Objective To observe any effects of pulsed electromagnetic fields (PEMFs) on the expression of transforming growth factor beta-1 (TGF-β1) after sciatic nerve injury and to investigate the possible mechanism of any regeneration of the injured sciatic nerve.MethodsForty-eight SD rats were randomly divided into a PEMF treatment group,a model group and a normal control group with 16 rats in each group.The three groups were then sub-divided into 1 day,3 day,7 day and 14 day subgroups.The rats of the model and treatment groups were clamped to produce a sciatic nerve injury model.The treatment sub groups were exposed to a 9 mT PEMF at 14 Hz for 2 hours once daily for 1,3,7 and 14 days,respectively.The model group was given sham exposure and the normal control group was reared conventionally and not given any special treatment.The histological changes in the rats' sciatic nerves were observed under a light microscope after hematoxylin-eosin staining.Expression of TGF-β1 was detected by immunohistochemical methods.ResultsAfter 7 and 14 days of treatment,Wallerian degeneration of the sciatic nerve in the treatment group was more obvious than in the model group.The expression of TGF-β1 increased during the treatment process and reached a maximum at the 14th day after nerve injury.The expression of TGF-β1 had increased significantly in the model and treatment groups compared with the control group at all observation time points.At the 3rd,7th and 14th day after the operation,the expression of TGF-β1 in the treatment group was significantly higher than that in the model group. Conclusion PEMFs can accelerate Wallerian degeneration of peripheral nerves and can up-regulate the expression of TGF-β1 after sciatic nerve injury,at least in rats.

[ Objective ] To supply a technological evidence for the rapid reproduction of Andrographis paniculata (Burm. f.) Nees (APN). [Methods] Different explants from sterile seedling of Andrographis paniculata (Burm. f.) Nees were cultured in vitro to induce the production of fascicular buds. [ Results ] Cotyledon with nodes and half cotyledon with nodes were the most suitable explants for culture, and the budding rate was 100% and over 90% respectively. 6-Benzylaminopurine (BA) in the concentrations of 0.5 ~ 1.0mg/L were beneficial for the reproduction and growth of buds. The age of explants had no correlation with budding. The optimal rooting medium was MT (Murashige and Tucher) medium added with Img/L NAA (naphthaleneacetic acid) or IBA (indolebutyric acid). A highest rooting rate as much as 61.9% was achieved after 10 days of culture. [Conclusion] An effective plant regeneration system has been established for explants of Andrographis paniculata (Burm. f.) Nees.

Objective To investigate the effect of lidocaine on Staphylococcus aureus exotoxin-stimulated peripheral blood mononuclear cells (PBMCs) from patients with atopic dermatitis (AD).Methods Peripheral blood samples were collected from 6 patients with AD,and PBMCs were isolated by a routine method.Then,the PBMCs were stimulated by the Staphylococcus aureus exotoxin toxic shock syndrome toxin-1 (TSST-1) in the absence or presence of lidocaine at varying concentrations.The 3H-TdR incorporation method was performed to detect the proliferation of monocytes,and enzyme-linked immunosorbent assay (ELISA) to quantify the levels of T helper type 1 (Th1) and Th2 cytokines released by PBMCs.Human HaCaT keratinocytes were co-cultured with lidocaine-and TSST-1-stimulated PBMCs from patients with AD for 72 hours,then,Western blot was conducted to examine the expression of filaggrin protein in HaCaT cells.Results TSST-1 (100 μg/L) significantly enhanced the proliferation of PBMCs from patients with AD (stimulation index =75 ± 2.12,P ＜ 0.05),as well as the release of tumor necrosis factor-α (TNF-α),interferon (IFN)-γ,interleukin (IL)-2,IL-12,IL-4,IL-5 and IL-13 by the PBMCs (all P ＜ 0.05).Compared with the blank control group,100 μmol/L lidocaine significantly inhibited the TSST-1-stimulated proliferation of PBMCs from patients with AD (stimulation index =58 ± 3.14,P＜ 0.05),as well as the release of IL-4,IL-5,IL-13,TNF-α and IFN-γ by the stimulated PBMCs (all P ＜ 0.05).Western blot showed that 100 μmol/L lidocaine significantly blocked the down-regulation of filaggrin expression in HaCaT cells (P ＜ 0.01).Conclusion Lidocaine has a significant inhibitory effect on the activation of TSST-1-stimulated PBMCs from patients with AD.

Objective To examine the reliability and validity of the Rating Scale of the Reliability in Mental Disorder Medical History (RSRMDMH) in order to develop a reliable measure to determine the reliability in mental disorder medical history.Methods RSRMDMH was conducted by concept,clinical feature in mental disorder medical history and assessment scales for malingering and compensationneurosis.Final 14 items was decided after initial usage and modification.It was administered to 600 subjects including the cases involved forensic problems,patients in general psychiatric clinic.Results ①The Cronbach' s α coefficients of RSRMDMH was 0.901.The split-half reliability was 0.803-0.924.The test-retest reliability and scorer reliability were more than 0.588 (P＜0.01).②The cut score of assessing different degree of the reliability in mental disorder medical history separately was ≤ 11,12-22,≥23.③Based on the experts diagnosis,the accuracy rate of RSRMDMH for evaluating different degree of the reliability in mental disorder medical history were more than 86.1％,and total accuracy rate was 94.8％.④Correlation analysis showed significantly correlation between RSRMDMH and assessment scales for malingering(self-report scale of brief psychopathological symptoms,SBPS).Conclusion The RSRMDMH has acceptable psychometrics properties on reliability and validity.It is a clinically reliable measure to determine the reliability in mental disorder medical history.

BACKGROUNDTo evaluate the efficacy and toxicity of the combination of gemcitabine and carboplatin in the treatment of patients with advanced non-small cell lung cancer (NSCLC).

METHODSForty-one patients with locally advanced (stage IIIB) or metastatic (stage IV) NSCLC were enrolled into the study. The patients received gemcitabine 1 000 mg/m² on days l, 8 and 15, and carboplatin AUC 5 on day 1, with 28 days as a cycle. Each patient received at least two cycles.

RESULTSOf the 41 patients, 2 cases got complete response, 18 got partial response, 15 had stable disease, and 6 had progressive disease, with an overall response rate of 48.8%. The response rate was 55.6% (10/18) in the initial patients, and 43.5% (10/23) in the retreated patients (P > 0.05). The median survival duration was 11.8 months. The 1-year survival rate was 49%. There were 29 patients whose KPS score increased. The main toxicities were leukopenia (incidence of 34.1% for grade III+IV) and thrombocytopenia (incidence of 29.3% for grade III+IV).

CONCLUSIONSThe combination of gemcitabine and carboplatin is a feasible, well-tolerated and active scheme in either first-line or second-line treatment of advanced NSCLC.

Objective: To investigate the biological significance of CerbB-2 expression in nasopharyn-geal carcinoma. Methods: The expression of CerbB-2 was detected in 90 nasopharyngeal carcinoma tissues and 22 nasopharyngitis tissues by SP immunohistochemical method. The relationship between CerbB-2 ex-pression and clinicopathological characteristics of nasopharyngeal carcinoma was investigated. Results: The positive expression rate of CerbB-2 protein was 65.56% in nasopharyngeal carcinoma tissues, and 31.82% in nasopharyngitis tissues, with a significant difference (P<0.05). The ratio of expression was 81.0% in patients of N_2 and N_3 lymth node stage, significantly different from that in patients of N_0 and N_1 lymph node stage (52.1%, P<0.05). The expression of CerbB-2 gene was not correlated with age, gender, clinical stage, T stage and distant metastasis of nasopharyngeal carcinoma (P>0.05). Conclusion: There is a high expression of CerbB-2 in nasopharyngeal carcinoma tissues, which might be an important event in the pathogenesis and progression of nasopharyngeal carcinoma.

Objectives To access the bacteriology in patients with sepsis due to biliary tract infection to provide a basis for empirical selection of proper antibiotic treatment.Methods This is a single-center retrospective study on 214 patients with biliary tract infection admitted from August 2014 to July 2016 to the surgical intensive care units (ICU) of The First Affiliated Hospital of Sun Yat-sen University.To study the demographic information,sequential organ failure assessment (SOFA),usage of antibiotics before ICU and duration of ICU were analyzed.Bile,peritoneal drainage and blood samples were collected.Results 47 septic shock patients and 25 septic patients due to biliary tract infection were enrolled in the trial.The two groups (the shock group vs.the sepsis group) had a significant difference in the duration of ICU stay [(6.4 ± 4.6) d vs.(2.3 ± 1.8) d,P ＜ 0.05].48 strains of pathogens were isolated from the bile samples.The major pathogens were Escherichia coli (E.coli) (n =23,47.9％),Enterococcus faecalis (n =8,16.7％) and Enterococcus faecium (n =2,4.2％).80 strains of pathogens were isolated from the peritoneal drainage culture samples.E.coli,pseudomonas aeruginosa,and Klebsiella pneumoniae ranked the top 3 species,accounting for 26.3％,11.3％ and 7.5％,respectively.The sensitivity of E.coli isolated from bile to amikacin,imipenem and panipenem were all over 90.0％.Conclusions E.coli was the principal gram-negative bacterium in biliary infection induced sepsis.Early administration of carbapenemes may reduce the occurrence of septic shock in these patients.

BACKGROUNDTo explore the significance of lung biopsy through CT-guided percutaneous paracentesis in the diagnosis of space-occupying lesions of the lung.

METHODSThirty-five patients with space occupying lesions of the lung underwent lung biopsy through CT-guided percutaneous paracentesis and DLTRA-CUT 16G, 18G or 20G soft-tissue-cutting biopsy needles and PICKER IQ computerized tomograph were used.

RESULTSOf the 35 patients, 26 were confirmed by pathological examination to suffer from primary malignant tumor, 1 from metastatic carcinoma, 3 from tuberculosis and 3 from inflammatory pseudotumor. No definite diagnosis was made in two patients. The diagnostic rate was 94.3%. After operation, minor pneumothorax occurred in 5 cases and traces of blood in sputum in 2 cases, however, they didn't need any treatment.

CONCLUSIONSLung biopsy through CT-guided percutaneous paracentesis is a safe and practical technique and may be widely used in hospitals if conditions permit.

ObjectiveTo assess the value of passive leg raising (PLR) test in predicting fluid responsiveness in patients with sepsis-induced cardiac dysfunction.Methods A prospective observational cohort study was conducted. Thirty-eight patients under mechanical ventilation suffering from sepsis-induced cardiac dysfunction admitted to Department of Surgical Intensive Care Unit of First Affiliated Hospital of Sun Yat-Sen University from September 2013 to July 2014 were enrolled. The patients were studied in four phases: before PLR (semi-recumbent position with the trunk in 45°), PLR (the lower limbs were raised to a 45° angle while the trunk was in a supine position), before volume expansion (VE, return to the semi-recumbent position), and VE with infusing of 250 mL 5% albumin within 30 minutes. Hemodynamic parameters were recorded in every phase. The patients were classified into two groups according to their response to VE: responders (at least a 15% increase in stroke volume,ΔSVVE≥15%), and non-responders. The correlations among all changes in hemodynamic parameters were analyzed by linear correlation analysis, and the receiver operating characteristic curve (ROC) was plotted to assess the value of hemodynamic parameters before and after PLR in predicting fluid responsiveness.Results Of 38 patients, 25 patients were responders, and 13 non-responders. There was no significant difference in the baseline and hemodynamic parameters at semi-recumbent position between the two groups. The changes in SV and cardiac output (CO) after PLR (ΔSVPLR andΔCOPLR) were significantly higher in responders than those of non-responders [ΔSVPLR: (14.7±5.7)%vs. (6.4±5.3)%,t = 4.304,P = 0.000;ΔCOPLR: (11.2±7.5)% vs. (3.4±2.3)%,t = 3.454,P = 0.001], but there was no significant difference in the changes in systolic blood pressure, mean arterial pressure, pulse pressure, and heart rate after PLR (ΔSBPPLR,ΔMAPPLR,ΔPPPLR andΔHRPLR) between two groups.ΔSVVE in responders was significantly higher than that of the non-responders [(20.8±5.5) % vs. (5.0±3.7) %,t = 8.347,P = 0.000]. It was shown by correlation analysis thatΔSVPLR was positively correlated withΔSVVE (r = 0.593,P = 0.000),ΔCOPLR was positively correlated withΔSVVE (r = 0.494,P = 0.002). The area under ROC curve (AUC) ofΔSVPLR≥8.1% for predicting fluid responsiveness was 0.860±0.062 (P = 0.000), with sensitivity of 92.0% and specificity of 70.0%; the AUC ofΔCOPLR≥5.6% for predicting fluid responsiveness was 0.840±0.070 (P = 0.000), with sensitivity of 84.0%and specificity of 76.9%; the AUC ofΔMAPPLR≥6.9% for predicting fluid responsiveness was 0.662±0.089, with sensitivity of 68.0% and specificity of 76.9%; the AUC ofΔSBPPLR≥6.4% for predicting fluid responsiveness was 0.628±0.098, with sensitivity of 76.0% and specificity of 61.5%; the AUC ofΔPPPLR≥6.2% for predicting fluid responsiveness was 0.502±0.094, with sensitivity of 56.0% and specificity of 53.8%; the AUC ofΔHRPLR≥-1.7%for predicting fluid responsiveness was 0.457±0.100, with sensitivity of 56.0% and specificity of 46.2%.Conclusion In patients with sepsis-induced cardiac dysfunction, changes in SV and CO induced by PLR are accurate indices for predicting fluid responsiveness, but the changes in HR, MAP, SBP and PP cannot predict the fluid responsiveness.

Objective To determine the timing for therapy and efficacy for different types of hepatic artery stenosis (HAS) after orthotopic liver transplantation(OLT). Methods From October 2003 to May 2007, a total of 21 patients had hepatic artery stenosis after OLT in this hospital. Of the 21 patients, 19 underwent stent placement in their narrowed hepatic arteries and 2 were regularly followed up. Liver function, clinical outcomes, and the hepatic artery potency were reviewed. Results The occurring rate of HAS was 3.43% (21/613) and its median time of diagnosis was 146 days (range, 2-515 days). Six patients with early HAS were treated with interventions and 2 of them died.For the 4 surviving patients, 2 received retransplantation. For the 15 patients with late HAS, 13 were treated with interventions and 4 of them died. Two patients received retransplantation. Seven surviving patients had abnormality in liver function. Another 2 patients had normal liver function because of hepatic portal form compensatory circulation. Conclusion The presence of ischemic bile duct lesion and whether or not favourable compensatory circulation exists or not should be considered before individualized therapeutic regimens adopted according to postoperative HAS types.