OBJECTIVE To investigate related factors of urinary tract infection due to indwelling catheter.(METHODS) A total of 19 cases of urinary tract infection due to indwelling catheter were retrospectively analyzed.RESULTS Among 49 patients with indwelling catheter 19 patients got urinary tract infection,the infection rate was 38.78%.The incidence of urinary tract infection of patients at 1-10 d,11-20 d,21-30 d and over 30 d catheter was 20.00%,30.77%,37.50%,and 69.23%,respectively. Escherichia coli was the most common pathogen(isolated),the others were Enterococcus faecalis,Candida albicans,Enterobacter cloacae,et al.CONCLUSIONS The operation of indwelling catheter,continued times of indwelling catheter,improper application of antibiotics are the important risk factors of urinary tract infection.The infection rate could be decreased after taking(prevention) measures according to various related factors.

OBJECTIVE To discuss the management methods of sputum sample retained clinically based on the praxiology,and aim at improving the quality of the sputum retained. METHODS Through investigating the quality of sputum sample retained routinely from the department of internal medicine in a general hospital at the duration from Sep 2004 to Feb 2005,the intervention effect was evaluated by carrying out the measure of praxiology intervention. RESULTS The qualification rate was 23.7% for the sputum sample retained routinely from the hospital at the duration from Sep 2004 to Feb 2005,after carrying out the measure of praxiology intervention,the qualification rate was 30.1% at the duration from Apr 2005 to Aug 2005.Statistic data showed that there was no significant difference. CONCLUSIONS The quality of the sputum sample retained routinely is poor,and the measure of praxiology intervention failed to improve the quality of the sputum sample.Microscopy is the most important measure to ensure the quality of the sputum sample for the cytology test before cultivating the sample,and should be a routine test in hospital.The study on praxiology intervention will be further carried out in the future.

Objective To observe the effect of electromyographic biofeedback combined with earlier rehabilitation on serum matrix metalloproteinase-9 (MMP-9) and its clinical efficacy for patients with cerebral infarction. Methods 90 patients with acute cerebral infarction were randomly divided into control group (n=30), rehabilitation group (n=30) and combination group (n=30). All the groups received basic medication, and the rehabilitation group combined with earlier rehabilitation, the combination group with electromyographic biofeedback and earlier rehabilitation. All patients were evaluated with Clinical Neurologic Functional Default Scoring (CNFDS) and the modified Barthel Index (MBI) before and 2 weeks after treatment. Their serum levels of MMP-9 were detected as well. Results The scores of CNFDS and MBI improved after treatment in all the groups (P<0.001), especially in the combination group (P<0.01). The levels of MMP-9 decreased more in combination group than in the rehabilitation group and the control group (P<0.001). Conclusion Electromyographic biofeedback combined with earlier rehabilitation can facilitate the recovery neural function, which may associated with the decrease of MMP-9.

Objective To evaluate the efficacy of modified arytenoid adduction in the management of patients with unilateral vocal fold paralysis(UVFP).Methods A retrospective review was performed on 22 patients who underwent modified arytenoid adduction for UVFP between February 2001 and December 2007.Pre-,and 3 months postoperative aspiration,perceptual(GRBAS),acoustic data(fundamental frequency,F_0,fundamental frequency perturbation,jitter,amplitude perturbation,shimmer,normalized noise energy,NNE)and aerodynamic(maximal phonatory time,MPT,mean airflow rate,MFR)were analyzed statistically.Results The ratings of postoperative aspiration were significantly decreased than that of the preoperation(P<0.0001).There was a significant decrease in GRBAS scales postoperatively versus preoperatively(P<0.0001).The mean values of voice acoustics parameters (F_0,jitter,shimmer,NNE)were significantly decreased,the maximum phonation time were significantly longer,and the mean airflow rate were significantly decreased after operation than that of the preoperation(P<0.001).Conclusion Modified arytenoid adduction is an effective medialization technique that can restore satisfactory speech and prevent aspiration in patients with UVFP.

Objective To summarize the clinical experience of surgical treatment for complete atrioventricular septal defect in infants.Methods From December 2013 to June 2004,56 patients aged from 53 days to 12 months with complete atrioventricular septal defect were undergone operations.All patients were diagnosed by 2D-echocardiography,and 18 patients underwent cardiovascular computed angiography (CTA).Rastelli type A had 44 cases,type B 3 cases,and type C 9 cases.The single pericardium patch repair was used for 37 cases,the two-patch repair for 3 cases,and the modified single-patch repair for 16 cases.The time of mechanical ventilation was 26 to 172 hours,and the time of staying at Intensive Care Unit (ICU) was 3 to 19 days.Results There were 5 early deaths caused by severe low cardiac output in 2 cases,renal failure in 2 cases,and severe pulmonary inflammation in 1 case.One late death was due to severe mitral regurgitation with pneumonia and heart failure.The operative mortality was 10.7％.A total of 47 patients was followed-up for 3 months to 5 years after surgery and their heart function was satisfactory.Conclusions The operation should be done between 6 months and 1 year when the diagnosis of complete atrioventricular septal defect (CAVSD) is clear.Its early surgical intervention is satisfactory.The result of surgical treatment for CAVSD depends on both probing intracardiac anatomy carefully and complete correction of associated cardiac abnormalities.

Objective To evaluate diagnostic method and treatment strategy for free floating thrombus in carotid artery.Methods From Ju12016 to Oct 2017,7 patients with free floating thrombus in carotid artery was diagnosed at our department.The medical history,symptoms,diagnosis,treatment strategy and prognosis of those patients were analyzed retrospectively.Results Among 7 patients,4 were symptomatic;4 patients were concomitant with severe carotid artery stenosis and 3 with mild to moderate stenosis.3 received carotid endarterectomy and patch angioplasty.4 received carotid artery stenting with distal cerebral protection divice.There was no perioperative and 30-day stroke,myocardial infarction,death or hyperperfusion syndrome occurred.The 12-month follow up showed no restenosis,no free floating thrombus recurrence and no ischemic cerebrovascular event.Conclusion Free floating filling defect in carotid artery is a typical sign for unstable plaque.Both carotid endarterectomy and carotid artery stenting can be used for the treatment of free floating thrombus.

Objective To explore the effects and possible mechanism of Mongolian medicine Eridun ·Wurile(EW)on neuronal apoptosis in rats with acute spinal cord injury(SCI).Methods The male SD rats were randomly divided into sham-operated group(sham group),SCI group,EW low-dose group,EW medium-dose group,EW high-dose group and EW high dose+AG490 group,with 15 rats in each group,and the SCI model of rats was established by Allen's method.EW low-dose group,EW medium-dose group and EW high-dose group were given EW suspension at a dosage of 0.32,0.63 and 1.26 g/kg for gavage after surgery,respectively;the EW high-dose+AG490 group was given Janus kinase 2(JAK2)inhibitor AG490(5 mg/kg)by gavage before surgery and EW(1.26 g/kg)by ga-vage after surgery;and the sham and SCI groups were given equal volume of distilled water,twice a day for 2 weeks.The hind limb motor function of each group was assessed by BBB grading score at 1 day,3,7 and 14 days postoperatively;the rats were executed 12 h after the last administration and the spinal cord water content was examined;the histopathological changes were observed by Hematoxy-lin-Eosin(HE)staining in the spinal cord of each group;the apoptosis of spinal neurons was detec-ted by in situ notch end labeling(TUNEL).The expression of Cleaved caspase-3,B-lymphoblas-toma-2(Bcl-2),Bcl-2 associated X protein(Bax),phosphorylated(p)-JAK2,and p-signal transduction and transcriptional activator 3(STAT3)proteins in spinal cord were detected by West-ern blot.Results Compared with the sham group,the BBB scores of rats in the SCI group were significantly lower,spinal cord edema and pathological structural damage were severe,the number of apoptotic cells and the expression of Cleaved caspase-3,Bax,p-JAK2 and p-STAT3 proteins in the spinal cord were significantly increased,while the expression of Bcl-2 was decreased(P＜0.05 or P＜0.01);compared with the SCI group,the BBB scores of EW low-dose group,EW medium-dose group and EW high-dose group gradually increased,the pathological injury degree of spinal cord tissue was relieved,and the number of apoptotic cells in spinal cord tissue was reduced,Cleaved caspase-3,Bax,p-JAK2,and p-STAT3 protein expressions were gradually down-regulated,while Bcl-2 protein expression was gradually up-regulated(P＜0.05 or P＜0.01);compared with EW high-dose group,the expression of P-JAK2,p-STAT3,Bax,Cleaved caspase-3 proteins down-regulated in the spinal cord tissue of EW high dose+AG490 group,and Bcl-2 protein were up-regu-lated,and the differences were statistically significant(P＜0.01).Conclusion EW plays a neu-roprotective role via inhibiting JAK2/STAT3 signaling pathway and reducing apoptosis in acute spi-nal cord injury rats.

Purpose: 5-Fluorouracil (5-Fu) is used as a conventional chemotherapy drug in chemotherapy forpatients with advanced colorectal cancer, but many patients still suffer from treatment failuredue to 5-Fu resistance. Emerging observations revealed the important role of chemokine(C-X-C motif) ligand 13 (CXCL-13) in tumor microenvironment and its relationship with prognosisin patients with colorectal cancer. This study is designed to reveal the important roleof CXCL-13 in causing colorectal cancer resistance to 5-Fu. Materials and Methods: CXCL-13 levels of patient's serum or cell culture supernatants were measured separatelyby enzyme-linked immunosorbent assay. In cell assays, cell viability is detected by Cell CountingKit-8. Therefore, the recombinant human CXCL-13 was used to simulate its high expressionin cells while its antibody and siRNA were used to reduce CXCL-13 expression in cells. Results: In this study, we demonstrated that CXCL-13 is associated with 5-Fu resistance by culturemedium exchange experiments and cytokine arrays of colorectal cancer resistant and nonresistantcells. Clinical studies showed that CXCL-13 is highly expressed in the serum of5-Fu–resistant patients. High levels of serum CXCL-13 also predict a worse clinical outcome.The addition of recombinant CXCL-13 cytokine resulted in 5-Fu resistance, while its antibodyovercame 5-Fu resistance, and knockdown of CXCL-13 expression by siRNA also reduced5-Fu resistance, which can be saved by added recombination CXCL-13. Conclusion These results not only identify a CXCL-13 mediated 5-Fu resistance mechanism but alsoprovide a novel target for 5-Fu–resistant colorectal cancer in prevention and treatmentstrategies.

Objective To explore the effects and possible mechanism of Mongolian medicine Eridun ·Wurile(EW)on neuronal apoptosis in rats with acute spinal cord injury(SCI).Methods The male SD rats were randomly divided into sham-operated group(sham group),SCI group,EW low-dose group,EW medium-dose group,EW high-dose group and EW high dose+AG490 group,with 15 rats in each group,and the SCI model of rats was established by Allen's method.EW low-dose group,EW medium-dose group and EW high-dose group were given EW suspension at a dosage of 0.32,0.63 and 1.26 g/kg for gavage after surgery,respectively;the EW high-dose+AG490 group was given Janus kinase 2(JAK2)inhibitor AG490(5 mg/kg)by gavage before surgery and EW(1.26 g/kg)by ga-vage after surgery;and the sham and SCI groups were given equal volume of distilled water,twice a day for 2 weeks.The hind limb motor function of each group was assessed by BBB grading score at 1 day,3,7 and 14 days postoperatively;the rats were executed 12 h after the last administration and the spinal cord water content was examined;the histopathological changes were observed by Hematoxy-lin-Eosin(HE)staining in the spinal cord of each group;the apoptosis of spinal neurons was detec-ted by in situ notch end labeling(TUNEL).The expression of Cleaved caspase-3,B-lymphoblas-toma-2(Bcl-2),Bcl-2 associated X protein(Bax),phosphorylated(p)-JAK2,and p-signal transduction and transcriptional activator 3(STAT3)proteins in spinal cord were detected by West-ern blot.Results Compared with the sham group,the BBB scores of rats in the SCI group were significantly lower,spinal cord edema and pathological structural damage were severe,the number of apoptotic cells and the expression of Cleaved caspase-3,Bax,p-JAK2 and p-STAT3 proteins in the spinal cord were significantly increased,while the expression of Bcl-2 was decreased(P＜0.05 or P＜0.01);compared with the SCI group,the BBB scores of EW low-dose group,EW medium-dose group and EW high-dose group gradually increased,the pathological injury degree of spinal cord tissue was relieved,and the number of apoptotic cells in spinal cord tissue was reduced,Cleaved caspase-3,Bax,p-JAK2,and p-STAT3 protein expressions were gradually down-regulated,while Bcl-2 protein expression was gradually up-regulated(P＜0.05 or P＜0.01);compared with EW high-dose group,the expression of P-JAK2,p-STAT3,Bax,Cleaved caspase-3 proteins down-regulated in the spinal cord tissue of EW high dose+AG490 group,and Bcl-2 protein were up-regu-lated,and the differences were statistically significant(P＜0.01).Conclusion EW plays a neu-roprotective role via inhibiting JAK2/STAT3 signaling pathway and reducing apoptosis in acute spi-nal cord injury rats.

Objective To compare the outcome of combined and staged approach on concomitant carotid and coronary severe stenosis.Methods From March 2013 to May 2015,27 patients with concomitant carotid and coronary severe stenosis were treated by carotid endarterectomy and coronary artery bypass grafting,15 cases received one-stage operation and 12 staged.The basic characteristics,details during surgery,complications,quality of life score,hospital stay and cost were compared.Results 27 patients received carotid endarterectomy and off-pump coronary artery bypass grafting under general anesthesia.Revascularization were performed on 27 carotid and 82 coronary artery.The characteristics of patients were similar between two groups,reflected with WIC,combined approach subgroup was (5.27 ± 0.88) and staged subgroup was (4.92 ± 1.24).The operation time was significantly decreased in the synchronous group [(295.33 ± 49.73)min vs (390.83 ± 73.45) min,P ＜ 0.001].Hospital stay days was also reduced [(30.20 ± 12.91) days vs(44.67 ± 6.34) days,P =0.002],the medical cost was lower in combined approach group,but no significant statistical difference.The complications including 1 case TIA,1 recurrent nerve injury in one-stage group and 1 case myocardial infarction,1 mediastinal bleeding post-operation and 1 pulmonary infection in stage group.No cerebral infarction and death.Quality of life scores(SF-36) of the two groups was 5.53 ± 1.30 and 5.75 ± 1.36 respectively,no significant difference.Conclusion The efficacy and safety of treatment for concomitant carotid and coronary severe stenosis patients with combined or staged approach was similar.But the combined approach program can reduce the hospital stay time and cost in some degree.