OBJECTIVE To evaluate the prevention of antibiotic-associated diarrhea(AAD) in surgical critical illness patients and strengthen the usage of antibacterials to AAD in hospital.METHODS Using prediction and retrospection to analyze the factors of AAD.RESULTS The main factors for AAD are changing antibiotics frequently,the age of patient,complicated disease of patient.CONCLUSIONS Rational use and rigorous control of antibiotics are the keys to prevent AAD in hospital.

Objective To observe the effects of insulin-like growth factor-Ⅰ (IGF-Ⅰ) and transforming growth factor-β1 (TGF-β1) on the expressions of sodium iodide symporter(NIS) and pendrin mRNA in a placental villous trophoblast cell line(HPT-8) exposed to different levels of iodine.Methods HPT-8 cells were cultured in vitro in the culture flask and divided into low iodine group-Ⅰ (LI-Ⅰ),low iodine group-Ⅱ (LI-Ⅱ),control group,high iodine group-Ⅰ (HI-Ⅰ) and high iodine group-Ⅱ (HI-Ⅱ) that exposed to different concentrations of iodine (0,5,50,500,5000 μg/L).After cell cultured for 24 h,the followings were added to the culture medium:iodine plus IGF-Ⅰ(0.050 mg/L),iodine plus TGF-β1 (0.001 mg/L).After cultured for another 24 h,total RNA was extracted,the expressions of NIS and pendrin mRNA of HPT-8 cells were determined by real-time quantitative PCR.Results The expression of NIS mRNA in HPT-8 cells:at different levels of iodine,the differences of NIS mRNA expression between groups were statistically significant in group with iodine alone(F =3.612,P ＜ 0.01).The expression of NIS mRNA in LI-Ⅰ group(0.44 ± 0.21) was significantly lower than that of control group(1.25 ± 0.77,P＜ 0.01).At the same level of iodine,in LI-Ⅰ group and HI-Ⅰ group,the differences of NIS mRNA expression within groups were statistically significant (F =13.632,6.900,all P ＜ 0.01).In LI-Ⅰ group,the expressions of NIS mRNA were higher in iodine plus IGF-Ⅰ(1.13 ± 0.38) and iodine plus TGF-β1 (0.81 ± 0.34) than that of pure iodine(0.44 ± 0.21,P ＜ 0.01 or ＜ 0.05);in HI-Ⅰ group,the expression of NIS mRNA was lower in iodine plus TGF-β1 (0.62 ± 0.30) than that of pure iodine(1.23 ± 0.91,P ＜ 0.01).The expression of pendrin mRNA in HPT-8 cells:at different levels of iodine,the differences of pendrin mRNA expression between groups were statistically significant in group with iodine alone(F =12.717,P ＜ 0.01).The expression of pendrin mRNA in LI-Ⅰ group(0.59 ± 0.15) was significantly lower than that of control group(1.03 ± 0.14,P ＜ 0.01) ; HI-Ⅰ group(1.29 ± 0.31) was higher than control group(P ＜ 0.05).At the same level of iodine,the differences of pendrin mRNA expression within groups were statistically significant in LI-Ⅰ,LI-Ⅱ,control and HI-Ⅰ groups (F=12.588,4.588,8.679,8.445,all P ＜ 0.01).In LI-Ⅰ,LI-Ⅱ and control groups,the expressions of pendrin mRNA were significantly higher in iodine plus IGF-Ⅰ(1.68 ± 0.82,1.51 ± 0.79,1.50 ± 0.51) than that of pure iodine(0.59 ± 0.15,0.89 ± 0.22,1.03 ± 0.14,all P ＜ 0.01); in HI-Ⅰ group,the expression of pendrin mRNA was significantly lower in iodine plus TGF-β1 (0.78 ± 0.20) than that of pure iodine(1.29 ± 0.31,P ＜ 0.01).Conclusions In the case of iodine deficiency,the mRNA expressions of NIS and pendrin in HPT-8 cells are decreased and the iodine uptake ability is decreased; the expression of pendrin mRNA in HPT-8 cells is increased and placental iodine uptake is increased under the conditions of mild iodine excessive.IGF-Ⅰ and TGF-β1 play a role in the placental iodine uptake through increasing iodine uptake under the conditions of iodine deficiency and decreasing iodine uptake under the conditions of iodine excessive.

BACKGROUND:Exercise can elicit generation of coronary col ateral circulation through numerous pro-angiogenic growth factors. It is not enough via a single factor to clearly definite signaling pathways for the generation of col ateral circulation. Many pro-angiogenic growth factors are involved in kal ikrein-kinin system, and there is no report about exercise effects on this system.
OBJECTIVE:To study effects of exercise training on bradykinin expression in rats with myocardial infarction.
METHODS:Thirty Wistar rats were randomly assigned to control group, myocardial infarction group and exercises training group. Rats in the control group were subjected to thoracotomy with no coronary artery ligation. Rats in the other two groups were modeled. In the exercise training group, 3 days after myocardial infarction, rats were subjected to 30-minute exercise training on treadmil , once a day for 4 weeks. At the terminal of the experiment, blood samples were obtained to analyze bradykinin expression by enzyme linked immunosorbent assay, and the myocardium was sampled to analyze relative blood flow by microsphere method.
RESULTS AND CONCLUSION:After exercise training, bradykinin level in the exercise training group was significantly higher than that in the myocardial infarction group (P<0.001). At the end of experiment, the relative blood flows of the exercise training and myocardial infarction groups were both increased compared with before experiment (P<0.05, P<0.001). At the end of experiment, the relative blood flow of the exercise training group was significantly higher than that of the myocardial infarction group (P<0.01). In al the three groups, bradykinin level was significantly correlated with the relative blood flow in the myocardium. These findings indicate exercises training can improve bradykinin expression apparently and increase blood flow in the myocardium, which il ustrates that the kal ikrein-kinin system plays an important role in exercise induced angiogenesis.

Objective:To assess the changing trends in Gleason score (GS)of Chinese prostate carci-noma (PCa)from January 1995 to December 2014.Methods:In the study,875 patients admitted to hospital from January 1995 to December 2004 (1995 -2004)and from January 2005 to December 2014 (2005 -2014)were divided into two groups.The mean levels and proportions of GS,primary and se-condary grades were studied.The patients were divided into four groups according to age: <60,60 -69,70 -79 and ≥80 years.Types of specimen included needle biopsy (NB),transurethral resection of the prostate (TURP)and radical prostatectomy (RP).Histological types were made up by acinar carci-noma and other types (including atrophic,pseudohyperplastic,foam,signet ring cell and ductal carcino-ma,and so on).The total prostate-specific antigen (tPSA)involved groups of <20.0 μg/L and ≥20.0 μg/L.We observed the mean levels and proportions of GS in age,types of specimen,histological types and total prostate-specific antigen in different periods,and used SPSS 17.0 software for statistical analysis.Results:Compared with 1995 -2004,the mean levels of GS,primary and secondary grades decreased 0.32 (P =0.003),0.19 (P =0.001)and 0.12 (P =0.016)in 2005 -2014,respectively. The proportions of ≤6 in GS increased 10.9% (P =0.003),and ≥8 decreased 14.0% (P <0.001). The difference of GS 7 was not statistically significant.In the primary grade,the ratio of grades≤3 in-creased 12.8% (P =0.001 ),and grade 4 decreased 7.4% (P =0.037),grade 5 decreased 5.5%(P =0.007).The ratio of secondary grades≤3 increased 7.6% (P =0.037).The difference of grades 4 and 5 was not statistically significant.Conclusion:GS in Chinese patients with PCa showed a down-ward trend,which is one of the notable features in the past 20 years in China.The types of specimen and age are important factors in GS,while the histological types and tPSA have less impact on the GS.

Objective To explore the application value of vacuum sealing drainage (VSD) in wound repair after resection of pilonidal sinus.Methods The retrospective cross-sectional study were conducted.The clinical data of 11 patients with pilonidal sinus who were admitted to the China-Japan Union Hospital of Jilin University from April 2015 to June 2016 were collected.All the patients received resection of pilonidal sinus after preoperative antibiotic therapy,and then received postoperative VSD and regular treatments of anti-infection and dressing changes.Observation indicators:(1) treatment situations:surgical procedures,operation time,volume of intraoperative blood loss,gross specimens,results of postoperative pathological examination,postoperative treatment (VSD),growth condition of granulation tissue,duration of hospital stay and treatment expenses;(2) follow-up situations:cases with follow-up,follow-up time,wound healing,postoperative complications and disease recurrence.Follow-up using outpatient examination and telephone interview was performed to detect the wound healing,postoperative complications and disease recurrence up to July 2017.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M(range).Results (1) Treatment situations:all the 11 patients underwent successful surgery for pilonidal sinus.The operation time and volume of intraoperative blood loss were respectively (79 ± 19) minutes and (10 ± 4) mL.Observation of gross specimens of 11 patients:hairs were scattered within the resected lesions in 7 patients,and hairs didn't found in 4 patients.Results of postoperative pathological examination of 11 patients:there were acute and chronic inflammation accompanied with granulation tissues in the subepithelial fibrous tissues,and discrete multinucleated giant cell reaction.Of 11 patients undergoing VSD,9 received VSD material changes for 3 times,2 received VSD material changes for once,and wounds were not sutured after VSD removal.The new granulation tissues of 11 patients were found at (5.9±1.3) days postoperatively.The duration of hospital stay and treatment expenses were respectively (33.3±8.3) days and (37 790± 8 811) yuan.(2) Follow-up situations:11 patients were followed up for 12-18 months,with a median time of 14 months.The wound healing time was (41.0±9.0)days.Of 11 patients with follow-up,10 were in the primary healing,1 who was complicated with wound infection and abscess of wound deep surface underwent sacral wound incision and drainage,gauze packing and routine dressing change,and then wound healed completely.There was no recurrence in 11 patients during the follow-up.Conclusions The VSD has great application value in managing wounds after resection of pilonidal sinus,with a lower incidence of wound infection and smaller scar,and it is worth recommending to patients with wide wounds,high tension and serious infection.

Most foreign bodies are often discharged without obvious symptoms after swallowing, but some may be misdiagnosed and stay in the body, resulting in serious complications. Different diagnostic methods should be integrated to diagnose such patients. Once diagnosed, they should be treated as soon as possible if necessary. The authors reported a case of retention in the body for 6 years after swallowing a wooden chopstick, resulting in the insertion into the psoas muscle after duodenal perforation, complicated by abdominal abscess. During the operation, endoscopic assisted laparoscopic foreign body removal was performed, and the patient showed good prognsis, which provided references for the diagnosis and treatment of the disease.

Objective:To explore the repair strategy of chest radiation ulcer after radical mastectomy for breast cancer and its clinical effect.Methods:The study was a retrospective observational study. From September 2020 to September 2023, 27 female patients (aged 37-83 years) with chest radiation ulcers after radical mastectomy for breast cancer who met the inclusion criteria were admitted to Beijing Jishuitan Hospital Affiliated to Capital Medical University, of which 7 patients developed significant pain in the chest region. Various examinations were completed to accurately assess the presence of tumors and depth of radiation ulcers. After tumor recurrence was ruled out, the ulcer wounds were thoroughly debrided (the wound size after debridement was 8 cm×7 cm to 18 cm×18 cm). At the same time, pathological examination of the wound tissue and bacterial culture of the wound tissue/exudate samples were performed. The wound repair surgery was performed at the same time after debridement or one week after vacuum sealing drainage (VSD) treatment. Based on the location and size of the wound, the age and overall condition of the patient, as well as the principle of minimizing damage to the donor site, the most suitable tissue flap was selected to repair the wound. The donor site wound was transplanted with a split-thickness skin graft or sutured together. The level and tissue structure of radiation injury, and the type and size of transplanted tissue flap were recorded. The results of postoperative pathological examination of wound tissue and bacterial culture of wound tissue/exudate samples, pain relief, survival of tissue flap, and wound healing were recorded. During the follow-up, the shape of the tissue flap, whether the ulcer recurred, the wound healing of the donor site, and whether the abdominal wall hernia occurred in the donor site of the rectus abdominis myocutaneous flap were observed.Results:Radiation injury involved ribs and costal cartilage in 21 cases, ribs, sternum, and clavicle in 4 cases, and clavicle and subclavian artery in 2 cases. Twelve patients were transplanted with rectus abdominis myocutaneous flap, eight patients with latissimus dorsi myocutaneous flap, three patients with internal thoracic artery perforator flap, three patients with superior epigastric artery perforator flap, and one patient with free deep inferior epigastric perforator flap. The size of tissue flap was 14 cm×8 cm to 20 cm×20 cm. After surgery, no tumor component was found in the pathological examination of wound tissue; 25 patients were positive and 2 patients were negative in bacterial culture results of wound tissue/exudate samples; the pain of 7 patients was completely relieved. The tissue flaps of 25 patients survived completely after surgery, and the wounds healed. Two patients had partial necrosis at the tip of the rectus abdominis myocutaneous flap, which healed after debridement and tissue flap repair. The patients were followed up for 6 months to 2 years. The appearance of the tissue flaps was good, and no ulcer recurred. The linear scar was left on the donor site, and no abdominal wall hernia occurred in the donor site of the rectus abdominis myocutaneous flap.Conclusions:Thorough debridement and VSD treatment after accurate assessment of the extent of damage, and the selection of appropriate tissue flap to repair the wound based on the patient's general condition, the wound characteristics, and the principle of minimizing damage to the donor site are good repair strategies for the chest radiation ulcers after radical mastectomy for breast cancer. By using the strategies, the wounds could be closed as soon as possible, preventing ulcer recurrence and having a good prognosis.

Objective:To explore the clinical effects of chimeric perforator flaps in repairing wounds with bone or internal fixation exposure and wounds with osteomyelitis.Methods:This study was a retrospective observational study. From January 2018 to December 2022, 20 patients with wounds with bone or internal fixation exposure and wounds with osteomyelitis who met the inclusion criteria were admitted to Beijing Jishuitan Hospital Affiliated to Capital Medical University, including 19 males and 1 female, aged from 21 to 73 years. Among the 21 wounds, there were 5 wounds with bone exposure, 12 wounds with osteomyelitis, and 4 wounds with internal fixation exposure. After the debridement in the first stage, the wound area was 6 cm×3 cm to 22 cm×10 cm. Then vacuum sealing drainage was carried out for 5 to 7 days. In the second stage, the wounds were covered with pedicled chimeric medial sural artery perforator flap, pedicled chimeric posterior tibialis artery perforator flap, free chimeric perforator flap pedicled with descending branch of lateral circumflex femoral artery, free chimeric medial sural artery perforator flap or free chimeric deep circumflex iliac artery perforator flap with incision area of 7 cm×5 cm to 25 cm×12 cm. The chimeric muscle flap was used to fill and cover irregular deep cavities. The wounds in the flap donor sites were sutured directly or repaired with medium-thickness skin grafts from the thigh. The survival of flap and the healing of wound in flap donor site were observed after operation. The recurrence of infection was followed up.Results:Among the 18 free chimeric perforator flaps, 16 flaps survived successfully; one flap experienced a venous crisis on the day of surgery and survived completely after emergency exploration and re-anastomosis; another one flap had partial distal necrosis, which healed after dressing changes. All the wounds in the flap donor sites healed evenly. All 3 pedicled chimeric perforator flaps survived; one of them developed sub-flap infection but healed after debridement and bone cement placement. The wound in the donor site of 1 flap developed incision dehiscence, which healed successfully after redebridement and suturing. The donor site wounds of the rest 2 flaps healed well. During 3 to 12 months of follow-up, the patients with wounds with bone or internal fixation exposure showed no signs of abnormal exudation or infection, and no infection recurrence was observed in patients with wounds with osteomyelitis.Conclusions:The application of chimeric perforator flaps is effective in covering wounds, filling dead spaces, and controlling infection in wounds with bone or internal fixation exposure and wounds with osteomyelitis. Moreover, this method minimizes the damage to the donor site.

Objective:To evaluate the clinical feasibility, safety, and advantages of small lateral cervical incision for parathyroid exploration and resection.Methods:A total of 31 consecutive patients who underwent parathyroidectomy with a small lateral cervical incision, in the Department of Endocrinology and Breast Surgery of the First Affiliated Hospital of Chongqing Medical University from Apr. to Nov. 2021, including 11 males and 20 females, aged (49.32±13.79) years, ranging from 28 to 86 years, were selected to make retrospective statistical analysis of the surgical time, hospital stay, intraoperative blood loss, postoperative drainage and postoperative complications of the patients. All patients were injected with carbon nanoparticles suspension injection guided by color ultrasound to locate the enlarged parathyroid gland before surgery. EXCEL 2019 software was used for statistical analysis.Results:Thirty-one patients underwent parathyroidectomy through a small lateral cervical incision. Primary hyperparathyroidism was performed in 19 cases (including 2 cases with bilateral small lateral cervical incision, 2 cases with unilateral excision of thyroid mass combined with parathyroidectomy, 1 case with resection of huge parathyroid adenoma, and 1 case with local anesthesia) . Twelve patients with secondary hyperparathyroidism underwent total parathyroidectomy through bilateral small lateral cervical incision and forearm autogenous parathyroid transplantation (including bilateral thyroid mass resection combined with bilateral total parathyroidectomy and forearm autogenous parathyroid transplantation in 2 cases, local anesthesia and cervical plexus nerve block in 2 cases, and ectopic parathyroid gland in thyroid in 1 case) . Among them, the average operative time of patients with primary hyperparathyroidism was (54.74±27.71 & 74.14±31.73) min, the average intraoperative blood loss was (8.11±5.05 & 14.43±10.94) ml, the average postoperative drainage was (14.37±24.64 & 26.36±32.87) ml, the average postoperative parathyroid hormone was (11.59±16.46 & 26.65±56.38) pg/ml, the average hospital stay was (10.00±5.09 & 10.96±4.55) d, and the postoperative complication rate was (3.2% & 0%) .Conclusions:Parathyroid gland exploration and resection through small lateral cervical incision is a safe and effective surgical method and can also complete thyroid exploration and parathyroidectomy at the same time. Appropriate anesthesia should be selected after a full assessment of the patient’s basic condition.

OBJECTIVES: Frizzled 7 (FZD7) is abnormally expressed and activated in a variety of cancers. In ovarian cancer, overexpression of FZD7 reduces the sensitivity of platinum-resistant ovarian cancer cells to ferroptosis, thereby allowing cancer cells to survive. However, whether FZD7 inhibits ferroptosis in ovarian cancer cells and its mechanisms are remain unclear. This study aims to explore the effects of FZD7 and its upstream regulator miR-1-3p on ferroptosis in ovarian cancer cells are evaluated to clarify the molecular mechanism for miR-1-3p and FZD7's involvement in ferroptosis in ovarian cancer cells. METHODS: Human ovarian cancer cell lines HO8910 and SKOV3 were used as the research subjects. In the first part of the experiment, human ovarian cancer cells were transfected with blank plasmid and FZD7 overexpression plasmid, respectively; in the second and third parts, human ovarian cancer cells were transfected with miR-1-3p mimics negative control, miR-1-3p mimics, miR-1-3p inhibitors negative control, and miR-1-3p inhibitors, respectively; in the fourth part of the experiment, human ovarian cancer cells were transfected with miR-1-3p mimics and miR-1-3p mimics+FZD7 overexpression plasmid, respectively, and normal cultured cells were set as the control group. The human ovarian cancer cell ferroptosis model was established by incubating human ovarian cancer cells with different treatments with ferroptosis inducer Erastin or RSL3. Real-time RT-PCR was used to detect the mRNA expression levels of FZD7 and miR-1-3p; Western blotting was used to detect the protein expression levels of FZD7; CCK-8 assay was used to detect the cell viability; lipid peroxidation colorimetric assay kit was used to detect the level of intracellular MDA; and iron assay kit was used to detect the level of intracellular Fe2+. Dual-luciferase assay was used to detect the targeting relationship between miR-1-3p and FZD7. RESULTS: Overexpression of FZD7 increased the cell viability of human ovarian cancer cell lines HO8910 or SKOV3 (P<0.05, P<0.01, or P<0.001) and decreased the intracellular MDA levels (P<0.01) in Erastin-treated or RSL3-treated ovarian cancer cells. FZD7 was a direct target of miR-1-3p, which inhibited the expression of FZD7 (P<0.01) by binding to the 3'-untranslated region (3'UTR) site of FZD7. MiR-1-3p mimics decreased the cell viability of human ovarian cancer cell lines HO8910 or SKOV3 (P<0.05, P<0.01, or P<0.001) and increased the intracellular MDA levels (P<0.01) in Erastin-treated or RSL3-treated ovarian cancer cells; while miR-1-3p inhibitors significantly increased the cell viability of human ovarian cancer cell lines HO8910 or SKOV3 (P<0.05, P<0.01, or P<0.001) and decreased the intracellular MDA levels (P<0.01) in Erastin-treated or RSL3-treated ovarian cancer cells. The effect of miR-1-3p mimics on enhancing the sensitivity of human ovarian cancer cells to Erastin-induced or RSL3-induced ferroptosis was abrogated by overexpression of FZD7(P<0.05 or P<0.01). CONCLUSIONS MiR-1-3p enhances the sensitivity of ovarian cancer cells to ferroptosis by targeting FZD7.
Female ; Humans ; Frizzled Receptors/genetics* ; MicroRNAs/genetics* ; Ovarian Neoplasms/genetics* ; Ferroptosis