) at the General Surgery Department of our hospital were followed-up at 1,3,6,12,24 months after surgery.Their weight,BMI,EWL,and blood parameters (TG,LDL-C,HDL-C,TC,FPG,HbA1c,UA,hs-CRP,ESR,and hemorheology indexes) were compared.The impact on postoperative obese HLAP was assessed.Results The weight,BMI,EWL and blood index (TG,LDL-C,HDL-C,TC,FPG,HbA1c,UA,hs-CRP,ESR,and hemorheology indexes) of the patients gradually decreased.The decrease was significantly different from that before surgery (P＜0.05),which became stable at 12 months and with no recurrence at 24 months after surgery.Conclusions LSG reduced body weight and improved metabolic status of the patients.It stopped the occurrence of obese HLAP.LSG can be used as an effective intervention for patients with obese HLAP.
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@#Objective To observe the effect of electroacupuncture on Caspase-9, cytochrome C (Cyt-C) and apoptotic protease activating factor 1 (Apaf-1) protein in rats with neurogenic bladder after complete spinal cord injury. Methods A total of 60 female Sprague-Dawley rats were involved, in which 36 rats were randomly selected to establish the neurogenic bladder model with T10 spinal cord transected. 24 successful models selected were randomly divided into model group (n=12) and electroacupuncture group (n=12). The other 24 rats were also randomly divided into sham group (n=12) and blank group (n=12). The electroacupuncture group was electroacupunctured on Ciliao (BL32), Zhongji (RN3), Sanyinjiao (SP6) and Dazhui (GV14) for seven days. All of them were assessed with urodynamic test, TUNEL method was used to determine the apoptosis rate of the spinal cord, and Western blotting was used to detect the expression of Caspase-9, Cyt-C and Apaf-1 protein. Results Compared with the blank group and the sham group, the maximum bladder capacity and compliance decreased (P<0.01), the urinary bladder pressure and leakage point pressure increased (P<0.05); the apoptosis rate of the spinal cord increased (P<0.001); the expression of Caspase-9, Cyt-C and Apaf-1 protein increased (P<0.05) in the model group and the electroacupuncture group. Compared with the model group, the maximum bladder capacity and compliance increased (P<0.01), the urinary bladder pressure and leakage point pressure decreased (P<0.05); the apoptosis rate of the spinal cord decreased (P<0.05); the expression of Caspase-9, Cyt-C and Apaf-1 protein decreased (P<0.05) in the electroacupuncture group. Conclusion Electroacupuncture on Ciliao, Zhongji, Sanyinjiao and Dazhui could improve the bladder function after spinal cord injury in rats. The mechanisms may be related with the down-regulation of Caspase-9, Cyt-C and Apaf-1 protein to reduce apoptosis.
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Investigating the influence of acupuncture on cellular signal transduction is an efficient pathway to reveal the action mechanism of acupuncture on spinal cord injury (SCI). In this study, the experiment research literature regarding acupuncture for SCI during past 10 years was reviewed and analyzed. As a result, it was found that acupuncture could regulate the expression of the first intercellular messenger as well as the second signal molecules including cyclic adenosine monophosphate, cyclic guanosine monophosphate, Ca2+, nitric oxide to intervene the apoptotic signaling pathway, Rho/Rock signaling pathway, Wnt signaling pathway, MAPK signaling pathway, Notch signaling pathway, etc., which could improve regeneration and repair of SCI. In conclusion, in future researches more attention should be paid to the cellular signal transduction networks and different effects among various acupoint combinations and acupuncture modalities on cellular signal transduction, which have an essential role for revelation of clinical application rules and optimization of clinical treatment protocol.
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Objective To establish the rat model for neurogenic bladder after complete suprasacral spinal cord injury, and analyze the urodynamics. Methods Forty adult Sprague-Dawley rats were randomly divided into control group (n=10) and experimental group (n=30). The spinal cord injury model on T10 was made with modified spinal cord transaction. The Crede's method was used to urinate assistantly af-ter modeling. The amounts of urine and successful rat model everyday were recorded. The urodynamics was measured in both groups, and the morphology was observed with HE staining. Results Four rats died in the experimental group. The amount of urine was the least and sta-ble on the 18th day, and 24 rats were successfully modeled on the 21st day. Compared with the control group, maximum bladder capacity de-creased (t=3.150, P=0.021), bladder base pressure, maximum bladder pressure and leak point pressure increased (t>3.125, P<0.01), and blad-der compliancy decreased (t=5.330, P=0.002) in the experimental group. Conclusion The complete suprasacral after spinal cord injury of neurogenic bladder in a rat model of manufacturing method is of high reliability, good repeatability, and low coefficient of variable character-istics for spastistic neurogenic bladder basic experimental studies.
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OBJECTIVE@#To investigate the effect of adenovirus-mediated ING4 with RGD on proliferation, apoptosis and cell cycle of human nasopharyngeal carcinoma cell CNE and explore its probable mechanism.@*METHOD@#CNE cells were infected with Ad. RGD-ING4 and adenovirus vector, ING4 gene expression level was detected by RT-PCR and the target protein expression was tested by Western blot. MTT assay was adopted to evaluate the efect of ING4 on cell growth of CNE, Annexin -V-PE/7-AAD Double staining was used to measure the efect of ING4 on apoptosis, and PI staining was used to measure the efect of ING4 on the cell cycle. Differential expression of P21, Bcl-2 and Bax gene was detected by RT-PCR,and Differential expression of Survivin and Caspase 3 protein was detected by Western blot.@*RESULT@#CNE cells were cultured with Ad. RGD-ING4 for 72 h ,the results showed that ING4 was overexpressed in CNE cells ,the growth of CNE cells was obviously inhibited , apoptosis rate was significantly increased and G2/M phase was arrested apparently. The results of RT-PCR showed that Ad. RGD-ING4 significantly down-regulated the Bcl-2 and up-regulates the Bax and P21 expression in CNE cells, and the difference was statistically significant(P < 0.01). Western blot showed that the expression of Survivin was decreased and Cleaved-Caspase 3 was increased.@*CONCLUSION@#Ad. RGD-ING4 can play the role of tumor suppressor synergies on nasopharyngeal carcinoma cell CNE by down-regulating Bcl-2, Survivin expression and up-regulating P21, Bax and Cleaved-Caspase 3 expression.
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Humans , Adenoviridae , Apoptosis , Carcinoma , Caspase 3 , Metabolism , Cell Cycle , Cell Cycle Proteins , Genetics , Therapeutic Uses , Cell Line, Tumor , Cell Proliferation , Gene Expression , Genetic Vectors , Homeodomain Proteins , Genetics , Therapeutic Uses , Inhibitor of Apoptosis Proteins , Metabolism , Nasopharyngeal Carcinoma , Nasopharyngeal Neoplasms , Metabolism , Pathology , Therapeutics , Proto-Oncogene Proteins c-bcl-2 , Metabolism , Survivin , Tumor Suppressor Proteins , Genetics , Therapeutic UsesABSTRACT
Objective:To assess the value of spiral CT in diagnosis and treatment of chronic otitis media.Methods:The spiral CT findings of 74 cases including 93 ears proved by operation and pathology were studied.Results:The lesions such as the disruption of the ossicular chain showed in spiral CT or three-dimensional image were in accord with those seen in the operation,the accuracy was 95.7%,the disruption of the ossicular chain and bony erosion in the tympanic cavity and antrum were severe in the typeⅢ chronic otitis media.Conclusion:Spiral CT is helpful to diagnose and definite the chronic otitis media,three-dimensional image can provide valuable information for surgery.
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Objective To study the scanning technique of 16-detector multic-slice spiral CT (MSCT) for combined pulmonary artery and deep vein of lower limb in pulmonary thromboembolism (PE) patients.Methods Forty suspected pulmonary thromboembolism patients were performed both pulmonary artery angiography (CTA) and indirect deep vein venography (CTV) on 16-detector MSCT. The parameters of the latter as following :total contrast volume 120-150 ml, injection rate 4.0-4.5 ml/s (from antecubital vein), delay time 4.0 for CTA 20-23 s, CTV 120-180 s, collimation for CTA 1.25 mm and 0.625 mm, CTV 2.5 mm, scan range of CTV: from popliteal vein to the level of bilateral renal vein into the inferior vena cava. Postprocessing include MPR, MIP, and VR. The test was used to analyzed the images.Results Twenty five patients had both pulmonary thromboembolism(PE) and deep vein thromboembolism (DVT), 8 patients had only DVT, 2 had only PE, and 5 had neither. There was no difference between different collimation in depicting thrombus. The CT value number of enhanced pulmonary artery and lower deep vein was obviously higher than the thrombus. The value of MPR, MIP, VR for PE was 100%, 100%, and 65%, The value of MPR,MIP,VR for DVT is 100%, 60%, and 50%.Conclusion The technique of combined pulmonary CTA and deep vein CTV of 16-detector MSCT will provide a new modality for pulmonary thromboembolism patients.
