Objective To observe the clinical effect of subcutaneous drainage tube in the prevention of abdominal surgical incision infection.Methods According the admission sequence,290 abdominal surgery patients were selected and randomly divided into the two groups,each group 145 cases.The patients of the observation gronp were placed subcutaneous drainage tube after operation,and the patients of the control group were not placed subcutaneous drainage tube.The wound healing,wound infection rate,and secondary debridement incidence of the two groups were observed and compared.Results The successful surgery were in 190 patients,and there was no patient in death.The incision healing rate of first grade in the observation group was 97.93％,which in the control group was 89.66％,The incision infection was in 3 cases (2.07％),which in the control group was 12 cases (8.28％).There were all statistically significant differences between the two group (all P ＜ 0.05).The secondary debridement of the observation group was in one case,which in the control group was in 7 cases,and the secondary debridement incidence of the observation group was significantly lower than that of the control group(P ＜ 0.05).Conclusion Placing the subcutaneous drainage tube for abdominal surgery patients can reduce the occurrence of wound infection and secondary debridement,and beconducive to postoperative recovery.

Objective To analyse effect of nalmefene hydrochloride adjuvant therapy on serum nitric oxide(NO), endothelin (ET) and cardiac troponin I ( cTnI) in patients with traumatic shock.Methods 48 patients who were diagnosed with traumatic shock were collected.All patients were randomly divided into experimental group and control group, 24 cases in each group.On the basis of conventional anti shock treatment, the control group were treated with naloxone, the patients in experimental group received nalmefene hydrochloride treatment, after treatment, the serum levels of NO, endothelin and cardiac troponin I were detected in all patients.Results After treatment, compared with control group, the serum level of NO was lower in experimental group(P<0.05);the serum level of ET was lower in experimental group(P<0.05);the serum level of cTnI was lower in experimental group(P<0.05).Conclusions Nalmefene hydrochloride adjuvant therapy could significantly reduce the serum levels of NO, ET and cTnI in patients with traumatic shock,control the development of the disease, prevent myocardial injury.

Objective To observe prospectively the changes of left ventricular size and function, and to evaluate the impact of primary percutaneous transluminal coronary angioplasty (p-PTCA) and stent implantation and thrombolytic therapy on left ventricular remodeling and function. Methods The patients with a first acute myocardial infarct and without contraindications to thrombolytic therapy were randomly assingned to p-PTCA group or urokinase (1?500?000 IU) therapy group within 12 hrs from the onset of symptoms or within 12～24 hrs if the evidence of myocardial ischemia in infarc zones was available. Two-demensional echocardaography were applied in the 2 nd , 12 th , and 24 th week after infarction, and major cardiac events were recorded. Results Sixty-five patients were enrolled (male 55, female 10, age 58.95?8.94 y). The patency of infarct related artery of 32 patients assigned to p-PTCA was 100%, while that of thrombolytic therapy group (33 patients) was 75.76%. The differences of end-systolic volume index (ESVI), end-diastolic volume index (EDVI), left ventricular ejection fraction (LVEF), and regional wall motion score index (RWMI) were significant statistically between p-PTCA group and thrombolytic therapy group ( P

Objective To observe the efficacy and adverse effect of IHDA [Idarubicin(IDA) + high-dose Cytarabine(HD-Ara-C)] as a remedy regimen in the treatment of pediatric patients with refractory acute lymphoblastic leukemia(ALL).Methods Twelve children with refractory ALL were treated by IHDA regimen as follows:IDA,10 mg/(m2·d),d1-3;Ara-C,1.0g/m2,q12h,d1-3.The children who achieved complete remission(CR)could get into the following sequential regimens or allogeneic hematopoietic stem cell transplantation (allo-HSCT).The same regimen was given to the children who didn't achieve CR when WBC ＞2.0×109/L.The efficacy and hematology or non-hematology adverse effect were evaluated.Results CR/partial remission (PR)/non-remission (NR) were respectively 4/3/5 cases after giving the first regimen,and CR/PR/NR were 5/3/4 cases after giving the second regimen,respectively.The overall remission was 66.7％ (8/12 cases),of which 5 cases(41.7％) achieved CR,3 cases (25.0％) reached PR and 4 cases(33.3％) reached NR.Grade Ⅳ myelosuppression occurred in all patients,but no severe infection and hemorrhage happened after the application of granulocyte colony stimulating factor (G-CSF),platelet transfusion and anti-infection treatment.Some reversible side effects like liver toxicity,myocardial damage and nerve injury were observed in some patients.There was no chemotherapy related mortality in all the patients.Two cases relapsed again followed up to October 2015.One achieved CR after applying chimeric antigen receptor T-cell immunotherapy and was receiving allo-HSCT now.Another was dead after applying FLAG (Prednisone+Fludarabine+Ara-C+G-CSF) save regimen.The time of the other 3 cases achieving CR was 26,10,4 months,respectively.Among the remaining 7 cases,3 cases were forced to receive hematopoietic stem cell transplantation,2 cases abandoned treatment and 2 cases failed to follow up.Conclusions The IHDA regimen is a well-effective and tolerated treatment for pediatric patients with refractory ALL,and could create an opportunity for the application of allo-HSCT.

OBJECTIVE:To evaluate the cost and effectiveness of Shenmai injection and Salvianolate for injection in adjuvant treatment of coronary heart disease with heart failure. METHODS:In prospective randomized controlled clinical study,103 pa-tients with coronary heart disease with heart failure were randomized into 2 groups:55 patients in group A received Shenmai injec-tion 50 ml added into 5% Glucose solution 250 ml intravenously on the basis of routine treatment,once a day;48 patients in group B received Salvianolate for injection 200 mg added into 5% Glucose solution 250 ml intravenously on the basis of routine treatment,once a day;treatment course lasted for 2 weeks. The improvement of clinical indicators and ADR were observed before and after treatment;2 drug treatment programs were evaluated and analyzed with pharmacoeconomics. RESULTS:Total effective rates of group A and B were 89.09% and 72.92%,with statistical significance(P<0.05);the incidence of ADR in group A and B were 9.09% and 12.50%,there was no statistical significance(P>0.05). The cost-effectiveness ratio of group A was significantly lower than that of group B,with statistical significance(P<0.05);the results of sensitivity analysis was consistent with it,indicat-ing the cost of Shenmai injection was in low level. CONCLUSIONS:Shenmai injection is more economic in adjuvant treatment of coronary heart disease with heart failure.

Objective To detect the levels of insulin-like growth factors in children with acute leukemia (AL). Methods A total of 50 previously untreated AL patients were selected, meanwhile 30 healthy children were selected as normal controls. AL children were given regular chemotherapy. All cases were not given the brain radiotherapy. The levels of insulin-like growth factor-1 (IGF-1), free insulin-like growth factor-1 (fIGF-1), insulin-like growth factor binding protein 3 (IGFBP-3) in AL patients before treatment and 6 months after complete remission were measured by enzyme-linked immunosorbent assay (ELISA), and were compared with those in normal controls. Results Before treatment, compared with normal controls, the serum levels of IGF-1, IGFBP-3 in AL patients were lower while the level of fIGF-1 was higher, and the differences were signiifcant (P<0.01). At six months after complete remission, the levels of IGF-1 and fIGF-1 in AL patients were similar to those before treatment, but were signiifcantly different from those in control group (P<0.05);the level of IGFBP-3 was signiifcantly higher than that before treatment (P<0.01), but was similar to that in control group. Before treatment, the level of IGFBP-3 in AL patients was positively correlated with the level of IGF-1 (r=0.777, P<0.01), and negatively correlated with the level of fIGF-1 (r=-0.714, P<0.01). Conclusion Insuline-like growth factors were involved in the pathophysiological process in children with AL.

Objective To explore the necessities and clinical value of acute intestinal obstruction with com-puted tomography of whole abdomen in over 80 years old patients.Methods 50 patients with acute intestinal obstruc-tion were diagnosed in department of emergency surgery and underwent the abdominal CT examinations.The clinical data,CT and surgery pathology of all patients were compared and analyzed.Results All cases were verified by surgi-cal operation and pathological diagnosis,including colorectal cancer(n =21)and incarcerated abdominal external her-nia(n =21),appendicitis(n =2),adhesive intestinal obstruction(n =2),intestinal volvulus (n =2),and intestinal intussusception(n =1)and stercoral intestinal obstruction(n =1),12 cases were accompanied by bowel necrosis and perforation.12 patients were treated by laparoscope surgery,38 cases by open laparotomy,48 patients acquired good recovery,and 2 cases died from extensive bowel necrosis and multi -organ failure.Conclusion CT examination in whole abdomen could rapidly and accurately diagnose the cause of intestinal obstruction,evaluate complications and risks,so as to provide reasonable treatment choice and time,making patients acquired the effective effects as soon as possible,reducing the bad consequences.

BACKGROUND:Clinical trials have shown that oral administration of valsartan can decrease in-stent restenosis after stent implantation.But whether valsartan used locally also has the sanle effect and the possible mechanism should be validated.OBJECTIVE:To observe the effect of valsartan-eluting stents on collagen deposition in neointima and AT2 receptor expression after implanting valsartan-eluting stents into rabbit abdominal orta.DESIGN:Randomized and controlled animal experiment.SETTING:Beijing Friendship Hospital.MATERIALS:The experiment was performed at the Laboratory of Beijing Friendship Hospital between October 2004 and March 2006.Fifteen New Zealand white rabbits,irrespective of gender,weighing 2.75-3.25 kg were selected(Animal Laboratory of Beijing Friendship Hospital).The rabbits were adaptively fed for one week.All the operations of rabbits during the experiment were accorded with animal ethical standards.Valsartan powder was presented as a gift by Novartis.China;Reagent of MASSON was provided by Department of Pathology of Beijing Friendship Hospital;1%picrosirius solution was provided by the Department of Pathology of China-Japan Friendship Hospital:Mice-anti-rabbit monoclonal AT2 antibody was product of Santa Cruz Biotechnology (USA);Envision reagent was purphased from Dako;primers were synthesized by SBS Genetech(SBS).METHODS:①The animals were randomized into bare-metal stent group,carrier-eluting stent group and valsartan-eluting stent group with 5 animals in each group.All rabbits were implanted with corresponding types of above-mentioned stents into abdominal aortas down below renal artery.②Quantitative angiography before,immediately after and 3 months after stent implantation were performed to compare vascular diameters of the aortas.③Three months Iater,the rabbits were executed after anaesthesia.The vessels with stents were processed with HE staining.Indices of the vascular neointimal formation,I.e. iBrier and external elastic membrane luminal area,the maximal intimal thickness,neointimal area and stenosis area percent were measured.④The collagen deposition in neointima was observed through MASSON staining,and the type of collagen was identified through picrosirius stain.⑤The expressions of AT2R mRNA and proteins were also compared by RT-PCR and immunohistochemistry among three groups.MAIN OUTCOME MEASURES:①The diameters of aorta with stent at different time;②Inner and extemal elastic membrane luminal area,the maximal intimal thickness,neointimal area and stenosis area percent;③Collagen deposition and type of collagen of the aorta with stent;④AT2R mRNA and protein expressions.RESULTS:Of 15 rabbits selected in the experiment,1 rabbit of the bare-metal stent group died during stent implanting,and 1 of the carrier-eluting stent group died during breeding after stenting.Finally,13 rabbits were included in final analysis.①There were no significant differences in the mean aortic diameters between any two of the three groups before,immediately after and 3 months after stent implantation(P＞0.05).②A larger 1uminal area and a less neointimal hyperplasia in valsartan eluting-stents group were found compared with the other two groups(P＜0.01).③MASSON staining showed that collagen deposition was rich in neointima of bare-metal stent group and carrier-eluting stent group while rare in neointima of valsartan eluting stent group.Pierosirius staining suggested that the deposited collagen was type Ⅲ collagen predominantly accompanied by type Ⅰ collagen around stents struts;the type Ⅲcollagen deposition was obviously decreased in valsartan eluting stent group.④AT2R protein only expressed in adventitia of bare-metal stet group and arrier-eluting stent group while expressed in all layers of valsartan eluting-stents group.The AT2R mRNA/a-Actin mRNA of valsartan eluting stent group was significantly higher than that in the other two groups(P＜0.01).CONCLUSION:Valsartan eluting-stents inhibits neointimal hyperplasia after stenting by decreasing collagen deposition.especially collagen Ⅲ.The mechanism may be related with the upregulation of AT2R mRNA and protein expressions by valsartan-eluting stent.

Objective To investigate the effects of IL-13 on fibrosis in hepatic stellate cells and its molecular mechanism .Methods The effects of IL-13 on the proliferation of hepatic stellate cell line LX-2 were measured by MTT assay .The transcription level of collagen typeⅠ( COLⅠ) in LX-2 cells was detec-ted by RT-PCR.The secretion of COLⅠin LX-2 cells was measured by ELISA assay and hydroxyproline as-say.Western blot assay was used to analyze the effects of IL-13 on the phosphorylation of signal transducer and activator of transcription(STAT6).Results Compared with control group, IL-13 (10 ng/ml, 20 ng/ml and 50 ng/ml ) significantly stimulated the proliferation of LX-2 cells in a dose-dependent manner ( P<0.05).The expression of collagen typeⅠin LX-2 cells at mRNA and protein levels were significantly up-regulated by IL-13 at a concentration of 50 ng/ml (P<0.05), but not affected by IL-13 at low concentra-tions (5 ng/ml, 10 ng/ml, and 20 ng/ml) (P>0.05).The expression of phosphorylated STAT6 protein in LX-2 cells was significantly enhanced upon the stimulation with 50 ng/ml of IL-13 ( P<0.05 ) for60 min or 120 min.C onclusion IL-13 promoted the proliferation of human hepatic stellate cells and up-regulated the expression of COLⅠat mRNA and protein levels .IL-13 might promote the fibrosis in human hepatic stellate cells through activating STAT 6 phosphorylation .

Objective: To investigate the predictive value of an early inflammatory response factor, Rho kinase activity for left ventricle remodeling (LVR) in patients with acute ST-segment elevation myocardial infarction (STEMI).
Methods: A total of 120 acute STEMI patients treated in our hospital from 2010-10 to 2013-06 were studied, all patients were ifrst time received primary percutaneous coronary intervention (PCI) with stent implantation. Rho kinase activity and B-type natriuretic peptide (BNP) were measured before PCI, echocardiography was conducted at 24 hours and 12 months after STEMI respectively to clarify LVR diagnosis. The patients were divided into 2 groups as LVR group, n=97 and Non-LVR group, n=23, the above indexes were compared between 2 groups.
Results: The level of Rho kinase was higher in LVR group than that in Non-LVR group, P<0.001, after adjustment, Rho kinase was the independent predictor for LVR (OR 3.36, 95%CI 2.01–5.78, P<0.001). The ROC of Rho kinase was 0.88 (95%CI 0.82–0.94) and the ROC of BNP was 0.54 (95%CI 0.41–0.70).
Conclusion: High Rho kinase activity could predict LVR in acute STEMI patients with primary PCI and stent implantation.