Objective To investigated the percutaneous transhepatic gallbladder drainage combined laparoscopic cholecystectomy in the treatment of purulent cholecystolithiasis for serious patients.Methods Our hospital in the past two years,76 underwent lap-aroscopic cholecystectomy in the acute calculous suppurative cholecystitis of elderly patients with clinical data were retrospectively analyzed.Patients could be divided into group A(surgery)within 72 hours after admission,group B(conservative treatment after percutaneous puncture drainage of the gallbladder,again)elective surgical procedures,A total of 2 groups.Comparative analysis of two groups of patients with complications of surgery,laparotomy rate and total effective rate.Results A,B two groups of postoper-ative complication rates were 36.11% and 15.00% respectively,each postoperative complication rates had significant difference(P<0.05);A,B two groups of transit open rate was 13.89% and 15.00%,A,B two groups of operation time,transit open rate had no significant difference(P>0.05),the total effective rate was lower than that in group B,group A statistically significant differ-ence(P<0.05).Conclusion PTGD combined LC is simple and effective treatment in high-risk acute purulent cholecystolithiasis.

Objective To evaluate the anesthetic efficacy of propofol used to supplement spinal anesthesia for sedation in the pediatric patients undergoing lower abdominal or lower extremity operations.Methods One hundred twenty pediatric patients of both sexes, aged 2-5 yr, weighing 11-21 kg, of ASA physical status Ⅰ or Ⅱ , scheduled for elective lower abdominal or lower extremity operations were randomly divided into 3 groups (n =40 each) using a random number table: general anesthesia group (group G), propofol used to supplement caudal block for sedation group (group PS+CB) , and propofol used to supplement spinal anesthesia for sedation group (group PS+SA).In group G, after induction of anesthesia, laryngeal mask airway was inserted, the patients were then mechanically ventilated, and anesthesia was maintained with iv infusion of propofol (5-7 mg· kg-1 · h-1), remifentanil (20-25 μg· kg-1 · h 1) and cisatracurium besylate (0.1 mg· kg-1 · h 1).In group PS+CB, caudal block was performed with the mixture 0.8 ml/kg of 1％ lidocaine and 0.25％ bupivacaine.In group PS+SA, spinal anesthesia was performed with isobaric bupivacaine 1.0 mg/age.Propofol was then infused at 3-5 mg · kg-1 · h-1 for sedation in PS+CB and PS+SA groups.Before anesthesia (baseline, T0) and at 1, 5 and 10 min after emergence from anesthesia (T1-3) , heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2) were recorded.The emergence time, time for recovery of orientation, and duration of stay in postanesthesia care unit were recorded.Pain was assessed and scored, and agitation was graded at 5 min after emergence from anesthesia, and the occurrence of intraoperative traction reaction, body movement and nausea and vomiting within 24 h after operation was recorded.Results No intraoperative traction reaction and body movement was found in group PS+SA, and no patients stayed in postanesthesia care unit in PS+CB and PS+SA groups.HR and MAP were significantly higher at T1-3 than at T0 in group G (P＜0.05).Compare with group G, the HR, MAP at T1-3, pain scores, agitation scores, incidence of nausea and vomiting were significantly decreased, and the emergence time and time for recovery of orientation were shortened in groups PS+CB and PS+SA (P＜0.05).Conclusion Propofol used to supplement spinal anesthesia for sedation is effective and provides faster recovery from anesthesia with fewer complications in the pediatric patients undergoing lower abdominal or lower extremity operations.

Objective:To study the effects of dexamethasone(DEX)on the cytotoxicity and apoptosis of NK-92MI cells and the mechanisms involved.Methods:NK-92MI cells were treated with different doses of DEX.The proliferative rate and cytotoxicity of the NK-92MI cells were detected by MTT colorimetry.The cell apoptotic rate was observed by flow cytometry with Annexin V and propidium iodide(PI)double staining.The expression of apoptosis-related gene,Bcl-2 and Bax was detected by RT-PCR.Results:After treated with 1?10-8mol/L to 1?10-3mol/L of DEX for 24 h,48 h and 72 h,the proliferation of NK-92MI cells was significant inhibited(P

We developed a microfluidic device to integrate sample introduction, bacteria culturing and results reading. The identification of multiple bacteria was achieved by combining the spatial resolution of the arrayed bacteria culture chambers and the color resolution benefited from the bacteria specific chromogenic media. A set of 4 common pathogenic bacteria responsible for urinary tract infection were used as a model to test the microfluidic assay. Our results showed that the bacteria identification assay can be completed in 15 h, with a limit of detection (LOD) of bacteria density down to 10 cfu / mL. Clinical sample testing using the microchip approach showed a coincidence rate of 96. 3% as compared with the conventional method. The developed microfluidic approach is simple and rapid, thus hold the potential to serve as a powerful tool for detection of multiple bacteria.

Objective To study the genome molecular characteristics of Getah virus(DY0824)which isolated in Shandong province,2008 by molecular biology methods.Methods Reverse transcriptasepolymerase chain reaction(RT-PCR)was used to amplify the structural gene and 3'UTR fragments then the RT-PCR products were inserted into PGEM-T easy to be sequenced.Computer software was used to analyze the nucleotide and deduced amino acid sequence,and draw phylogenetic trees,including Clustal X1.83 and MegaAlign and Mega4.Results The capsid protein of DY0824 consists of 804 nucleotides,encoding 268 amino acids and the full-length of E2 protein is 1266 nucleotides,encoding 422 amino acids.The nucleotide homology of the capsid protein and the E2 protein with other strains were 95.4%-99.9%and 94.8%-99.5%,and the amino acid were 97.4%-100%and 97.6%-100%.The 3'UTR of the virus include 401 nucleotides and there are three repeat sequence elements.Conclusion Compared with the prototype virus,the Getah virus isolated in Shandong province had 7 amino acid differences in capsid protein genes and 10 amino acid differences in E protein genes.The 3'UTR region had multi-nucleotide changes.

Objective To explore the relationship between the objective indexes and TCM syndromes of occupational hand arm vibration disease ,and to provide clinical data for the objectification of TCM syndrome differentiation. Methods 101 patients with occupational hand arm vibration disease were collected ,including 24 patients with Xingbi,39 with Tongbi and 38 with Zhuobi,according to the theory of traditional Chinese medicine syndrome differentiation ,the relationship was observed between different TCM Syndrome types and various of parameters,such as 5-and 10-minute rewarming rates in cold water rewarming test,terminal latency,amplitude, conduction velocity ,average time ,average amplitude of abductor pollicis brevis and abductor digiti minimi in electromyography. Results 5-and 10-minute rewarming rate in cold water rewarming test did not differ significantly among the three groups(P > 0.05). Amplitude of median nerve motor conduction differed significantly among the three groups of Xingbi,Tongbi and Zhuobi(χ2 = 6.14,P < 0.05),Further comparison between the groups was made in Xingbi and Tongbi(χ2=0.132,P=0.895),Xingbi and Zhuobi(χ2=2.277,P=0.023),Tongbi and Xingbi (χ2 = 2.172 ,P = 0.030). There were no significant differences among the three groups in latency and conduction velocity of the median nerve motor conduction and latency ,amplitude and conduction velocity of ulnar nerve motor conduction(P>0.05). The differences of conduction velocity and amplitude of median nerve and ulnar nerve sensory conduction,average time and average amplitude of abductor pollicis brevis and abductor muscle among the three groups had no statistical differences(P>0.05). Conclusions The distribution is different in the amplitude of median nerve motor conduction among the three groups of Xingbi,Tongbi and Zhuobi,further analysis shows that the difference is mainly reflected in the Xingbi group. We conclude that the median nerve axonal injury is lighter in Xingbi group than in the other two groups.

On the basis of the well-established principles and techniques about flow chamber, we have designed and made a kind of parallel plate system to apply steady fluid shear stress to osteoclast-like cells etc. in vitro. Biocompatible rubber and metal clamping apparatus made of aluminium alloy are used to seal the flow chamber without changing its even height designed beforehand. The influence of hydrostatic pressure on cells is minimized by adjusting the glass slide and the fluid surface in the upper reservoir to the same horizontal plane. This system can be used to investigate the responses of osteoclast-like cells etc. to fluid shear force in terms of morphology, physiology or biochemistry.
Biomechanical Phenomena ; Cell Culture Techniques ; instrumentation ; Humans ; Osteoclasts ; cytology ; Pulsatile Flow ; Stress, Mechanical

Objective: Study of the results and the degree on occupational noise-induced deafness in-to the different high frequency hearing threshold weighted value, in order to provide theoretical basis for the re-vision of diagnostic criteria on occupational noise-induced deafness. Methods: A retrospective study was con-ducted to investigate the cases on the diagnosis of occupational noise-induced deafness in Guangdong province hospital for occupational disease prevention and treatment from January 2016 to January 2017. Based on the re-sults of the 3 hearing test for each test interval greater than 3 days in the hospital, the best threshold of each frequency was obtained, and based on the diagnostic criteria of occupational noise deafness in 2007 edition, Chi square test, t test and variance analysis were used to measure SPSS21.0 data, their differences are tested among the means of speech frequency and the high frequency weighted value into different age group, noise ex-posure group, and diagnostic classification between different dimensions. Results: 1. There were totally 168 cases in accordance with the study plan, male 154 cases, female 14 cases, the average age was 41.18 ±6.07 years old. 2. The diagnosis rate was increased into the weighted value of different high frequency than the mean value of pure speech frequency, the weighted 4 kHz frequency increased by 13.69% (χ²=9.880, P=0.002) , 6 kHz increased by 15.47% (χ²=9.985, P=0.002) and 4 kHz+6 kHz increased by15.47% (χ²=9.985, P=0.002) , the difference was statistically significant. The diagnostic rate of different high threshold had no obvious differ-ence between the genders. 3. The age groups were divided into less than or equal to 40years old group (A group) and 40-50 years old group (group B) , there were higher the diagnostic rate between high frequency weighted 4 kHz (A group χ²=3.380, P=0.050; B group χ²=4.054, P=0.032) , weighted 6 kHz (A group χ²=6.362, P=0.012; B group χ²=4.054, P=0.032) , high frequency weighted 4 kHz+6 kHz (A group χ²=6.362, P=0.012; B group χ²=4.054, P=0.032) than those of speech frequency average value in the same group on oc-cupational noise-induced deafness diagnosis rate, the difference was statistically significant. There was no sig-nificant difference between age groups (χ²=2.265, P=0.944) . 4. The better ear's mean value of pure speech fre-quency and the weighted values into different high frequency of working years on each group were compared, working years more than 10 years group was significantly higher than that of average thresholds of each frequen-cy band in 3-5 group (F=2.271, P=0.001) , 6-10 group (F=1.563, P=0.046) , the difference was statistically significant. The different high frequency weighted values were higher than those of the mean value of pure speech frequency, and the high frequency weighted 4 kHz+6 kHz had the highest frequency difference, with an average increase of 2.83 dB. 5. The diagnostic rate into weighted different high frequency was higher in the mild, moderate and severe grades than in the pure speech frequency. In the comparison of diagnosis for mild occupational noise-induced deafness, in addition to the weighted 3 kHz high frequency (χ²=3.117, P=0.077) had no significant difference, the weighted 4 kHz (χ²=10.835, P=0.001) , 6 kHz (χ²=9.985, P=0.002) , 3 kHz+4 kHz (χ²=6.315, P=0.012) , 3 kHz+6 kHz (χ²=6.315, P=0.012) , 4 kHz+6 kHz (χ²=9.985, P=0.002) , 3 kHz+4 kHz+6 kHz (χ²=7.667, P=0.002) were significantly higher than the diagnosis rate of the mean value of pure speech frequency. There was no significant difference between the two groups in the moderate and se-vere grades (P>0.05) . Conclusion Bring into different high frequency hearing threshold weighted value in-creases the diagnostic rate of occupational noise-induced deafness, the weighted 4 kHz, 6 kHz and 4 kHz+ 6 kHz high frequency value affects the result greatly, and the weighted 4 kHz+6 kHz high frequency hearing threshold value is maximum the effect on occupational noise-induced deafness diagnosis.

Objective:To investigate the expression of microRNA-155 (miR-155) in serum and kidney of C57BLKS/db (db/db) mice and its role in the pathogenesis of diabetic kidney disease (DKD).Methods:The db/db mice ( n=24) were divided into 6, 8, and 10 weeks old groups ( n=8) with age increasing according to the random number table, and C57BL/6 mice of the same age were used as control group. The expression of miR-155 in mouse serum and kidney tissue was determined using real-time quantitative PCR. The mRNA and protein expression of Ets-1, eNOS, AGTR1 in renal tissues was verified by real-time quantitative PCR, Western blotting and immunohistochemistry. Results:Compared with the control group, the expression of miR-155 in serum of db/db mice at 6, 8 and 10 weeks of age were significantly increased (all P<0.01), and the increase of miR-155 was most obvious at 10 weeks of age ( P<0.01). Meanwhile the expression of miR-155 in kidney tissues of 6, 8 and 10 weeks old db/db mice was significantly up-regulated (all P<0.01), and the highest expression of miR-155 was at 10 weeks of age ( P<0.01). Immunohistochemistry showed that Ets-1, eNOS and AGTR1 were localized in glomerular endothelial cells. The results of real-time quantitative PCR showed that the mRNA expression of Ets-1, eNOS and AGTR1 were down-regulated in the kidney tissues of db/db mice at 6, 8 and 10 weeks of age compared to the control(all P<0.05), and the level of down-regulation was the most obvious at 10 week. Western blotting results showed that there was no significant change in Ets-1, eNOS and AGTR1 in 6-week-old db/db mice compared to the control group; the eNOS protein expression was down-regulated at 8 weeks of age ( P<0.05); the expression of AGTR1 protein was down-regulated ( P<0.05), and the protein expression of Ets-1 and eNOS were significantly down-regulated at 10-week age (both P<0.01). Conclusions:The expression of miR-155 in serum and kidney tissues of db/db mice increases during the progression of DKD, while the expression of miR-155 target genes Ets-1, eNOS and AGTR1 decreases with the progression of DKD. MiR-155 may participate in the development and progression of DKD by inhibiting its target genes Ets-1, eNOS and AGTR1, affecting endothelial cell function.

OBJECTIVE: To analyze the impact of GBZ 49-2014 Diagnosis of Occupational Noise-induced Deafness and GBZ49-2007 Diagnostic Criteria of Occupational Noise-induced Deafness on the diagnosis of occupational noise-induced deafness( ONID). METHODS: A total of 84 individuals,who were workers exposed to noise and diagnosed as observation subjects by GBZ 49-2007 were selected as the subjects of study by judgment sampling. They were diagnosed based on the criteria of GBZ 49-2014 and GBZ 49-2007. The impact of different diagnostic audiometry,different age and gender correction methods and the inclusion of a weighting of 0. 1 high-frequency 4. 0 k Hz hearing threshold of GBZ 49-2014 on the diagnosis of ONID was analyzed. RESULTS: The binaural high frequency threshold average( BHFTA) calculated by GBZ 49-2014 were lower than that of GBZ 49-2007 [( 52. 1 ± 10. 3) vs( 52. 8 ± 10. 1) d B,P < 0. 05 ],but monaural threshold of weighted value( MTWV) of the good ear calculated by GBZ 49-2014 were higher than speech frequency threshold average( SPTA) of the good ear of GBZ 49-2007 [( 23. 2 ± 4. 1) vs( 19. 3 ± 4. 8) d B,P < 0. 01]. All of the 84 patients had BHFTA ≥40 d B and SPTA < 26 d B when diagnosed by GBZ 49-2007,and could not be diagnosed as ONID. A total of33. 3% patients had BHFTA ≥40 d B and MTWV ≥26 d B when diagnosed by GBZ 49-2014 which could be diagnosed as mild ONID. The detection rate of ONID was 21. 4% to 34. 5%( P < 0. 01) when the threshold of 4. 0 k Hz was used as the weighting diagnostic threshold of hearing in the case of using different diagnostic audiograms and different age and sex correction methods. CONCLUSION: A high-frequency hearing threshold of 4. 0 k Hz with a weighting of 0. 1 was included in GBZ 49-2014 as a diagnostic threshold,which reduced the diagnostic threshold of ONID.