BACKGROUND: Knowing the pathological changes of the lungs after the wallop from the bullet wound helps to improve the method or mean of dealing with the wound or to reduce the damage to lung functions after the wound.OBJECTIVE: To probe into the functional and pathological changes of the lung tissues after bullet wound.DESIGN: Open experimental study of the animals.SETTING: Department of the Integrated Traditional Chinese and Western Medicine, General Hospital of the Chinese People's Armed Police Forces.MATERIALS: The experiment was completed from June 2003 to December 2003 at the General Hospital of the Armed Police Forces. Six healthy grown-up cross-bred dogs, half male and half female, weighing ( 16.3 ± 0.58 ) kg, aged (8 - 12) months old, were provided by the Experimental Animal Center of the Military Academy of Sciences of Chinese PLA. Animal Center's license No. Was SCXK(army)2002-001. The animals were fed with water and food with no restrictions in an environment in which the temperature was 22 to 23 ℃ and the humidity was 74% - 80%.METHODS: Grown-up healthy domestic dogs were shot at the thick muscular part of their left hind legs with a size 81 automatic rifles, 7.62 mm in caliber and bullet of type-560. Caution was taken to avoid damage to the major vessels and the bone tissues. The shooting distance was 5 meters. Immediate hemostasis and bandaging were performed after shooting. And 6 hours later, pathological examination of the lungs was carTied out.MAIN OUTCOME MEASURES: Pathological changes of the lungs.RESULTS: After the bullet wound, the main pathological manifestations of the lungs were detelectasis of the pulmonary alveoli and the decrease of air volume complicated with inflammatory alveoli infiltration, lung edema, obscure structure of pulmonary alveoli, passive congestion of the small blood vessels, etc.CONCLUSION: The lung wound was obvious after bullet wound and its mechanism was associated with stress, inflammatory reaction of the adjacent tissues and far domino effect. Blood rheological changes after the wound were one of the most important factors to affect the microcirculation of the cerebral and lung tissues. It was found that clear blood rheological changes occurred at the earlier stage after the wound, and the chief manifestations included the increase of the whole blood viscosity and the index of the erythrocyte aggregation at the time of low sheering rate. The changes reached their peaks 6hours after the wound. On the one hand, because of the increase of whole blood viscosity and the index of erythrocyte aggregation, stasis of red blood cells might happen. And embolism of micro blood vessels in the brain and lungs would change the microcirculation of the brain and lungs. On the other hand, when serious injury of local tissues happens, the body's stress reaction would be strong and secretion and the release of stress hormones and certain active biological small molecular substances would increase, such as nitrogen monoxide(NO), tumor necrosis factor(TNF), endothelin(ET), etc. Their increase would stimulate the micro blood vessels of the brain and lungs and disturb their diastole and constriction functions. After the wound by high-speed projectile, blood flow volume in the animal's cerebral and lung tissues reduced sharply. The micrangium of the brain and lung dilated, and its diameter increased, which resulted in ischemia and hypoxia of the brain and lung tissues, and therefore edema of the brain and lung tissues and hypofunction of the lungs. Therefore, for the bullet wound of the limbs, in addition to dealing with local damage, the brain, the lungs and other important organs should be protected. This provides a theoretical basis for improving the brain and lung function after the bullet wound.

Objective To investigate antibiotic resistance of Klebsiella pneumoniae and Escherichia coli in old patients with lower respiratory tract infections. Methods Kirby Bauer agar diffusion method was used to evaluate the drug sensitivity in 240 strains of Klebsiella pneumoniae and Escherichia coli isolated from patients with lower respiratory tract infection. Phenotypic confirmatory test recommended by NCCLS1999 was used to detect extended spectrum beta lactamases(ESBLs). Results The resistant rates of Klebsiella pneumoniae and Escherichia coli to 14 antibiotics in old patients and in non old patients with lower respiratory tract infections were amoxicillin 93 2% vs 87 3%, piperacillin 57 1% and 42 9%, cefuroxime 51 4% and 33 3%, cefotaxime 40 1% and 17 5%, ceftazidime 13 6% and 3 2%, ceftriaxone 39 0% and 17 5%, cefoperazone 37 3% and 15 9%, cefepime 10 2% and 3 2%, amikacin 47 5% and 34 9%, ciprofloxacin 54 2% and 38 1%, imipenem 0, cefoperazone/sulbactam 0, piperacillin/tazobactam 1 1% vs 0, and cefmetazole 9 6% and 4 8% respectively. Out of 240 clinical strains of Klebsiella pneumoniae and Escherichia coli, 78(32 5%) were considered ESBLs producers by phenotypic confirmatory test. The prevalence of ESBLs in old patients was 38 4%, which was much higher than that in non old patients(15 9%). The resistant rate of ESBLs producing strains to imipinem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole was the lowest, being 0, 0, 2 6% and 12 8%. Conclusions The resistant rates of Klebsiella pneumoniae and Escherichia coli to most antibiotics and the prevalence of ESBLs in old patients with lower respiratory tract infection were higher than that in non old patients. Imipinem, cefoperazone/sulbactam, piperacillin/tazobactam and cefmetazole were the effective antibiotics to infections caused by ESBLs producing strains.

Objective To determine the efficacy of coronary artery bypass grafting (CABG) in children with coronary obstructive disease subsequent to Kawasaki disease. Methods Between Feb 2005 and Sep 2009, 6 children with ischemic heart disease due to Kawasaki disease comprised the study group. The age of patients at operation was ranged from 6 to 12 years with a mean of ( 8.0 ± 2.3 ) years. The preoperative EF was ranged from 0.33 to 0.71 with a mean of 0.57 ± 0.15. There was one case with moderate mitral valve regurgitation. Results All patients survived the procedures. The mean number of bypass graft was 2.0 ±0.6,with 4 internal thoracic arteries and 7 radial arteries. Mitral valve repair was employed in 1 case. The cardisc function ( NYHA and EF) was significantly improved postoperatively. Postoperative CTA showed no graft disease in all cases. Conclusion CABG using the arterial grafts can provide attractive mid-term results in patients with obstructive coronary arteries associated with Kawasaki disease.

Objective To investigate the relationship of complements C3 and C4 with essential hypertension and its risk factors, homocysteine (HCY) and blood lipids.Methods We selected 20 healthy subjects for physical checkup as control group and 45 patients with hypertension as hypertension group.According to The Guidelines for Prevention and Treatment of Dyslipidemia in Chinese Adults, the hypertension group was divided into lipid regulating therapy group and non-lipid regulating therapy group.We determined the levels of complements C3 and C4, HCY, total cholesterol, low density lipoprotein and apolipoprotein.Pearson linear correlation regression analysis was used to analyze the correlation of the complements with HCY and blood lipid indexes.Results Complements C3 and C4 were significantly higher in the hypertension group than in the control group (P<0.05).HCY was also significantly higher than that in control group (P<0.05).The Pearson linear correlation analysis showed that in the hypertension group Complement C3 was positively correlated with cholesterol, low density lipoprotein and apolipoprotein B (P<0.05).Complements C3 and C4 were not related to HCY (P=0.073, P=0.699).Compared with the non-lipid regulating therapy group, C4, cholesterol, low density lipoprotein and apolipoprotein B were significantly decreased in the lipid regulating therapy group (P<0.05).The Pearson linear correlation analysis showed that in the lipid regulating therapy group complements C3 and C4 were not related to low density lipoprotein (P>0.05) or to homocysteine (P=0.074, P=0.894).Conclusion Complements C3 and C4 are closely related to essential hypertension.Activation of the complement system is one of the important risk factors for hypertension.The lipid regulating therapy can significantly alleviate immune damage in patients with essential hypertension.Hyperhomocysteinemia is an independent risk factor for essential hypertension.

Objective: To investigate the safety and effectiveness of three-dimensional (3-D) rotational angiography reconstruction of left atrial and pulmonary vein stereo image embedded with real-time X-ray fluoroscopy system for guiding radiofrequency catheter ablation (RFCA) in treating the patients with atrial ifbrillation (AF).
Methods: A total of 60 consecutive AF patients who received RFCA in our hospital from 2011-04 to 2013-04 were studied. The patients were randomly divided into 2 groups and 3-D Carto3 mapping system was applied for guiding RFCA in both groups. n=30 in each group. Treatment group, the patients received Siemens ARTIS Zeego digital subtraction system for left atrial and pulmonary vein rotational angiography, then, stereo images were reconstructed and embedded with real-time X-ray lfuoroscopy for RFCA guidance. Control group, conventional left and right pulmonary venography was conducted for RFCA guidance. The procedural and X-ray exposure times, rates of success and complications were recorded and compared between 2 groups.
Results: All 60 patients had successful RFCA, compared with Control group, the patients in Treatment group had obviously less procedural time and X-ray exposure time, while the success rate and complications were similar between 2 groups.
Conclusion: 3-D rotational angiography reconstruction of left atrial and pulmonary vein stereo image embedded with real-time X-ray lfuoroscopy system is safe and effective for guiding RFCA in treating the AF patients, which may reduce the procedural and X-ray exposure times.

Aminopeptidase H (APH) is an universally distributed aminoendopeptidase in the tissue of many organism. However, it is hard to investigate its mechanism underlying the catalysis and the function in cell. In this paper, the full DNA sequence of this enzyme was cloned from chicken liver, then subcloned to the vector pET22 b(+). The recombined vector was transformed into E. coli Rosetta(DE3), and the APH gene was expressed by the induction of IPTG. It was found the recombinant protein exhibited same mo lecular weight as authentic APH on SDS-PAGE analysis; the expression level increased with induction time and approached maximum of 94.7 mg/L till 6 hours, which contained 16.7% of the total protein. Moreover, this recombinant protein showed similar prop erties of subunit composition, thermal stability and optimum pH with native APH, based on the enzymatic assay, purification and analysis of enzymological properties. Therefore, it is confirmed that APH was expressed in this prokaryote system with a high-level of 1636 u/L aminopeptidase activity. These results would help to elucidate the catalysis mechanism and biological function of APH by providing enough material.
Aminopeptidases ; biosynthesis ; genetics ; Animals ; Chickens ; Endopeptidases ; biosynthesis ; genetics ; Enzyme Stability ; Escherichia coli ; genetics ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; isolation & purification

Objective: To explore the application of grid health education model in improving college students health literacy. Methods: The clustered stratified random sampling method was used among the pre-formative education freshmen in a Xi-an university, with 1 123 students randomly selected totally. The intervention group (578) received health literacy education based on grid health education model, while the control group (545) receuved the original health education model. The effect of gird model of health education on health literacy was compared between two groups of college students after one-semester intervention. Results: Insufficient health literacy was found among freshmen participants in Xi an(17.12%, 17.61%); health literacy on prevention and treatment of chronic diseases (15.92%, 16.70%) was significantly lower than the national average level of urban residents(22.73%). Health literacy of the two groups of college students was significantly improved(47.75%, 27.71%, χ 2=20.50, 5.47, P<0.05). The grid health education model had significant effects in improving health literacy among college students, except for health literacy on safety and emergency(P<0.05). Conclusion Health literacy of college students is insufficient compared to that of urban residents in China. Grid model of health education model is superior to conventional health education model, which is in line with the requirements of health education in colleges in the new era.

ObjectiveTo investigate the time characteristics of brain function induced by acupuncture at acupoint of LI4(Hegu).MethodsThe data of functional magnetic resonance imaging(fMRI) induced by acupuncture at acupoint LI4(Hegu) was processed with modified temporal cluster analysis(MTCA) to obtain the time and trend of brain function.ResultsThe stimulation of acupuncture at acupoint LI4 induced the change of brain function,and time curve of brain functional during the acupuncture experiment was obtained.ConclusionThe effect of acupuncture at acupoint LI4(Hegu) on brain function has time characteristics.

The stability of the occipitocervical region mainly depends on the integrity of the bony structure,surrounding ligaments and joint capsules.The instability of this region often leadsto the clinical symptoms of compression injury of nerve and vascular,which requires early surgical intervention to rebuild its stability.Posterior occipitocervical fixations are main surgical treatment for the occipitocervical diseases.However,the posterior fixations are not suitable for some patients with congenital or iatrogenic causes.Recently,the anterior occipitocervical fixation with the screws anchored at clivus or into the occipital condyles have been used for the following operations.1.Anterior bone graft fusion.One case which was performed by oral approach was reported well fusion,but the stability was poor and there was a possibility of displacement.2.Anterior shaped titanium cage and plate fixation.The literatures reported that this anterior operation was completed in 35 cases by oral,oral combined with mandibulotomy,and anterior retropharyngeal approaches.This fixation has a good biomechanical stability and is widely used in clinical applications,including occipitocervical tumors and deformities.And the complications including intraoperative vascular,spinal and dural injuries,postoperative drinking cough,non-fusion,deep infection,and death.3.Anterior occipital-atlantoaxial joint screw fixation.Seven cases were performed by anterior occipital-atlantoaxial joint screw fixation through anterior percutaneous approach.This fixation is less trauma,but required precise placement of screw and not conducive bone fusion,and it is suitable for traumatic instability of the upper cervical spine,atlantoaxial dislocation and basilar invagination.Each procedure of anterior occipitocervical fixation is not suitable for all patients,and it should be adopted according to the patient's condition,surgical hardware conditions and the surgeon's habits.

Objective:To evaluate the feasibility of the screw and plate for clival fixation using a transoral expanded approaches.Methods:The transoral expanded approaches were performed on craniocervical segment specimens obtained from 7 subjects, including transoral approach (TO), transoral with soft (TOP) or hard (TOHP) palate split, mandibulotomy (MO) and mandibuloglossotomy (MLO). The distribution and thickness of soft tissue, the configuration of the vertebral arteries, the distance between the midline and the vertebral arteries, the exposed area of the clivus and cervical spine, and the range of screw angle (the angle between the line from the lower incisor or the central base of the mandible to the exposed area of the clivus and the tangent line of the clivus) were evaluated.Results:The thickness of the soft tissue on the posterior pharyngeal wall above the clival pharyngeal nodules was 3.5±0.6 mm. That on the anterior C 1-C 5 vertebrae was 5.0±0.5 mm. The distances from the bilateral vertebral arteries to the midline was 19.5±1.2 mm at C 1, 2, 14.6±2.7 mm at C 2, 3, 14.0±2.7 mm at C 3, 4, and 13.9±2.7 mm at C 4, 5. For the TO approach, the longitudinal diameter of the exposed clivus was 8.3±3.0 mm. The distance from the lower incisor to the superior margin of the exposed clivus, the lower margin of the exposed clivus, the anterior arch of C 1, the vertebral body of C 2 and C 3 were 104.7±4.3 mm, 99.2±6.8 mm, 81.4±4.3 mm, 75.1±4.0 mm and 68.7±6.5 mm, respectively. Six specimens were exposed to the C 3, while one was exposed to the C 2. For the TOP approach, the longitudinal diameter of the exposed clivus was 18.5±4.8 mm. The distance from the lower incisor to the superior margin of the exposed clivus and the pharyngeal nodules were 107.9±6.7 mm and 104.8±6.7 mm, respectively. For the TOHP approach, the longitudinal diameter of the exposed clivus was 26.3±1.8 mm (the clival length) with distance from the lower incisor to the superior margin of the clivus 112.4±12.6 mm. For the MO/MLO approach, the entire clivus was exposed. The distance from the central base of the mandible to the superior and inferior margin of the exposed clivus and the pharyngeal nodules were 141.8±15.7 mm, 131.0±9.9 mm and 120.5±8.2 mm, respectively. The inferior margin of the exposed cervical vertebra was C 5, 6. The rate of the clival screw placement through anterior occipitocervical fixation using TO, TOP, TOHP, MO and MLO was 0%, 71% (5/7), 86% (6/7), and 100%, respectively. The screw angle was 99.0°±1.8°, 92.6°±7.7°, 92.6°±7.7°, 75.1°±7.7°, and 75.1°±7.7°, respectively. Conclusion:Occipitocervical fixation with clival screw and plate could be conducted in most cases via TOP and TOHP approaches. However, in some cases with small split-mouth or mouth opening limited, smaller clival screw angle caused by basilar impression or basilar invagination, requiring fixation and reconstruction of the lower cervical spine, and the MO/MLO approaches could be still required to achieve the fixation.