Objective To study curative efficacy of tanreqing injection in treatment of severe craniocerebral injury in patients with pulmonary infection pathogen and its effects on Inflammatory factor.Methods80 patients of severe craniocerebral injury who received therapy from April 2012 to April 2015 in our hospital were selected as research objects.There were pulmonary wheezing, wheezing, shortness of breath, fever and other clinical symptoms.According to draw method,those patients were divided into the experimental group (n=40) and the control group (n=40).Two groups were given drug sensitivity test to give the corresponding antibacterial drugs, treatment for 2 weeks, The control group was treated with routine treatment, while the experimental group was on the basis of the control group, treated with tanreqing injection, every time 30ml, add 5% glucose Injection 250ml after mixing, intravenous infusion, 1 times a day.Then the curative effect, body temperature, pulmonary rales disappeared, cough disappeared time, the infection rate of pathogenic bacteria, neutrophils, white blood cell count, procalcitonin, high sensitivity C reactive protein recovery time, interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) level of two groups were compared.ResultsAfter treatment, the total effective rate of the experimental group was significantly higher than the control group[95.00%(38/40) vs 70.00%(28/40)] (P<0.05);Body temperature, pulmonary rales disappeared, cough and expectoration disappeared time was significantly shorter than the control group[(4.90±1.02)d vs (9.06±2.16)d,(6.02±1.21)d vs (10.85±2.37)d,(5.79±1.03)d vs (9.65±1.68)d](P<0.05);The positive rate of pathogenic bacteria was significantly lower than the control group[5.00%(2/40)vs 47.50%(19/40)](P<0.05);The recovery time of neutrophil, white blood cell count, procalcitonin and high sensitive C reactive protein was significantly shorter than the control group[(6.10±1.20)d vs (9.06±1.68)d,(4.72±0.97)d vs (7.34±1.23)d,(7.67±1.26)d vs (11.93±1.57)d,(7.21±1.02)d vs (11.29±1.73)d](P<0.05);IL-6、TNF-α level was significantly lower than the control group[(85.91±9.03)ng/L vs (102.08±10.42)ng/L,(17.38±1.01)ng/L vs (24.05±1.37)ng/L] (P<0.05).ConclusionTanreqing injection is well for severe craniocerebral injury,which can improve the clinical symptoms, protect the brain tissue, significantly reduce the pathogenic bacteria of pulmonary infection, and regulate the expression of inflammatory factors.

With the understanding of tumor metabolism, the process and mechanism of tumor metabolic reprogramming gradually attracted much attention in recent years.Oncogenes and tumor suppressor genes are constantly changing the pathway and flux of tumor metabolism in tumorigenesis to meet the needs of tumor growth and proliferation.The role of c-MYC, TP53, HIF-1αas well as the related signal pathways in tumor metabolic reprogramming would be discussed.

Objective To inquire into the changes of learning and memory ability and the level of SP, VIP in the brain of the model of Spleen insufficiency. To observe the influence invigorating spleen and restoring virility on above changes. Methods Establishing the spleen insufficiency model of rat by adopting bitter decline diarrhea, wild eating and overworking, to examine influence of invigorating spleen and restoring virility on the ability of learning and memory with the change of SP and VIP in the brain. Results In the period of study and remember of the water maze experiment, the swim whole distance time was long and mistake number was many in the model group; the swim whole distance time was short and the mistake number was little in the group of invigorating the Spleen and restoring virility. In the period of study and remember of the diving platform experiment, the mistake number of times is more and the incubation period was short in the model group; the mistake number was less and the incubation period was long in Spleen invigrating group. At the period of remember mistake number was more. In the model group, the immunoreaction masculine substance of SP level decrease obviously in the hypothalamus ventral kernel, the hippocampi CA1 area and forehand cortex; on above mentioned parts, the group of invigorating spleen and restoring virility increases distinctly, in the group of restoring virility increases distinctly in the hippocampi CA 1 area and forehead cortex, but decreased in hypothalamus ventral kernel. In the model group, the immunoreaction masculine substance of VIP level decreased obviously;in the hippocampi CA1 area and cortex;on above mentioned parts, the groups of invigorating spleen and restoring virility increases obviously. Conclusion In the model group, the ability of learing and memory with SP and VIP level in the brain changed. Invigorating spleen and restoring virility can improve above changes remarkably.

Objective To assess the classification and characteristics of headaches using the International Classification of Headache Disorders,3rd edition (beta version) criteria in a headache outpatient clinic.Methods In this prospective cross-sectional study,all consecutive patients presenting with headache to a headache outpatient clinic of Peking Union Medical College Hospital between April 1 st,2014 and February 28th,2015 were included.Results The average age of 593 patients was (42.I ± 15.6) years with female-male ratio 1.89∶ 1.Primary headaches were found in 483 (81.5％) patients,of which migraine and tension-type headache were found in 264 (44.5％) patients and 168 (28.3％) patients respectively.Chronic daily headache and new headache were found in 158 (26.6％) patients and 130 (21.9％) patients,while cough headache and thunderclap headache were found in 9 (1.5 ％) patients and 5 (0.8％) patients respectively.Patients with migraine were more likely complicated with medicationoveruse headache than patients with tension-type headache (x2 =4.21,P =0.032).Patients with tensiontype headache were more likely complicated with chronic daily headache than patients with migraine (x2 =18.92,P =0.000).Conclusions In this headache outpatient clinic,most patients were primary headaches.Chronic daily headache and new headache were common,while cough headache and thunderclap headache were uncommon.These headache syndromes should be paid attention to identify the possible underlying malignant etiologies.

Objective To investigate the clinical and molecular epidemiologic features of human rhinovirus (HRV) in children with acute lower respiratory tract infection (ALRTI) in Shanghai by detecting HRV from bronchoalveolar lavage fluid (BALF) .Methods One hundred and thirty-five BALF samples were collected from children with ALRTI at Children′s Hospital of Fudan University from January to June in 2014 . The specimens were tested by one-step real-time reversible transcription (RT )-polymerase chain reaction (PCR) for HRV .Gene fragments of VP4/VP2 capsid protein of the HRV genome were amplified and sequenced .The phylogenetic trees of HRV strains were drawn .Chi-square test was used for statistical analysis .Result Among these 135 samples ,6(4 .4% ) were HRV positive , including 4 positive for HRV-A and 2 positive for unknown genotype .The age of children with HRV positive was 8 months to 8 years ,including 5 cases ≤ 3 years old .The nucleotide homology within 4 HRV-A samples varied 76 .5% -100 .0% .These 4 HRV-A sequences were respectively compared with reference strains of HRV-A ,HRV-B and HRV-C in GenBank .The nucleotide homology varied 73 .1% -91 .7% ,57 .8% -66 .0% and 59 .0% -65 .0% ,respectively .Among 135 children with ALRTI ,124 were diagnosed with ordinary pneumonia including 4 (3 .2% ,4/124) HRV positive and 11 were diagnosed with severe pneumonia (with respiratory failure and/or heart failure) including 2 HRV positive .All children with HRV presented with fever and cough .Most of them (5/6) were co-infected with other pathogens .In 5 children with HRV positive ,the peripheral blood leukocyte counts were less than 10 × 109/L , neutrophil percentages were less than 0 .50 ,C-reactive protein was less than 8 mg/L and procalcitonin was less than 0 .05 μg/L .All the children were clinically cured .Conclusions The detection of HRV in BALF samples indicates that HRV is one of the pathogens in children with ALRTI in Shanghai and HRV-A is more common .Gene fragments of VP4/VP2 capsid protein of HRV pathogenic strains display a high degree of genetic variability .

Objective To explore the ways to decrease the postoperative complications of pancreaticoduodenectomy. Methods Thirty-four patients who underwent pancreaticoduodenectomy between January 1998 and December 2004 were reviewed retrospectively. A duct-to-mucosa pancreaticojejunostomy was performed mostly for patients, and an end-to-end pancreaticojejunal invagination for 5-patients with a soft pancreas and a small pancreatic duct. The end-to-side hepaticojejunostomy and the Roux-en-Y reconstruction of gastrointestinal continuity were performed for all patients. Results The hospital mortality was zero. The postoperative complications occurred in the form of wound infection was 4(12%), delayed gastric emptying was 1(3%), pneumonia was 1(3%), intra-abdominal collections was 1(3%) and pancreaticojejunostomy leak was 1(3%). In 1 patient with pancreaticojejunostomy leak, the closure was achieved with the conservative treatment. Intra-abdominal bleeding, intra-abdominal abscess and other anastomotic leakage were not seen in any of patients. The median follow-up was 21 months (ranging from 6 months to 5 years), none of patients had clinical evidence of steatorrhea, bile reflux gastric disease, anastomotic ulcer, retrograde cholangitis and dumping syndrome, there was no new case of diabetes. Conclusions Proper method of reconstruction produces encouraging results in decreasing the complications after pancreaticoduodenectomy.

AIM: To study the effect of vascular endothelial growth factor(VEGF) on hematopoietic differentiation from mouse embryonic stem cells(ESC) in vitro.METHODS: ES-D3 was allowed to grow on mouse fetal fibroblast feeder layer,and then was developed into embryoid bodies(EB).EB cells were transferred into medium supplemented with different concentration of VEGF and VEGF+SCF for 1 week.Six groups,including.VEGF 5 ?g/L,VEGF 10 ?g/L,VEGF 20 ?g/L, VEGF 5 ?g/L+SCF,VEGF 10 ?g/L+SCF and VEGF 20 ?g/L+SCF,were designed.The group of spontaneous differentiation without cytokine(s) was used as control.Hematopoietic transcription factor GATA-2 and early hematopoietic differentiation genes(c-kit and ?-H1) were detected by RT-PCR.The content of CD34~+ cells in each group were measured by flow cytometry.The cells derived from ESC were incubated in semisolid methycellulose cultures.The numbers of total colony-forming units in culture(CFU-C) were counted by reverse microscope.RESULTS: ES-D3 grew and formed EB at day 4.VEGF had a stimulatory effect as a single factor on the expression of genes associated with early hematopoietic differentiation(GATA-2,c-kit and ?-H1),the generation of CD34~+ cells and CFU-C in EB.The effects of VEGF+SCF were the most potent in the experimental groups according to the percent of CD34~+ cells and the numbers of hematopoietic colonies.The most highest inducing efficacy was achieved in VEGF 20 ?g/L or VEGF 10 ?g/L combined with SCF.CONCLUSION: VEGF promotes the differentiation of ESC into hematopoietic cells in vitro.The strongest effect was achieved when VEGF was combined with SCF.

OBJECTIVE To investigate the in vitro effect of 4 kinds of implant materials on the biofilm formation of Staphylococcus epidermidis.METHODS S.epidermidis was cultured,purified and identified.Susceptibility test was done for S.epidermidis and the ability to produce biofilm was proven.The test samples were made into wafer shape for titanium alloy,Co-Cr-Mo alloy,ultrahigh molecular weight polyethylene(UHMWPE)and home-made polymethyl methacrylate(PMMA).S.epidermidis was cultured with 4 kinds of test samples for 5 days respectively.Bacteria adhering on surfaces of 4 kinds of test samples were dissolved with trypsin,and then diluted into bacterial suspensions.Each bacterial suspension was inoculated quantitatively and CFU were counted.Biofilm on surfaces of 4 kinds of test samples prepared by vacuum drying method was observed with SEM.RESULTS The strain proven to be S.epidermidis,was resistant to semisynthetic penicillins,and could produce biofilm.CFU count showed that CFU were the most on the UHMWPE surface and the number of CFU were(24.96?1.459)?105.CFU were(17.44?1.883)?105 on the PMMP surface.(0.424?0.065)?105 CFU were discovered on the surfaces of titanium alloy and(0.382?0.075)?105 CFU on Co-Cr-Mo alloy.When each group compared with UHMWPE and domestic PMMA respectively,all P value was

Objective To present our experience of dealing with complete penile amputation.Methods Two cases of penile complete amputation were reported.The first case was a 34-year-old man,suffered amputation of the penis approximately 2.5 cm distal from the pubic area with a sharp knife.3.5hours later,the patient was transferred to our hospital.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavernosum to the corresponding proximal segment.One dorssl artery,two dorsal veins,and dorsal nerve were anastomosed under a 10 × microscope with interrupted 9-0 nylon nonabsorbable sutures.The second case was a 25-year-old man,presented to the emergency room 15 hours after distal penile amputation,which had 2 wounds as a result of self-mutilation caused by psychiatric problems.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavemosum to the corresponding proximal segment using 4-0 polyglactic acid sutures.Results In the first case,the tourniquet was released after replantation,and the distal penis appeared to revascularize,as noted by the gradual increase in redness and size.An arterial pulse was detected,and the superficial penile veins displayed normal turgor,and no bleeding was found.On postoperative day 3,the penile skin started to necrotize.On day 12,the necrotic skin was superficially debrided,and a fistula was observed in the corresponding urethral segment.Two weeks later,the fistula was sutured with 4-0 interrupted synthetic absorbable suture,and a transposition flap to embed the whole injured penis shaft was created from the proximal scrotal skin.The glans was exposed.Two months after the second operation,the embedded penis was released from the scrotum.After follow-up of two years,the patient had glans re-epithelialization with normal voiding,sensation,and erections.In the second case,the glans was still pink,but the penile skin started to necrotize on postoperative day 3.On day 14,serious infections were noted,the necrotic skin was superficially debrided,and the amputated penis was relieved.Conclusions Prompt diagnosis and early treatment are essential to avoid the potential complications of ischemic necrosis and autoamputation.Venous outflow is a critical factor for success of replantation.Microsurgical reanastomosing of the dorsal penile vein,penile arteries,and dorsal nerves can be identified as the standard method for penile replantation.The bipedicled scrotal flap can provide adequate skin cover for penis defects.

Objective:To investigate the therapeutic effect of modified Zhuyujingkang decoction combined with glucosamine sulfate on cervical spondylosis and its influence on the serum level of thromboxane B2(TBX 2). Methods:From June 2017 to June 2019, 82 patients with cervical spondylosis in the Maternal and Child Health Hospital of Zhoushan were selected, and they were divided into control group and observation group according to the random digital table method, with 41 cases in each group.The control group was treated with glucosamine sulfate, and the observation group was treated with modified Zhuyujingkang decoction on the basis of the control group.The course of treatment in both two groups was 4 weeks.The therapeutic effects of the two groups were compared.The changes of VAS, NDI and TBX 2 before and after treatment were compared. Results:The total effective rate of the observation group was 92.68%, which was higher than 70.73% of the control group(χ 2=6.609, P<0.05). After treatment, the VAS score of the observation group was (3.82±0.42)points, which was lower than (4.52±0.38)points of the control group( t=8.479, P<0.05). The NDI score of the observation group was (22.31±2.68)points, which was lower than (27.39±1.89)points of the control group( t=9.919, P<0.05). The serum level of TBX 2 in the observation group was (57.84±3.19)ng/L, which was lower than (65.74±2.48)ng/L in the control group( t=12.519, P<0.05). Conclusion:The therapeutic effect of modified Zhuyujingkang decoction combined with glucosamine sulfate on cervical spondylosis is good.It can reduce the pain, improve the related function of neck and shoulder, and reduce the level of TBX 2, which is worthy of clinical reference.