Objective To study the application of super-selective external carotid artery embolization in head and neck diseases. Methods DSA and super-selective external carotid artery embolization were carried out in 41 cases of head and neck diseases including 12 cases of epistaxis,7 nasopharyngeal fibroangioma,1 traumatic arterial bleeding,14 vascular malformation,and 7 malignancies. Results No recurrence of nose bleeding after embolization of epistaxis was seen within 6 - 12-month follow up. The operative bleeding was reduced significantly by preoperative embolization in nasopharyngeal fibroangioma. No recurrence of bleeding was achieved after embolization of traumatic artery. Among the cases of vascular malformation,3 were proven to be significantly effcient,6 effcient,and 5 inefficent in the 6 - 12-month follow up. Among the 7 malignant cases,3 survived more than 2 years. Conclusion Super-selective external carotid artery embolization is safe and effective in the treatment of head and neck diseases. (J Intervent Radiol,2006,15: 330-332)

Objective To discuss the frequency of ventilator pipe replacement in ICU ward for reducing the frequency of VAP occurrence caused by bacterial colonization in ventilator-line. Methods 30 patients hospitalized to ICU ward from Janurary,2008 to June, 2009 who had mechanical-ventilation above 48h were randomly divided into group A, B and C with 30 patients in each group, then bacteria culture and strain analysis were employed for the pipeline sample of ventilator inspiratory side at the time point to be use and used mechanical ventilation for 1 day, 3 days and 7 days. Results There was no bacteria grew after ventilator-line sterilization, and positive ratio of bacterial culture in 1d, 3d and 7d were 46.66%,53.33% and 100.00%, respectively. Conclusions The frequency of ventilator pipe replacement should be shortened in patients with abdominal infection, to replace every 3 days is suitable in ICU where infectious patients gathered.

Objective To provide reference for establishing diagnosis and differential diagnosis methods of rare yeast-like fungal bloodstream infection for clinical microbiology laboratory.Methods Trichosporon asahii (T.asa-hii)and Geotrichum capitatum (G.capitatum)bloodstream infection was diagnosed and differentially diagnosed through clinical data analysis,morphological examination,biochemical reactions,and molecular biology technology. Results Two types of yeast-like fungal bloodstream infections in case 1 and case 2 both occurred in leukemia agranulocytosis phase after chemotherapy,such infections were serious and highly similar.The cultivated colonies on blood agar plates of case 1 and case 2 were performed gram stain and microscopic examination.Hyphae,arthro-spores and microconidia were visible in the former,thickness of hyphae branches and length of arthrospores were different,most presented rectangular and barrel shape;the latter can be seen hyphae with transparent septum bro-ken up into arthrospores,presented rectangular shape,did not produce blastoconidia.Identification with API 20C AUX showed that they were T.asahii and G.capitatum.The PCR product sequences were compared with NCBI, suggesting that T.asahii and G.capitatum were at sexual stage.Conclusion Comprehensive application of a varie-ty of technical methods is helpful for improving the diagnosis accuracy of bloodstream infection with yeast-like fungi, identifying Trichosporon and Geotrichum to the species level may help physicians to understand such rare fungal in-fection,choose antifungal agents rationally,and improve clinical prognosis.

Objective To observe the influence of adrenocorticotropic hormone (ACTH4-10) in the changes of podocyte proliferation,apoptosis and expression of nephrin and podocin on adriamycin (ADR)-induced podocyte injury and investigate the protective effect of ACTH4-10.Methods All podocytes were randomly divided into following groups:normal control,ADR-induced group and ACTH4-10 intervention group (low,middle and high concentration).Normal control group was not treated,ADR-induced group was induced to set the model of podocyte injury by ADR (1 μmol/L) for 24 hours and ACTH4-10 intervention groups were intervened by 1 μg/L,10 μg/L and 100 μg/L ACTH4-10 for 1 hours respectively,prior to setting the model of podocyte injury.Cell counting kit (CCK-8) was used to detect the multiplication of podocytes and TUNEL apoptosis detection kit was used to detect podocyte apoptosis.Real-time PCR and Western blotting were used to examine the expression of nephrin and podocin.Results Compared with control group,podocyte proliferation and expression of nephrin and podocin was decreased significantly in ADR-induced group (P ＜ 0.05),meanwhile podocyte apoptosis was increased obviously (38.14％ vs 5.12％).Compared with ADR-induced group,podocyte proliferation and expression of nephrin and podocin was increased generally with concentration of ACTH4-10.Although podocyte apoptosis rates (20.45％,17.39％,11.02％) were increased in ACTH4-10 intervention group (low,middle and high concentration) while comparing with normal control group,podocyte apoptosis decreased obviously while comparing with ADR-induced group.Conclusions ACTH4-10 can stabilize the expression of nephrin and podocin on slid diaphragm,and has the protective effect on podocyte injury induced by ADR,while the effect depends on the concentration of ACTH4-10.

Objective:To explore the validity of a function assessing tool based on the International Classification of Functioning, Disability and Health′s (ICF′s) rehabilitation set in assessing aging-related disability.Methods:A total of 1610 elderly people from 15 nursing homes across China were assessed using the tool based on the ICF′s rehabilitation set and with the 12-item short form health survey (SF-12). The structural validity of the responses was analyzed using factor analysis, and criterion-related validity was also evaluated.Results:The factor analysis yielded three factors with eigenvalues greater than 1. Their cumulative explanatory power was 74.4%. Item d550 eating had double loading in the factor analysis. The item scores and the total scores of the disability assessment tool were significantly negatively correlated with the physiological function domain scores and the psychological function domain scores.Conclusion:The function assessment tool based on the ICF′s rehabilitation set when combined with a numerical rating scale has good structural and criterion-related validity in the assessment of disability due to aging.

ObjectiveTo investigate the effects of ulinastatin postconditioning and combining ulinastatin postconditioning with pretreatment on myocardial inflammatory response in patients undergoing cardiac valve replacement under CPB.MethodsEighty NYHA class Ⅱ or Ⅲ patients of both sexes aged 21-59 yr undergoing cardiac valve replacement under CPB were randomly divided into 4 groups ( n =20 each): group control (group C) ; group ulinastatin pretreatment ( group U1 ) ; group ulinastatin postconditioning (group U2 ) and group ulinastatin pretreatment and postconditioning combined (group U3 ).Ulinastatin 20 000 U/kg was infused via central vein at 500-1000 U·kg-1 ·min-1 after tracheal intubation until 10 min before cross-clamping of ascending aorta in groups U1 and U3.Ulinastatin 10 000 U/kg was infused into root of aorta at 4000-5000 U· kg- 1 · min- 1 at 5-7 min before declamping of aorta in groups U2 and U3.Blood samples were obtained from radial artery before cross clamping of ascending aorta,at 40 min after aortic cross-clamping,at 45 min after declamping of aorta (T3) and at the end of operation for polymorphonuclear leukocyte (PMN) count,routine analysis of blood and determination of plasma concentrations of IL-10,TNF-α,IL-1 and IL-6 (by ELISA).Myocardial specimens were obtained at 45 min after declamping of aorta for determination of IL-1β and IL-6 expression by immune-histochemistry.Results Ulinastatin pretreatment and/or postconditioning significantly increased plasma IL-10 concentration and decreased plasma IL-1,IL-6,TNF-α concentrations and PMN count and myocardial IL-1β and IL-6 expression in groups U1,U2 and U3 as compared with group C.Plasma IL-10 concentration was significantly higher and plasma IL-1,IL-6 and TNF-α concentrations,PMN count and myocardial IL-1β and IL-6 expression were lower in group U3 than in groups U1 and U2.ConclusionUlinastatin postconditioning can inhibit myocardial imflammatory response in patients undergoing valve replacement under CPB.The protective effect can be augmented by combining ulinastatin postconditioning with pretreatment.

Objective To evaluate the effects of ulinastatin on cardiac function in heart valve replacement patients with cardio-pulmonary bypass (CPB).Methods 120 patients received valve replacements were divided into 4 groups at random.Group U 1,preconditioning group:ulinastatin parenteral solution (20 000 U/kg) was injected into the central veins for 10 min before the ascending aorta was clamped.Group U2,postconditioning group:ulinastatin ( 10 000 U/kg) was injected into the aortic root for 5 min before the aortic clamp was opened.Group U3,combined the treatments of group U1 and group U2.Group C was served as control without using ulinastatin.The ST-T of ECG at different 8 time points was recorded from preanesthesia to the end of operation.The dosage of vasoactive agents in the 4 groups was recorded after the aortic clamp was opened.Blood samples were taken from the radial artery at 4 time points during 1O min before the ascending aorta was clamed to the end of operation for determining the serum concentration of H-FABP,IMA,CK-MB,MDA and SOD.The changes in myocardium were examined by microscope.Results The automatic reheating rate of heart in group U1,group U2,and group U3 were 70％,73％ and 90％ respectively,which were all higher than group C (33％) after the aortic clamp was opened in 3 -5 min.The scores of reperfusion arrhythmia,change of ST segments in ECG ( elevation or depression),the dosage of vasoactive drugs ( dopamine and adrenaline) and their using time,the concentration of MDA,H-FABP,IMA and CK-MB in group U1 and group U2 were ＜ than those of group C ( P ＜0.05 ),but was ＞ than those of group U3 ( P ＜0.05 ).The activity of SOD in group U1 and group U2 were ＞ than those of group C ( P ＜ 0.05 ),but was ＜ than those of group U3 ( P ＜ 0.05 ).There were no significant differences between group U1 and group U2( P ＞0.05 ).The myocardium in group C had focal coagulative necrosis.The damage of myocardium in group U3 was minor,the cytoplasm and nucleus was homogeneous,and the boundaries were distinct.Conclusion Ulinastatin parenteral solution preconditioning and postconditioning could improve heart function after valves replacement on CPB.The protective effects were not significantly different regarding ulinastati was administered into the central veins before the ascending aorta was clamped vs.it was injected into the aortic root before the aortic clamp opening.Combined these 2 administration methods and dosages could produce collaborative protection.

Objective:To explore the distribution of different subsets of monocyte in peripheral blood of patients with thyroid-associated ophthalmopathy (TAO).Methods:A cross-sectional study was performed.Fifty-nine TAO patients and 30 healthy subjects were recruited continuously in Zhongshan Ophthalmic Center from January 2017 to December 2019.Clinical data of subjects were recorded, and the severity and activity of TAO were graded based on the criteria of NOSPECS and CAS.TAO patients were grouped according to clinical activity of TAO, and the patients were treated by triamcinolone acetonide (TA) injection or methylprednisolone pulse therapy (MPT) accordingly.Peripheral blood of the subjects was collected and monocytes were isolated.The proportion of different monocyte subsets was assayed by a flow cytometry.The differences in distribution of monocyte subsets between TAO group and normal control group, stable TAO group and active TAO group, TA injected group and MPT treated group were compared and analyzed.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-Sen University (No.2014MEKY005), and the written informed consent was obtained from each subject before any medical intervention.Results:The proportion of classical monocyte (CMo) subset in TAO group was (81.77%±5.53)%, which was significantly lower than (84.35±5.83)% in the normal control group ( P=0.034); the proportion of intermediate monocyte (IMo) subset in the TAO group was (10.17±4.19)%, which was significantly higher than (7.69±4.09)% in the normal control group ( P=0.006); no significant difference was found in the proportion of non-classical monocyte (NMo) subset between the two groups ( P=0.892). The proportion of CMo subset in the active TAO group was (77.29±5.80)%, which was significantly lower than (82.64±5.03)% in the stable TAO group ( P<0.01), and the proportion of IMo subset in the active TAO group was (13.79±4.82)%, which was significantly higher than (9.20±3.56)% in the stable TAO group ( P<0.01); no significant change was found in the proportion of NMo subset between the two groups ( P=0.283). There was no difference in the proportion of different TAO subsets before and after TA injection ( P>0.05). In MPT treated group, the proportion of CMo subset in TAO patients was significantly increased and the proportion of IMo subset was significantly decreased (both at P<0.05); there was no significant difference in proportion of NMo subset before and after MPT treatment ( P=0.187). Conclusions:IMo subset is enriched in patients with TAO, and the IMo subset content varies over the disease activity.MPT may inhibit the shift of CMo subset towards IMo subset.

With the rapid development of organ transplantation in China,the donation after cardiac death (DCD) donor organs are widely used.However,the quality of these organs is relatively poor,so the way to preserve and maintain organ still remains a severe problem.Among them,ischemic reperfusion injury (IRI) impairs the organs severely.Acetaldehyde dehydrogenase 2 (ALDH2) protects organs from stress conditions,including ischemia-reperfusion injury,and the activation and autophagy inhibition also protects the organs from stress conditions as well.Recent studies showed that ALDH2 can regulate autophagy to inhibit the organ injury during ischemia-reperfusion.Our study aims to discuss the new findings in this mechanism.

Objective:To reveal the research hotspos and the dynamic frontier in feeding intolerance in critically ill patients.Method:We took feeding intolerance and critical illness as the theme, the CNKI and WOS core database as the research object, and used CiteSpace software as research tool, to conduct a visual atlas analysis on the research status and hotspos evolution at home and abroad. Results:There were totally 2 426 feeding intolerance related papers published, and quantity of publications increased year by year. Australia and some European and American countries are in a leading position. The institutions in the lead regarding scientific research level were Royal Adelaide Hospital, Adelaide University, Louisville University, Repatriation General Hospital and Queens University. The researches mainly focused on the investigation of mechanism, symptom evaluation, and management of feeding intolerance .Conclusion:The feeding of critically ill patients has attracted more and more attention. In the future, we should further carry out high-quality and large-scale empirical research, explore new technologies and big data, and develop evidence-based prevention and management strategies for feeding intolerance.