Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Community-Acquired Infections ; diagnosis ; epidemiology ; therapy ; Humans ; Pneumonia ; diagnosis ; epidemiology ; therapy

Objective To investigate the clinical value of classic intrafascial supracervical hysterectomy(CISH) by including the clipping of the uterine artery.Methods A total of 60 cases of benign uterine diseases were included in the study.After the uterine artery had been dissected and clipped on both sides under laparoscope,classic intrafascial supracervical hysterectomy was performed.Results All the operations were performed successfully under laparoscope.No conversions to open surgery were needed.Operating complications happened in no case.The operating time was 72~186 min(91.4?26.3 min),the amount of blood loss was 50~150 ml(76.5?20.6 ml),the time to postoperative gastrointestinal function recovery was 18~30 h(22.7?5.8 h),and the volume of pelvic drainage within 24 hours,50~160 ml(80.5?31.8) ml.Postoperative body temperature was elevated to 38.5 ℃ in 2 cases,the postoperative pyrexia rate being 3.3%.The length of postoperative hospital stay was 4~7 d.Follow-up for 6~18 months(10.6?4.2 months) in the 60 cases showed 3 cases of small amount of vaginal bleeding at 1~3 months,which were cured with the use of antibiotics and hemostatics for 5~7 d.Conclusions Classic intrafascial supracervical hysterectomy by including the clipping of the uterine artery is a safe and effective improvement to CISH technique.

OBJECTIVE: To study flavonoids from the leaves of Zelkova serrata. METHODS: The leaves were extracted with 70% ethanol by continuous thermal reflux. The extract was separated and purified by silica gel column chromatography, polyamide column chromatography, preparative TLC and other isolation techniques. Their structures were identified by their physical properties and spectroscopic data. RESULTS: Eight flavonoids were isolated and identified as myricetin (1), dihydromyricetin (2), quercetin (3), myricitrin(4), myricetin-3-O-β-D-xyloside(5), quercetin-3-O-β-D-xyloside(6), quercitrin(7), and rutin(8). CONCLUSION: All compounds were isolated from Schneider Zelkova leaves for the first time.

Objective To investigate the clinical efficacy of total laparoscopic hysterectomy(TLH) with separating and blocking uterine arteries.Methods From January 2004 to June 2006,68 cases of uterine benign diseases underwent TLH by blocking uterine arteries after separating and clipping uterine arteries with Titanic clip.Results All operations were performed successfully without conversion to open surgery and complications.1 patient,who had twice gastrohysterectomy histories,underwent bipolar coagulating uterine arteries as to the failure of separating bilateral uterine arteries.Pelvic adhesion release was performed in 18 cases,unilateral or bilateral adnexectomy in 14 cases,oophorocystectomy in 8 cases,appendectomy in 1 case,and cholecystectomy in 1 case simultaneously.The operation time was 90-185 min,(112.6?27.5)min.The time of separating uterine artery in one side was 3-15 min,(5.2?3.4)min.The intraoperative blood loss was 50-150 ml,(86.5?39.6)ml.The time to first bowel movement was 18-48 h,(27.3?4.8)h.The rate of postoperative pyrexia was 4.4%(3/68),and the hospital stay was 4-7 d,(5.1?1.8) d.A follow-up period of 2-6 months,(3.5?1.6) months,showed 3 cases of vaginal dropping hemorrhage 1-2 months after operation,which was cured with the use of antibiotics and hemostatics for 5-7 d.Conclusions TLH with separating and blocking uterine arteries is a safe,effective and feasible procedure with less complication,so it is worthy of being recommended.

(0.05)). Multivariate analysis revealed that adjuvant radiotherapy and histology of tumor significantly affected the prognosis(P=(0.045) and P=(0.009), respectively). Whereas loco-regional control was only significantly affected by adjuvant radiotherapy(P=(0.000)). CONCLUSION: Adjuvant radiotherapy and histology of tumor are the important prognostic factors in the rectal cancer patients after treatment with multimodality therapy based on surgery.

Objective To re-evaluate the prognostic value of the 6th edition of UICC/AJCC staging system in patients with nasopharyngeal carcinoma (NPC) treated with intensity-medulated radiation therapy (IMRT). Methods From February 2001 to March 2007, Clinical data of 570 NPC patients initially treated with IMRT in Cancer Center of Sun yat-sen University were reviewed and the long-term survival was analyzed according to T, N and overall stages. Results The median follow-up was 42 months. 184 patients were followed up to 5 years. The 5-year local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS) and overall survival (OS) of the whole group were 93. 0%, 85.4% and 83. 3% ,respectively. No statistically significant difference of LRFS was detected between the either two of stage T_1, T_(2a) and T_(2b)(100%, 100% and 94. 5% ;T_1 vs. T_(2b), χ~2 = 1.92, P =0. 166 ;T_(2a) vs. T_(2b), χ~2= 0. 35, P =0. 555), stage T_(2b) and T_3 (94. 5% and 91.3% ;χ~2 = 2. 62, P = 0. 106), or stage T_3 and T_4 (91.3% and 89. 5% ; χ~2 = 1.55, P =0. 214). The 5-year DMFS of stage N_2 was similar with stage N_1 or stage N_3(80. 2%, 86. 2% and 61. 4% ; N_2 vs. N_1, χ~2=2.22, P=0.136;N_2 vs. N_3, χ~2= 1.92, P=0.165). No statistically significant difference of 5-year OS was observed among stage Ⅰ , Ⅱ_a and Ⅱ_b(91.7%, 100% and 95. 3% ; Ⅰ vs. Ⅱ_b χ~2 =0.32, P=0.574;Ⅱ_a vs. Ⅱ_b,χ~2-0.25, P=0.617), or between Ⅳ. And Ⅳ_b(67.9% and 75. 0% ;χ~2 = 0.25, P = 0. 616). Conclusions The 6th edition of UICC/AJCC staging system shows poor predictive value for the long-term survival of NPC patients treated with IMRT.

BACKGROUND: Cervical sympathetic ganglia block accelerates the re covery of the homeostasis of organic nervous-endocrine-immune system, butit is still unclear whether it can suppress the imbalance of homeostasis in duced by post-traumatic stress disorder. OBJECTIVE: To observe the effect of cervical sympathetic ganglia blockon the mortality of mice with combined radiation and burn injury, andwhether it can become an easy and effective method to treat secondarydamage after serious trauma. DESIGN: A randomized grouping design, an animal controlled experiment. SETTING: Department of Anesthesiology, Guangzhou General Hospital, Guangzhou Military Area Command of Chinese PLA.MATERIALS: The experiments were carried out in the Institute of Combined Injury, the Third Military Medical University of Chinese PLA between February 2004 and July 2005. Totally 160 Kunming mice were randomly divided into control group (n=50) and cervical sympathetic ganglia block group (n=50). In the control group, the mice were only induced to models of combined radiation and bum injury, and treated with injection of 0.3 mL saline at cervical part. In the cervical sympathetic ganglia block group, the mice were induced to models of combined radiation and burn injury, and then treated with cervical sympathetic ganglia block, once a day for 14 days continuously.METHODS: Methods to induce injury in the animals: ① Radiation injury: The mice were given even radiation of 60Coγ ray (5 Gy) at a distance of 1.5 m to the whole body, the rate of absorptive dosage was (5.17-5.33) mGy/s. ② Burn injury: After the radiation injury, coagulated gasoline was smeared on the back and burnt for 8 s to induce degree Ⅲ burn injury of 15% of the total body surface, which was proved by the pathological section. Methods of cervical sympathetic ganglia block: Cervical sympathetic ganglia block was given bilaterally, and then the mice were injected with 0.2 mL lidocaine (5 g/L), and it was observed whether the symptoms similar to Horner syndrome (hyperemia of conjunctiva, drooping eyelid,blushing, smaller eyeslit) occurred or not at 5 minutes after injection.MAIN OUTCOME MEASURES: The mortality at 2, 5, 7, 10, 20 and30 days after injury and the changes of the numbers of red blood cells,white blood cells and blood platelet in peripheral blood at 7, 14 and 21 days after injury were observed in both groups. The effects of cervical sympathetic ganglia block on the levels of tumor necrosis factor-alpha (TNF-α),interleukin-1β (IL-1β) and interleukin-6 (IL-6) in serum at 3, 6 and 14days after combined radiation and burn injury were also observed.RESULTS: All the 160 mice were involved in the analysis of results without deletion. ① Compared with the control group, the mortalities at 5,7, 10, 15, 20 and 30 days in the cervical sympathetic ganglia block group were significantly decreased [control group: 8%, 22%, 32%, 54%, 74%,82%, 90%; cervical sympathetic ganglia block group: 8%, 14%, 16%, 22%,28%, 34%, 56%]. ② Compared with the control group, the numbers of red blood cells, white blood cells and blood platelets in peripheral blood at 7,14 and 21 days after injury in the cervical sympathetic ganglia block group were significantly increased [at 21 days: red blood cells: 23.21×1012 L-1, 14.58×1012 L-1; blood platelet: 16.87×1011 L-1, 12.57×1011 L-1; white blood cells: 20.65×109 L-1, 14.58×109 L-1]. ③ The levels of TNF-α, IL-1β andIL-6 in serum at 3, 6 and 14 days after injury in the cervical sympathetic ganglia block group were significantly decreased as compared with those in the control group [at 14 days: TNF-α: 189, 365 ng/L; IL-1β: 14, 23 ng/L;IL-6: 70, 132 ng/L].CONCLUSION: Cervical sympathetic ganglia block can significantly decrease the mortality of animals with combined radiation and burn injury,and it is an easy and effective method to treat serious trauma, and the mechanism may be realized through accelerating the recovery of hematopoietic function and suppressing the excessive inflammatory reaction.

Objective To evaluate the survival benefit of amphotericin B (AmB) plus flucytosine or fluconazole for treatment of patients with acquired immunodeficiency syndrome (AIDS)-associated cryptococcal meningitis.Methods The following database were searched from the beginning to October 2013,including Cochrane library,PubMed,OVID,Embase,Wanfang Date,CNKI and Chinese Biomedical Database,and the references of eligible studies were manually screened.Reference lists of relevant articles were screened according to selection and extraction criteria.Meta-analysis was performed using RevMan 5.2.Results Four prospective controlled studies with a total of 399 patients with cryptococcal meningitis were identified,including 386 patients with AIDS-associated cryptococcal meningitis and 13 human immunodeficiency virus (HIV)-negative patients.Two hundred and twentyseven patients were treated with AmB and flucytosine combination therapy,including 217 patients with AIDS-associated cryptococcal meningitis and 10 HIV-negative patients.One hundred and seventy-two patients were treated with AmB and fluconazole combination therapy,including 169 patients with AIDS-associated cryptococcal meningitis and 3 HIV-negative patients.The Meta-analysis revealed that the mortality rate in AmB plus flucytosine combination therapy group was 6.6％ (95％ CI:18.5％-31.6 ％) at two weeks point,which was significantly lower than that in AmB plus fluconazole combination group (19.7％,95％CI:-23.6％-62.9％; OR=0.51,95％CI:0.27-0.93,P＜0.05).But at 10 weeks point,the mortality rate in flucytosine combination group was 12.9％ (95％oo CI:-22.2％-48.0％),which was lower than that in fluconazole combination group (31.4％,95％ CI:-23.1％-85.9 ％).However,there was no statistically significant difference between these two groups at 10 weeks point (OR=0.70,95％CI:0.44-1.13,P=0.15).Conclusion Administration of AmB plus flucytosine at early stage can reduce the mortality rate in patients with AIDS-associated cryptococcal meningitis.

Objective To assess the Chinese System for Cardiac Operative Risk Evaluation (SinoSCORE) model in patients undergoing heart valve surgery at our center.Methods From January 2009 to December 2011,2098 consecutive adult patients who underwent heart valve surgery at our center were collected and scored according to the SinoSCORE model.All patients were divided into three risk subgroups.The entire cohort and each risk subgroup were analysed.Calibration of the SinoSCORE model was assessed by the Hosmer-Lemeshow(H-L) test.Discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve.Results Observed mortality of all 2098 patients was 3.00％.Despite there were significant differences between the SinoSCORE population and our own population sample,the SinoSCORE model showed good calibration(Hosmer-Lemeshow:P =0.783) and discriminative power (area under the ROC curve of 0.752)in predicting in-hospital mortality at the entire cohort.Conclusion The SinoSCORE model give an accurate prediction for individual operative risk in heart valve surgery patients at our center.

Objective: To investigate the chemical constituents of Gracilaria lemaneiformis. Methods: Compounds were isolated by normal phase silica gel and Sephadex LH-20 gel column chromatography. Their structures were elucidated by analyses of spectroscopic data. Results: Nine compounds were isolated from the ethanol extract of G. lemaneiformis, their structures were elucidated as palmitic acid (1), 1, 3-dipalmitin (2), 1-monopalmitin (3), uracil (4), adenosine (5), 2α-oxa-2-oxo-5α-hydroxy-3,4-dinorcholestane (6), 1-O-β-D-galactosyl-(6→1)-α-D-galactosyl-2, 3-O-dihexadecanoyl- glycerol (7), 1-O-α-D-glucose-2, 3-O-dihexadecanoyl-glycerol (8), and β-sitosterol (9). Conclusion: All of these compounds are obtained from this plant for the first time.