Objective To observe characters of sputum of patients with tracheotomy by heat and moisture exchanger(HEM)undergoing hyperbaric oxygen therapy(HBOT)in multi-person chamber.Methods In randomly block design,239 patients were selected and received HBOT using HEM combined with L-shape tube(group HEM,n=128)and by L-shape tube(group L,n=111)respectively.The characters and volume of sputum,times of sucking sputum and cases of sealing/extubation of tubes were assessed over first and tenth sessions of HBOT.Results The times of sucking and volume of sputum over first session of HBOT in the group HEM were more than those in group L.The sputum was changing from ropiness over first session to tenuity over tenth sesion(P＜0.01).Cases with sealing/extubation of tubes in group HEM were more than those of group L(P＜0.01).Conclusions It is helpful to humidify and discharge deposited sputum of patients over routine hyperbaric oxygen by HEM.And the case8 of sealing/extubation of tubes are also reduced.

Objective To explore the methods and standards of catastrophic health expenditure for China,and improve the operability in defining those impoverished due to diseases.Methods 600 households with inpatients were randomly sampled from 12 villages of three townships in City M in Hubei province for household survey.Literature review and expert consultation methods were used to measure and determine the threshold of catastrophic health expenditure( CHE) of City M,with improvements made by grouping.Results In a uniform standard,the CHE occurrence of the income method and expenditure method is lower than the non-existence expenditure method and WHO method,verifying theoretically that the standard set for the former should be higher than the latter.In addition,the income method and expenditure method present differently in China.Standards set should vary with different measurement methods,maintaining approximate CEH expenditure for the same region.For the income method and expenditure method,the recommended benchmark reference is 25%,with an adjustable range of 35%~45%.Mutual verifications of these methods can further determine a rational CHE value.Conclusions The CHE methods support the definition of people impoverished due to diseases beyond their household payment capacity.Different thresholds however should be set for different methods,and the relative standards should be translated into absolute standards by grouping.

Objective:To evaluate the efficacy and safety of cytoreductive surgery (CRS) in conjunction with hyperthermic intra-peritoneal chemotherapy (HIPEC) for treating patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC). Methods:A total of 62 CRC patients with complication of PC were divided into the CRS group, namely, Group One (n=29, CRS and systemic adju-vant chemotherapy) and the CRS+HIPEC group, namely, Group Two (n=33, CRS+HIPEC). The primary end point of the study was overall survival (OS) and the secondary end point was serious adverse events (SAE). Results:Patients' clinicopathologic characteris-tics, peritoneal carcinomatosis index, and completeness of cytoreduction therapy were well balanced and comparable between the two groups. The median follow-up was 41.9 mo (6.5 mo to 110.0 mo) in Group One and 32.0 mo (10.5 mo to 95.9 mo) in Group Two. The median OS was 8.5 mo (95%CI:4.9 mo to 12.1 mo) in Group One and 14.5 mo (95%CI:11.9 mo to 17.1 mo) in Group Two (P=0.007). Within 30 days after the surgery, SAE occurred in 3 of the 29 patients in Group One, and 9 of the 33 patients in Group Two (P=0.126). Multivariate analysis revealed that HIPEC, CC0-1 score, and chemotherapy over six cycles were the independent factors for OS improvement. Conclusion:The CRS+HIPEC method improves the OS of patients with PC from CRC, suggesting an acceptable safety.

Objective To investigate the role of Th17 cells and related cytokines in Helicobacter pylori(H.pylori) infection.Methods To establish a mouse model of H.pyloriinfectious gastritis.Meanwhile,a treatment group and control group were set up.The histological changes in the gastric mucosa were observed and scored under light microscopy;The expression of IL-17 and IL-23 mRNAs as well as protein in gastric tissue was detected by RT-PCR and ELISA,respectively;Th17 cells in mice splenocyte were evaluated using the flow cytometry (FCM) method.Results We found significantly higher levels of IL-17 and IL-23 protein and mRNA levels in supernatant of gastric tissue homogenates of infection group as compared to controls and Th17 cells in spleen from mice of H.pylori infection group were all obviously higher than that of control group;IL-17 mRNA,IL-23 mRNA and the ratio of Th17 cells in mice splenocyte of H.pylori infection group mice increased gradually with the time prolonged;The levels of both mRNA and protein levels of IL-17and IL-23 decreased significantly in the treatment group compared with pre-treatment;There was a positive correlation between IL-17 and IL-23 expression levels of mice gastric mucosa and gastric inflammation degree.Conclusion H.pylori infection induced the immune response of Th17 cells;The levels of IL-17 and IL-23 increased in gastric mucosa of mice after H.pyloriinfection;The degree of H.pylori-infected mice gastric inflammation was positive correlation with the levels of IL-17 and IL-23 of gastric mucosa.

ObjectiveTo observe the effect of early rehabilitation on motor function, high-sensitivity C-reactive protein (hs-CRP), interleukin-1（IL-1） and interleukin-6（IL-6） in patients with acute cerebral infarction (ACI). Methods160 patients with ACI were randomly divided into rehabilitation group (n=80) and control group (n=80), who accepted early rehabilitation and routine medicine or medicine only, respectively. They were assessed with modified Edinburgh-Scandinavian Stroke Scale (MESSS) and their peripheral level of hs-CRP, IL-1 and IL-6 were detected before and 1, 2, 4, and 8 weeks after treatment. Results4 and 8 weeks after treatment, the level of hs-CRP, IL-1 and IL-6 were lower in rehabilitation group than in control group（P＜0.05）, as well as the scores of the MESSS （P＜0.01）. The incidence of improvement is more in rehabilitation group than in control group（P＜0.05）. ConclusionEarly rehabilitation can reduce the expression of hs-CRP, IL-1 and IL-6, and improve the neurological function in patients with ACI.

Objective To evaluate the feasibility and safety of transumbilical laparoendoscopic sin-gle-site dismembered pyeloplasty ( U-LESS-P ) for the treatment of ureteropelvic junction obstruction (UPJO). Methods Between Mar.2011 and Mar.2012, U-LESS-P was performed in 8 consecutive pa-tients with UPJO by one experienced laparoscopic surgeon .The patients included 5 males and 3 females, with an average age of 28 (16-45) years.Of the 8 patients, six presented with flank pain , and two were a-symptomatic and discovered incidentally by health check .Of the 8 patients, seven had UPJO on the left side and one on the right side .The diagnosis was established by renal ultrasonography , diuretic renal scan , intra-venous urography (IVU) or/and computed tomography urography (CTU).Renal ultrasonography, IVU and ( or) CTU showed hydronephrosis and UPJO in the affected side , while diuretic renal scan demonstrated re-nal function deteriorated .No patients had undergone abdominal surgery previously .A 2-2.5 cm umbilical in-cision was made for single-port access .The procedures were performed using 30°5 mm or 10 mm laparoscope with a combination of conventional and bent laparoscopic instruments . Results All procedures were com-pleted successfully .None was converted to open surgery or traditional laparoscopic surgery .The mean opera-tive time was 153 (117-190) min, and the average estimated blood loss about 20 (10-40) ml.The mean time to resume oral diet was 1.5 days.The drainage remained 2-7 days.The mean hospital stay was 6 (4-8) days.With the follow-up of 3-6 months, symptom-free was investigated in all 8 cases.Ultrasonography , diuretic renal scan and IVU showed decreased or disappeared hydronephrosis .No operative complication , such as anastomotic stoma stenosis , was founded . Conclusions U-LESS-P is a safe and effective proce-dure for the treatment of UPJO , with the advantages of decreased operative morbidity , postoperative rapid re-covery and improved cosmetic result .

OBJECTIVE: To investigate the clinical application of retroperitoneoscopic dismembered pyeloplasty for pediatric ureteropelvic junction obstruction (UPJO). METHODS: Of the 85 pediatric patients with UPJO, 56 were boys and 29 were girls. The age of the patients ranged from 2.5 to 11 years (mean = 4.6 years).B-ultrasonography showed hydronephrosis <15 mm (mild) in 15 patients,15-30 mm (moderate) in 59, <30 mm (severe) in the other 6. Intravenous urography (IVU) showed good imaging in 55 patients within 30 min, light imaging in 27 at 30-120 min, and no imaging in 3 after 120 min. The 85 patients underwent retroperitoneoscopic dismembered pyeloplasty. Conventional antegrade or modified antegrade double-J stenting was inserted in the 85 patients intraoperatively. RESULTS: The operation was successful in all, with no conversion to open surgery during the operation. The mean operation time was 146 min (125-240 min).The mean blood loss was 68 mL (55-112 mL).The mean postoperative hospitalization was 7 d (6-8 d ).Urine leakage occurred in 1 patient and with a good drainage, urine leakage disappeared in 1 week. Follow-up ranged 3-24 months (mean = 11 months).IVU showed on UPJ stricture, and good imaging in 75 patients within 30 min, light imaging in 10 at 30-120 min. Hydronephrosis was remitted:hydronephrosis resolution in 51 patients, mild in 6 and moderate in 3. CONCLUSION Retroperitoneoscopic dismembered pyeloplasty is a safe, effective and mini-invasive procedure for pediatric ureteropelvic junction obstruction, with a rapid postoperative recovery. It will be the ideal treatment for UPJO in pediatric patients.
Child ; Child, Preschool ; Female ; Humans ; Kidney Pelvis ; surgery ; Laparoscopy ; methods ; Male ; Retroperitoneal Space ; Ureteral Obstruction ; diagnosis ; etiology ; surgery ; Urologic Surgical Procedures ; methods

OBJECTIVE： To establish the method for the content determination of related substance in Terazosin hydrochloride tablets. METHODS： HPLC and principal component self-control with correction factor were adopted. The determination was performed on Agilent Zorbax Eclipse XDB C18 column with mobile phase consisted of acetonitrile-perchloric acid solution （20 ∶ 80， V/V） at the flow rate of 1.0 mL/min. The detection wavelength was set at 246 nm， and sample size was 20 μL. The column temperature was 50 ℃. The linear equations of terazosin hydrochloride， impurity A， B， C were drawn. The correction factors of each impurity related to terazosin hydrochloride were calculated by slope， and relative retention time was used to determine the position of impurities. The contents of impurity A， B and C in 3 batches of Terazosin hydrochloride tablets were determined and compared with the results of impurity control method. RESULTS： The relative retention time of impurity A， B， C was 0.39， 0.74， 2.77， respectively； the linear range of them were 0.25-3.0 μg/mL， respectively. The correction factors were 0.75， 1.09， 0.84， respectively. The detection limits were 0.35， 0.51， 0.43 ng， and the limits of quantification were 0.70， 1.02， 0.86 ng， respectively. The contents of impurity A， B and C in 3 batches of Terazosin hydrochloride tablets were 0.11％-0.13％， 0.03％ and 0.09％-0.12％； impurity B did not detected. The results are consistent with the determination of impurity control method. CONCLUSIONS： The method is simple， rapid and accurate for the content determination of related substances A， B， C in Terazosin hydrochloride tablets.

Ulcerative colitis （UC） is a common chronic digestive system disease in clinic. The disease is repeated and difficult to treat， and the pathogenesis is complex， which is related to oxidative stress response. Nuclear factor E₂-related factor 2 （Nrf2） is an important factor in antioxidant reaction， which regulates the expression of downstream heme oxygen-1 （HO-1）， and plays a role in maintaining redox homeostasis. In the course of UC， the biological activity and content of Nrf2 and HO-1 are decreased， the antioxidant and anti-inflammatory abilities of tissues are weakened， the intestinal epithelial cells are damaged， and the intestinal mucosal barrier is destroyed. At present， western medicine mainly focuses on controlling inflammation and alleviating symptoms in clinical treatment. Although it has a certain effect， there are many problems such as easy recurrence after drug withdrawal and long-term side effects. Studies have shown that Chinese medicine has rich and flexible therapeutic methods and has broad application prospects in the prevention and treatment of UC. In recent years， with Nrf2/HO-1 pathway as the entry point， a large number of basic and clinical experiments on this signal in UC have been carried out in the field of Chinese medicine， and the results show that the intervention of Nrf2/HO-1 pathway is an important potential target for the treatment of UC by Chinese medicines. Based on the etiology and pathogenesis of deficiency-excess in complexity， Chinese medicine regulates Nrf2/HO-1 pathway by clearing heat and detoxifying dampness， activating blood circulation to remove stasis and relieve pain， invigorating Qi， tonifying middle， and warming interior， and treating both symptoms and root causes， to improve the tissue's ability to resist oxidative stress， maintain the balance between pro-inflammatory factors and anti-inflammatory factors， relieve inflammatory response， and play a therapeutic role in UC. This paper summarized and analyzed the effect of Chinese medicine targeting the Nrf2/HO-1 signaling pathway on interfering with UC and its mechanism. The purpose of this study is to provide references for researchers to have a more comprehensive understanding of the mechanism of Chinese medicines in the Nrf2/HO-1 signaling pathway in UC and promote the rational application of Chinese medicines in the prevention and treatment of UC in the future.