Objective To study the influence of carbon dioxide pneumoperitoneum on the pregnancy outcome and newborn rat malformation in pregnancy rats. Methods SD rats were randomly divided into control group (group A and group B) and the experimental group (group C; group D; group E). There were 10 rats in each group, the general situation,abortion rate, premature delivery rate,newborn rats numbers,weights and lengths and malformation rates were recorded. Results There was no malformation in newborn rats in all groups (P > 0. 05 ). Conclusion It was safe to undergo laparoscope operation in metaphase pregnancy with low CO2 pneumoperitoneum,which has no influence on abortion rate and malformation rate.

Objective To probe the therapeutic effects, indications and safety of the percutaneous lumbar discectomy (PLDP). Methods To ameliorate percutaneous punctured route based on classic PLD and modified jaw structure of pulpforcep, with statistic analysis of the therapeutic results of 352 cases of patient undergone PLDP and follow up ranging from 6 to 38 months retrospectively. Results The effective ratios were excellent in 45.5%, good for 45.4% and bad in 9.1%. 44 of 352 cases with pulps prolapse were cured. No intervertebral inflammation and paradisc hematoma took place. One case complicated with cauda equina injury and 4 cases with appliances broken inside the disc. Conclusions PLDP is effective and safe, not only adaptive to the contained disc herniation, but also for noncontained herniation.

Objective To observe the relationship between clinical medication and the prognosis in elderly community-acquired pneumonia (CAP).Methods A prospective randomized controlled single-blind study in Tianjin Hospital Internal Medicine.A total of 160 elderly patients with CAP were selected from January 2011 and January 2015.According to the computer,patients were randomly divided into treatment group and control group,80 cases in each group.Treatment group adopted routine treatment and moderate amount of glucocorticoids in combination with a low-dose of diuretic,and the control group only received routine treatment.In two groups of patients,we observed the initial treatment effect,change in pulse oxygen saturation,the rate of invasive test,the incidence of adverse reactions,mortality rate,total hospital stay,etc.Results Compared with control group,the initial treatment was better,the improvement rate in SPO2 was increased,and the rate of invasive test was decreased in treatment group 72 hours after treatment (x2 =6.234,3.906 and 7.059,respectively,P=0.013,0.048 and 0.008).After the overall prognosis and outcome analysis,compared with control group,the percentage of patients transferred to the intensive care unit,the mortality rate was decreased (x2=4.783 and 4.737,P=0.029 and 0.030),hospitalization cost was declined,and the total hospital stay was shorted (x2 =-72.087 and-5.127,both P＜0.0001).There was no statistically significant difference in the incidence of adverse reactions such as electrolyte disorder and mental disorder(both P＞0.05).Conclusions Corticosteroids in combination with a low-dose of diuretic for the auxiliary treatment of elderly CAP can reduce the mortality rate,decrease the rate of invasive test,and shorten the duration of hospitalization,with no obvious increase of adverse events,and it help to improve the prognosis of CAP patients.

Objective To develop a capacity-controlled ventriculoperitoneal shunt device to relieve the symptoms of hydrocephalus patient.Methods The device was composed of head-end shunt tube,middle reservoir and celiac shunt tube.The ends of the reservoir were equipped with one-way valve to drive cerebrospinal fluid to celiac shunt tube in case of the pressure on the reservoir.The capacity-controlled drainage of cerebrospinal fluid was implemented through the times of the pressure.Results The device drained cerebrospinal fluid to relieve the symptoms of hydrocephalus patient,and the complications due to over-or under-drainage were eliminated.Conclusion The device gains advantages in design and easy operation,and is an effective and safe shunt choice for types of hydrocephalus patients.

Objective To determine the expression of macrophage migration inhibitory factor (MIF)in different molecular subtypes of breast cancer and its clinical significance so as to detect the biological markers of different molecular subtypes of breast cancer.Methods We divided 100 breast cancer patients into four molecular subtypes by immunostaining:luminal subtype,HER-2(+)subtype,basal-like (BLs)subtype and normal breast-like (NBLs)subtype,and then compared the expression of MIF in the groups.We analyzed the associations of MIF-positive expression rate with age,menstruation,tumor size,auxiliary lymph node metastasis,histological type and grade,and clinical stage of the breast cancer patients.We also compared MVD level and 5-year overall survival rate between MIF-positive patients and MIF-negative ones.Results The positive expression of MIF was correlated with HER2(+)subtype breast cancer and auxiliary lymph node metastasis (P < 0.05 ).The patients with MIF-positive expression had a significantly higher level of MVD than those with MIF-negative expression (P < 0.05 ). Kaplan-Meier method showed that MIF-positive patients had a poor prognosis than MIF-negative ones (Log-rank=1 9.5 1 6,P = 0.000).Conclusion Breast cancer patients with MIF-positive expression may be mostly of HER2 (+)subtype,and tend to develop auxiliary lymph node metastasis.These patients have a significantly higher level of MVD and poor prognosis than those with MIF-negative expression.

Objective To investigate the preventive effect of low molecular weight heparin or tranexamic acid in the rabbits with hypercoagulation induced by impact injury and intravenous infusion of the endotoxin. Methods Combination of impact injury and endotoxin was created by strike on rabbit chest with type BIM-Ⅱ biological impact machine and injection of endotoxin via vein.Thirty-two male New Zealand rabbits were divided into four groups in a completely random design as follows:impact injury combined with endotoxin without treatment group(control group),treatment with low molecular weight heparin(L group),treatment with tranexamic acid(TA group),and treatment with low molecular weight heparin and tranexamie acid(L+TA group).The changes of interleukin-1β(IL-1β)and interleukin-6(IL-6)were observed by using the enzyme-linked immunosorbent assay;changes of antithrombin-Ⅲ(AT-Ⅲ)activity,tissue factor(TF)and tissue factor pathway inhibitors(TFPI)were detected by the chromogenic substrate method chromozym P:the content of fibrinogen was observed by coagulation analyzer.The lung and kidney were removed from the experimental animals at 24 hours post impact injury forhistopathologic observation. Results In the control group,the activity of AT-Ⅲ was decreased obviously.while the content of fibrinogen and the activity of TF and TFPl were increased,with formation of the thrombosis in the kidney after injection of PLS.Compared with control group,the activity of TF and the content of IL-1β and IL-6 were reduced but the TFPI was increased in the L group,which resulted in a decrease of TF/TFPI ratio.with decrease of formation of the micro-thrombosis in the organs.The content of IL-1β and IL-6 in the TA group were reduced,which was still higher than that in tIle L group.In the TA group.the activity of IF and TFPI Was lower than that in the L group and control group,with higher TF/TFPI ratio than the L group.The frequency of thrombosis increased in pulmonary artery and other important organs.The content of IL-1β and IL-6 in the L+TA group wag lower than that in the L group.In the L+TA group.the activity ofTF was lower than that inthe L group and control group,but the activity of TFPI was higher than that in the L group and control group.with lower TF/TFPI ratio than the L group.There found no increase of thrombus in the pulmonary arterial and other important organs. Conclusions Besides anticoagulation function,the low molecular weight heparin can inhibit the inflanunation reaction,reduce the release of TF and attenuate the coagulation reaction.On the basis of treatment with low molecular weight heparin,application of the tranexamic acid will not lead to the formation of thrombus,but the only use of the tranexamic acid would have the contrary results.The rtsults of the study provide a theoretical and experimental basis for clinical diagnosis and prevention of hypercoagulation induced by injury and infection.

Objective To ameliorate the percutaneous lumbar discectomy(APLD)for improving the effectiveness and amplifying the indicative range of PLD.Methods To ameliorate percutaneous punctured route based on classic PLD and discectomy of extracting pulp out of the herniated disc with special pulpforceps. The statistical analysis of the therapeutic results on 750 disc protrusions of 655 cases undergone APLD following up from 6 to 54 months retrospectively. Results The effective ratios were excellent in 40.2%, good for 46.6% and bad of 13.3%. No occurrance of intervertebral inflammation and paradiscal hematoma, there were only 1 case complicated with injuried cauda equina, and 4 cases with broken appliance within disc.Conclusions APLD is effective and safe, not only indicative for inclusion disc herniation,but also for noninclusion herniation.

Objective To analyze the distribution characteristics of Pseudomonas aeruginosa and Acinetobacter baumannii ,and to investigate the changing pattern of antimicrobial resistance of these strains isolated during 2012 - 2014 .Methods Strains of Pseud‐omonas aeruginosa and Acinetobacter baumannii isolated from January 2012 to December 2014 were collected .Antimicrobial suscep‐tibility of clinical isolates was tested by Kirby‐Bauer method .Results In the past three years ,214 strains of Pseudomonas aerugino‐sa and 347 strains of Acinetobacter baumannii were isolated .The nosocomial infection rate of Pseudomonas aeruginosa decreased year by year ,while the Acinetobacter baumannii ′s increased .Most strains were isolated from sputum ,wound secretion and urine . The strains of Pseudomonas aeruginosa and Acinetobacter baumannii were distributed in various departments of the hospital .The detection rates of these strains were the highest in ICU ,respectively 27 .6% and 34 .9% .Both the resistance rates of Pseudomonas aeruginosa to ceftazidime ,imipenem ,Amikacin and Acinetobacter baumannii to Piperacillin/Tazobactam and imipenem had in‐creased ,while the resistance rates of Acinetobacter baumannii to polymyxin B had decreased with each passing year .Conclusion Pseudomonas aeruginosa and Acinetobacter baumannii causes severe nosocomial infections and the antimicrobial resistance rates in‐creased ,especially the resistance rates to carbapenem are becoming more higher in recent years .Acinetobacter baumannii shows strong antibacterial activity in vitro to Polymyxin B .Therefore ,antimicrobial resistance surveillance should be strengthened to direct rational use of antibiotics .

Aim To study the effects of totle flavone of allium cepa L.var agrogatum Don(TFAD)on the blood-liquid metabolism in experimental hyperlipoproteinemia rats.Methods The model of experimental hyperlipoproteinemia was established by giving hyperlipid diet to Wistar rats.After the model was established,the rats were treated by TFAD.Then TC、TG、LDL-C、HDL-C of serum,MDA and SOD activties of serum and liver,TXA2 and PGI2 of plasma,blood viscosity were mesured,and pathology of liver was observed.Results After treated by TFAD(25～100 ?g?g-1 po for 21 days),TC、TG、LDL-C、AI、TC/HDL-C and MDA were reduced remarkably,HDL-C and the activity of SOD increased,PGI2 in plasma rose while TXA2 decreased,the blood viscosity of whole blood was depressed significantly,meanwhile the fatty degeneration of hepatic cells was relieved.Conclusions The results suggest that TFAD can adjust the blood-liquid metabolism of experimental hyperlipoproteinemia rats and restrain fatty deposition in liver which may be related to TFAD's function of preventing lipoprotein peroxidization,maitaining physiologic equilibrium of PGI2/TXA2,and ameliorating the abnormity of blood rheology.

Objective To study the coagulation of patients with lung cancer or esophagus cancer in thoracotomy during perioperative period.Methods Variables [reaction time(R),clotting time(K),? angle,maximum amplitude(MA)]detected by thrombelastography were measured in 10 cases of lung cancer and 10 cases of upper or median esophagus cancer before anesthesia(T0),at the end of 1 h after operation beginning(T1)and 30 min after operation(T2).The control group consisted of 10 healthy volunteers.Results In lung cancer group and esophagus cancer group,R was shorter than control group(P