Objective To evaluate the effect of probucol combined with simvastatin on blood levels of oxidied low density lipoprotein (ox-LDL) and inflammatory factors in acute stage of cerebral infarction. Methods A total of 122 patients with acute stage of cerebral infarction were randomly divided into two groups:observation group ( n = 62),and control group( n = 60). After two weeks of follow-up ,the levels of high sensitivity C-reactive protein(hsCRP) ,oxLDL ,fibrinogen ( FIB ), interleukin 6 (IL-6) and blood lipids were detected. The side effect was recorded and the difference between two groups was analyzed. At 7 d and 14 d, curative effects were evaluated by standard scale of clinical neurological deficit. Results Compared with the control group, 2weeks after the medication, low-density lipoprotein cholesterol( LDL-C), apolipoprotein B ,ox-LDL, IL-6 and hsCRP were significantly decreased in the observation group (P <0.01 ). Conclusion The treafment of probucol combined with simvastatin could reduce the levels of ox-LDL and inflammatory factors in acute stage of cerebral infarction, and prevent hemorrhagic transformation and recurrence of cerebral in farction.

To investigate the relationship between platelet-leukocyte aggregates (PLA) and serum high sensitive C-reactive protein (hs-CRP)in type 2 diabetic patients with retinopathy (DR).The blood levels of platelet-neutrophil aggregates( PNA )and platelet-monocyte aggregates ( PMA ) were determined by flow cytometry and serum hs-CRP by ELISA in 30 patients with proliferative diabetic retinopathy( PDR group),30 patients with no-proliferative diabetic retinopathy( NPDR group),25 diabetic patients without DR( DM group),and 30 normal controls.The levels of PNA,PMA,and hs-CRP in PDR group were significantly higher than those in normal control,NPDR,and DM groups.The levels of PNA,PMA,and hs-CRP in NPDR group were significantly higher than those in normal control and DM group( P＜0.01 or P＜0.05 ).The PNA and PMA were correlated positively with hs-CRP in patients with DR ( r =0.587,0.576 ; P ＜ 0.05 ).The data showed that the levels of PLA and hs-CRP were raised significantly in patients with DR,and the levels of PLA were positively correlated with inflammatory response and the seriousness of DR,suggesting that these findings may play an important role in the development of DR.

Objective To evaluate the feasibility,safety and efficacy of ESD for precancerous lesions and early cancer of remnant stomach after partial gastrectomy.Methods ESD was performed in 11 cases of high grade intraepithelial neoplasia/early cancer of remnant stomach.The short-term and long-term indices including time of procedure,complication,En Bloc resection rate,R0resection rate,local recurrence rate as well as lymph node metastasis were recorded and analysed.Results ESD was completed in all patients with only one case of delayed massive bleeding which was controlled by endoscopy successfully.Average procedure time,En Bloc resection rate,R0 resection rate were 85.5 minutes,100％ and 90％,respectively.No local recurrence or lymph node metastasis was detected during post-ESD surveillance (15 ～ 51 months).Conclusion High grade intraepithelial neoplasia and early cancer of remnant stomach after partial gastrectomy might be indication for ESD because of its safety and definite effect.Additionally,careful management of the fibre tissue is the key to procedure success.

OBJECTIVETo explore the effects of different beta-lactam antibiotics on the inducing of LPS release from gram-negative bacteria and on the protection of infected animals.

METHODSWistar rats were employed as the model and were inflicted by 30% TBSA III degree scalding and sepsis caused by PA103. The rats were randomly divided into 3 groups, i.e. simple antibiotic treatment group (A), treatment after sensitization with galactosamine (GalN) group (G) and treatment after blocking with carrageenan (CGN) group (C). The rats were injected intra-peritoneally with imipenem (IMP, 5 mg) and ceftazidime (CTZ, 10 mg) for single time, respectively. Same amount of aseptic normal saline was injected in the control group, and GalN (50 mg) was added in G and CGN (1 mg) in C groups. The blood bacterial concentration and plasma LPS levels were determined at different time points after the treatment by antibiotics. The mortality was observed in G and C groups at 10 days after treatment.

RESULTSThe blood bacterial amount could be decreased by both IMP and CTZ evidently. Large amounts of LPS released from PA103 could be induced by IMP and CTZ during their bactericidal process. But the plasma LPS level in rats treated by CTZ was markedly higher than that by IMP (P < 0.05 approximately 0.01). The mortality in G group treated by CTZ was much higher than that by IMP (P < 0.05). Nevertheless, the mortality in C groups was the same no matter CTZ or IMP was applied (P < 0.05).

CONCLUSIONThere was no difference of the bactericidal power between IMP and CTZ. But CTZ was more powerful in inducing LPS release from bacteria than IMP. It was implied by the difference between these two antibiotics that IMP might be better choice in clinical application for burn infection due to its lower potential of inducing LPS release from the bacteria.

Animals ; Anti-Bacterial Agents ; pharmacology ; Burns ; complications ; Ceftazidime ; pharmacology ; Cell Division ; drug effects ; Colony Count, Microbial ; Female ; Galactosamine ; pharmacology ; Imipenem ; pharmacology ; Lipopolysaccharides ; metabolism ; Male ; Pseudomonas Infections ; etiology ; mortality ; prevention & control ; Pseudomonas aeruginosa ; drug effects ; growth & development ; metabolism ; Rats ; Rats, Wistar ; Sepsis ; blood ; etiology ; prevention & control ; Survival Rate ; Time Factors

Objective To investigate the circulating levels of platelet-leukocyte aggregates (PLA) in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods The circulating levels of platelet-neutrophil aggregates (PNA) and platelet-monocyte aggregates (PMA) were quantified in 30 patients with DEACMP (DEACMP group) and 30 patients with acute carbon monoxide poisoning (ACOP group) by using flow cytometry assay,whose results were compared with those of 20 healthy subjects (controls).Results Circulating PNA and PMA levels in DEACMP group and ACOP group at acute stage were significantly higher than those in controls,respectively (P＜0.05),while no significant difference was noted between ACOP group and DEACMP group at acute stage (P＞0.05),indicating that platelets were in activation status and PLA levels raised significantly in patients with DEACMP and ACOP at acute stage.Circulating PNA and PMA levels were significantly higher in DEACMP group at acute stage than those in DEACMP group at stable stage (P＜ 0.05),suggesting that platelet activation were controlled after the illness state were stabilized in patients with DEACMP.Conclusion Platelet is involved in the pathogenesis of DEACMP and the change trend of circulating PLA levels is basically consistent with illness state.

OBJECTIVETo evaluate the differences in the clinical therapeutic effects on spasmodic hemiplegia after stroke among the alliance therapy of scalp acupuncture, music therapy combined with rehabilitation, the simple rehabilitation therapy and the combination of music therapy and rehabilitation.

METHODSA total of 76 patients of post-stroke spasmodic hemiplegia were randomized into a rehabilitation group (25 cases), a combination group with music therapy and rehabilitation (25 cases) and an alliance therapy group with scalp acupuncture, music therapy and rehabilitation (26 cases). In the rehabilitation group, the routine rehabilitation therapy was applied, including the removal of various incentives that cause spasm, the correction of body position and the physical therapy. In the combination group, the music therapy was added on the basis of the treatment as the rehabilitation group. The music physician used the rhythmic auditory stimulation, the patterned sensory enhancement and the therapeutic instrumental music playing to set up the task in the treatment. In the alliance therapy group, scalp acupuncture was added on the basis of the treatment as the combination group. The anterior oblique line of vertex-tempora (MS 6) and the posterior oblique line of vertex-tempora (MS 7) on the contralateral side were selected and stimulated with penetrating needling technique. The needles were retained. During the needling retaining, the needles were rotated once every 10 min, for 2 min each time. The treatment was given one session a day, totally for 5 sessions a week, continuously for 4 weeks. The Fugl-Meyer assessment (FMA), Barthel index (BI) and the modified Ashworth scale (MAS) of the affected elbow and the passive knee movement at static condition were observed in the patients before and after treatment.

RESULTSThe results of FMA, BI and MAS were not different before treatment in the patients among the three groups (all>0.05), indicating the comparability among groups. After treatment, FMA and BI scores were all increased apparently in the three groups as compared with those before treatment (all<0.05). MAS grade was reduced remarkably as compared with that before treatment (all<0.05). After treatment, FMA and BI scores in the alliance therapy group were higher than those in the combination group and the rehabilitation group (all<0.05). FMA and BI scores in the combination group were higher than those in the rehabilitation group (both<0.05). MAS grade in the alliance therapy group was lower than those in the combination group and the rehabilitation group (both<0.05). MAS grade in the combination group was lower than that in the rehabilitation group (<0.05).

CONCLUSIONThe alliance therapy with scalp acupuncture, music therapy and rehabilitation achieve the remarkable clinical therapeutic effects on post-stroke spasmodic hemiplegia as compared with the routine rehabilitation and the combination of music therapy and rehabilitation.

Objective     To investigate short-term outcomes of robot-assisted Heller-Dor myotomy (RAHM-Dor) for achalasia of cardia and our learning curve experience. Methods     The clinical data and recent follow-up results of 42 patients who received RAHM-Dor from November 2015 to January 2020 in the Department of Thoracic Surgery of the First Affiliated Hospital of Nanchang University were retrospectively analyzed, including 20 males and 22 females with a mean age of 40.8±18.4 years. Results    Dysphagia was the most common symptom, followed by heartburn and regurgitation. The mean operation time was 122.8±23.9 min. The mean blood loss was 47.5±32.7 mL. Two patients suffered mucosal injury, and successfully repaired by suturing during surgery. There was no esophageal fistula, conversion to an open operation or perioperative death in this series. The median length of hospital stay was 8 (6, 9) d. In all patients, the Stooler and Eckardt scores of postoperative 1, 6 and 12 months decreased compared to those of pre-operation (P<0.001). Conclusion     RAHM-Dor is a safe and feasible avenue for the treatment of achalasia of cardia, and can achieve a satisfying short-term results. The learning curve shows a transition to the standard stage from the learning stage after 16-18 operations.