Objective To investigate the risk factors of pneumonia in patients with non ST segment elevation-acute cononary syndromes (NSTE-ACS).Methods A total of 183 cases with NSTE-ACS was divided into pneumonia and non-pneumonia groups.The possible risk factors were screened firstly,then nonconditional logistic model multivariate analysis was used to investigate risk factors including age,sex,weight,smoking,chronic obstructive pulmonary disease (COPD),hypertention,diabetes,left ventricular failure,renal failure,low serum albumin,early revascularization and early rehabilitation exercise on the occurrence of pneumonia in NSTE-ACS.Results The differences were statistically significant in factors including age,smoking,COPD,diabetes,left ventricular failure,renal failure,low serum albumin,early revascularization,and early rehabilitation exercise between two groups (P ＜ 0.05).By analysis of logistic,risk factors on the occurrence of pneumonia in NSTE-ACS were age,smoking,COPD,diabetes,left ventricular failure,renal failure,and low serum albumin(P ＜0.05).Early revascularization and early rehabilitation exercise were the protective factors to avoid pneumonia.Conclusions Left ventricular failure,age,smoking,COPD,diabetes,renal failure,and low serum albumin were the risk factors of pneumonia occurred in NSTE-ACS,but early revascularization and early rehabilitation exercise were the protective factors to avoid pneumonia.Actively treating the risk factors and early initiating the protective factors can effectively reduce the incidence of pneumonia.

[Objective] To observe the effect of TCM on bladder cough.[Method]Take the principles of removing pathogens to stop cough,reinforcing essential qi to nourish deficiency and considering both the superficial and inside,and divide 54 cases into 5 types:attacked externally with wind cold,with wind heat,with dryness,overheat of liver fire and both deficiency of lung and kidney,make treatment by differentiation of signs.[Result]38 cases were cured,6 had marked effect,6 were effective,4 had no effect,and the total effective rate was 92%.[Conclusion]TCM has obvious cure effect in treating bladder cough.

Coma ; diagnosis ; etiology ; Female ; Humans ; Hyperparathyroidism, Primary ; complications ; diagnosis ; Male ; Middle Aged

Objective To evaluate the imaging manifestations in diagnosis lipoma of upper alimentary canal.Methods 8 cases with lipoma of upper alimentary canal were performed by barium meal and dual-contrast gastrointestinography(n=8),ultrasound(n=1),computed tomography(n=2)and endoscopy(n=5).Results (1)Barium meal and dual-contrast gastrointestinography could diagnose benign space-occupation of upper alimentary canal.(2)Ultrasound and endoscopy could diagnose benign space-occupation.(3)The density of fat of lesion could well be displayed by computed tomography and contrast-enhenment computed tomography and lipoma could be diagnosed before opertion.Conclusion The combination of gastrointestinography,endoscopy and computed tomography can be regarded as the first procedure for diagnosis lipoma of upper alimentary canal.

Objective To discuss the best resistance factors of paclitaxel(Taxinol)on benign biliary scar fibrosis,in order to provide an effective basis for clinical prevention and treatment of benign biliary scar fibrosis.Methods Human bile duct epithelial cells were cultured in vitro,the prepared PTX at 0.001 uM,0.005 uM,0.1 uM,0.5 uMand 1 uMconcentration were separately added into cells for 48 h.The half inhibitory rate of BEC (IC50) were determined by MTT and the optimal concentration were confirmed.Human bile duct epithelial cells were cultured in 0 h,24 h,48 h and 72 h,the inhibitory rate of BEC at 100 nM,250 nM,and 500 nM PTX-Chitosan Sustained release membranes and the optimal concentration of PTX were determined by MTT and the optimal concentration of PTX-SRM were obtained.Human bile duct epithelial cells were cultured for 48 h and 72 h,the mRNA and protein expression ofα-SMA,E-cadherin,Vimentin were detected by Western Blot and Real-time PCR methods.Results The optimum resistance concentration of PTX to benign biliary scar was 250 nM.PTX and PTX-SRM could effectively inhibit the proliferation and transformation of BEC,and the best effective treatments to resist benign biliary scar fibrosis were low and middle concentrations of PTX-SRM,the best drug loading were 100 nMand 250 nM.The inhibition duration of PTX-SRMon BEC was longer than PTX alone(P<0.05).Conclusion The inhibition of PTX-SRMon BEC proliferation and transformation is better than the single drug of PTX,which provides a new scientific and feasible method for clinical prevention and treatment of benign biliary scar.

Objective To investigate surgical treatment for tumor involved inferior vena cava at the upper segment of kidney.Methods The clinical data of 35 patients with tumor involved inferior vena cava at the upper segment of kidney who were admitted to Changhai Hospital affiliated to the Second Military Medical University from January 2007 to May 2015 were retrospectively analyzed.All the patients received preoperative imaging examinations to insure the site and range of inferior vena cava involvement at the upper segment of kidney.Renal cell carcinomas with inferior vena cava involvement were found in 19 cases,leiomyosarcomas of inferior vena cava in 5 cases,leiomyomatosis involving inferior vena cava in 3 cases,adrenocortical carcinoma involving inferior vena cava in 3 cases,liver cancer involving inferior vena cava in 2 cases,right adrenal pheochromocytomas in 2 cases,retroperitoneal fibrosarcoma involving inferior vena cava in 1 case.According to tumor involvement types,the different surgical approaches,planes and method of inferior vena cava exclusion,reconstruction method and prevention of tumor embolus detachment were selected.Patients were followed up by outpatient examination and telephone interview till May 2015.Results Among 19 patients with renal cell carcinomas with inferior vena cava involvement,10 patients were placed inferior vena cava filters through internal jugular vein before surgery,10 patients underwent total hepatic vascular exclusion and 9 patients underwent intrahepatic inferior vena cava exclusion.All the 19 patients received tumor resection and inferior vena cava embolectomy.Of the 5 patients with leiomyosar-comas of inferior vena cava,3 patients underwent total hepatic vascular exclusion and 2 patients underwent intrahepatic inferior vena cava exclusion.The diseased segments of 5 patients were resected,including 4 patients of artificial vascular graft and 1 patient complicated with resection of right kidney receiving simple ligation of inferior vena cava and left renal vein at proximal and distal tumors.Of the 3 patients with leiomyomatosis involving inferior vena cava,2 patients received total hepatic vascular exclusion and 1 was treated surgically under cardiopulmonary bypass.All the 3 patients underwent inferior vena cava embolectomy and hysterectomy.Three patients with adrenocortical carcinoma involving inferior vena cava and 2 patients with liver cancer involving inferior vena cava underwent total hepatic vascular exclusion.Among the 5 patients,4 had direct suture after tumor removal combined with partial inferior vena cava resection,and 1 had patch repair after partial inferior vena cava resection.Two patients with right adrenal pheochromocytomas were exposed proximal and distal lifting devices of inferior vena cava without clamp,and the tumors were peeled off completely.Intraoperative death happened in the patient with retroperitoneal fibrosarcoma involving inferior vena cava who was prepared to undergo intrahepatic inferior vena cava exclusion but encountered intraoperative pulmonary embolism due to tumor thrombus shedding.Thirty-four patients of 35 patients underwent operation successfully without serious perioperative complications and a patient died in the perioperative period.The mean operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were 2.8 hours (range,1.5-5.0 hours),2 000 mL (range,400-5 000 mL) and 9.2 days (range,6.0-16.0 days).Thirty-four patients were followed up for a median time of 12 months (range,1-60 months).During the follow-up period,a patient with leiomyosarcomas of inferior vena cava and 2 patients with adrenocortical carcinoma involving inferior vena cava died of tumor recurrence,a patient with liver cancer had tumor recurrence,other patients were tumor-free survival.Conclusions Inferior vena cava at the upper segment of kidney is not contraindication for tumor resection.The appropriate way to expose,clamp and reconstruct are selected to safely remove the tumor based on extension and method of tumor involving inferior vena cava.

Objective To explore the effect of the mutant and expression level of N-ras on chronic myelogenous leukemia. Method We investigated the mutant by direct sequencing in a K562 human chronic myelogenous leukemia cell line, with determination of the expression level of N-ras mRNA in K562 by RT-PCR. Result No single point mutation was detected in K562 cell line, furthermore, the expression level of N-ras gene is abnormaly high in contrast to normal human. Conclusion Our results indicated that the expression level of N-ras gene was obviously high in K562 cell line, and the underlying mechanism was not only mutation, so that further investigation is called for.

Objective:To observe the efficacy and safety of Qingpeng ointment in the prevention and treatment of chemotherapeutic phlebitis. Methods:Totally 72 patients with non-small cell lung cancer undergoing chemotherapy after pneumonectomy were randomly divided into control and observation groups. The control group was treated with the conventional therapy to prevent phlebitis, and on the basis of conrentional therapy the observation group was treated with Qingpeng ointment at the injection site and along with the vein be-fore the chemotherapy, at the beginning of the chemotherapy, during the chemotherapy and after the chemotherapy in the same day and on the next day. The treatment course was 3 days. The incidence of phlebitis, hierarchical cases, VAS score and pain duration between the groups were compared, and the adverse drug reactions were observed. Results:The pain degree and duration induced by phlebitis showed no significant differences between the groups(P>0. 05), while the pain degree and duration in the observation group were de-creased when compared with those in the control group. The incidence of phlebitis in the observation group was obviously lower than that in the control group with statistically significant difference (P <0. 05). No adverse reactions were found with the external use of Qingpeng ointment. Conclusion:Qingpeng ointment has certain efficacy with high safety in the prevention of tumor-chemotherapeutic phlebitis, which can improve patients’ compliance, and is worthy of promoted application in clinics.

Objective To evaluate the surgical results of off-pump for plication for left ventricular aneurysm. Methods The study included 34 patients with left ventricular aneurysm,who underwent left ventricular aneurysmecto- my and plicatien on pump in group Ⅰ(17 cases)and simply aneurysm plicatien off pump in group Ⅱ(17 cases).All patients except two in group I underwent coronary artery bypass grafting simultaneously.Results There was one early death in group Ⅱ because of refractory ventricular arrhythmia.The complication included atrial fibrillation,ventricular arrhythmias,heart failure and delayed healing of wound.The aneurysm in group Ⅰ[(45?15)%of the ventricle]is larger than in groupⅡ[(29?12)%of the ventricle,P

Objective To explore the effect of Paclitaxel-Chitosan Sustain film on growth, apoptosis and cell cycle of biliary fibroblasts cells. Methods Human biliary fibroblasts cells were cultured and treated with PTX-CSF and naked PTX,separately, untreated cells as blank control. The experiment was divided into five groups:untreated group, simple PTX-treated group (250nM) and low, medium and high chitosan sustained-release film PTX-treated group (100 nM, 250 nM, 500 nM). The proliferations of cells were determined by MTT assay. The apoptosis and cell cycle of cells were detected by FCM. Results The proliferation of biliary fibroblasts cells was inhibited by PTX-CSF with time-dependent and dose-dependent, and the inhibiting effect was more obvious than naked PTX treatment as the time went on. Meanwhile, PTX-CSF could inhibit the magration of bile duct fibroblasts induced by TGF-β1,and had longer effect than naked PTX. After 72 h, the apoptosis rate of cells treated with PTX-CSF was significantly higher than cells treated with naked PTX or untreated cells(P<0.05), the difference between naked PTX or untreated cells was not significant. Compared with untreated cells, the proportion of G 2/M in cells treated with PTX or PTX-CSF were significantly increased, and the former was sinificantly higher than the latter(P<0.05). Conclusion Compared with naked PTX, PTX-CSF has strong cytotoxic effects and obviously sustained-release effect. The effective concentration can be maintain for a long time by PTX-CSF, and it could be as the novel drug delivery system to continuously inhibit proliferation of bile duct fibroblasts.