Objective To investigate the effect of ganoderic acid A( GA-A) on apoptosis, invasion and KDR expression of human U251 cells.Methods Ganoderic acid A( GA-A) was prepared, human U251 cells were treated with 0.1, and 0.5 mmol/L GA-A, and the experiment was divided into blank control, low concentration and high concentration group.The expressions of KDR mRNA and KDR protein was assayed by RT-PCR and Western blot.The effect of GA-A on the proliferation and invasion capability of U251 cells was determined by CCK-8 and transwell assay in vitro, respectively.Flow cytometry was used to detect the influence of GA-A on the cell cycle and apoptosis of U251 cells, and TUNEL staining was detected the cell apoptosis too.Results Compared with the control group, KDR mRNA and protein expression of high concentration and low concentration group were significantly decreased(P <0.05), GA-A can significantly reduce the cell growth rate, reduce the proportion of cells in G1 phase and increase the proportion of S phase and G2 /M phase,cells apoptosis was significantly increased in the high concentration and low concentration group ( P <0.01), and cells proliferation and invasion was significantly decreased (P <0.05).Compared with low concentration group, the high concentration group induce cell apoptosis and inhibit the expression of KDR more significant (P <0.05). Conclusions Ganoderma acid A can induce apoptosis in U251 cells, inhibit proliferation and invasion, and can inhibit the expression of KDR mRNA and protein, which may be one of the mechanisms of anti-tumor.

Objective To study the clinical effect of microsurgical surgery for the treatment of intracranial aneurysms in the acute phase. Methods 88 patients with intracranial aneurysm who were treated with the microscopic surgery in our hospital were selected as the research object. The prognosis was evaluated by Glasgow scale ( GOS) ,and the mortality rate during the follow-up period and postoperative complications were observed. Results All the patients received surgery success. The operation time was (60. 5 ± 20. 3) min,and the intraop-erative blood loss was (45. 2 ± 21. 5) mL. 12 months after operation,according to the GOS score of daily living ability,42 patients were of good prognosis and the other 46 cases were of poor prognosis. The good prognosis rate was 47. 7% and it is significantly higher than that of 3 months and 6 months after surgery. The difference was statistically significant (P<0. 05). There were 4 cases died among the 88 patients with a mortality of 4. 5%. Conclusion Using microsurgical treatment to treat intracranial aneurysms can receive good prognosis and low mortality rate. Complications were significantly improved after symptomatic treatment.

OBJECTIVETo investigate the bacterial epidemiology in our department in recent years, so as to provide assistance to the clinical management of burn patients.

METHODSA retrospective analysis was carried out with 345 bacterial cultures from burn wound and drug-sensitivity results in 784 burn patients during 1993 to 1999 in our department.

RESULTS(1) Among all the bacteria, gram negative (G(-)) bacilli accounted for 56.8%, while gram positive (G(+)) cocci and fungi in 3.8%. (2) Among all the G(+) cocci, 65.4% were Staphylococcus aureus, in which MRSA was identified in 53.9% during 1993 - 1999 and in 64.3% during 1998 - 1999. Pseudomonus aeruginosa accounted for 37.2% of all G(-) bacilli. (3) The 3rd generation of cephalosporins shew excellent anti-bacterial capabilities, but the bacterial resistance to them increased significantly. (4) MRSA was very sensitive to both vancomycin and norvancomycin with no report of antibiotic resistance to them.

CONCLUSIONG(-) bacilli were still predominant bacteria in our burn department when compared to G(+) cocci. The 3rd generation cephalosporins are the routine antibiotics for the present. But resistant bacteria are on the increase. There are also more and more MRSAs isolated from burn wounds. For this, vancomycin and norvancomycin should be preferably used.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; Burns ; microbiology ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Pseudomonas aeruginosa ; drug effects ; Retrospective Studies ; Staphylococcus aureus ; drug effects

Objective The aim of this study was to evaluate the clinical and phychology profile after total cavopulmonary connection procedure and to identify the significant determinants of quality of life.Methods Data from 21 patients underwent total cavopulmonary connection procedure from January 2008 to December 2015 were retrospectively analyzed.Patients under went echocardiography aud cardiopulmonary exercise testing.Used ST-36 questionnaire to perceived health status.The NT-ProBNP levels was test.Results 21 patients aged between 19 to 36 years(mean 26.6 years) were enrolled.The mean follow-up time was(44.2 ± 29.9) months.The mean EF was (59.4 ± 6.2) ％,and the peak oxygen uptake was (19.9 ± 3.6) ml · kg-1 · min-1,perceut predict value was(52.5 ± 8.9) ％.SF-36 score was well.Independent risk for impaired exercise capacity was interval time from surgery.Conclusion The exercise capacity of total cavopulmonary connection patients was impaired.Identify more predict factors of the quality of these patients need further study.

Objective:To investigate the effect of preoperative use of diuretics on cardiac surgery-associated acute kidney injury(CSA-AKI)in elderly patients.Methods:In this single-center retrospective study, 1 638 patients aged ≥60 years and undergone cardiac surgery(including coronary artery bypass grafting, valve replacement and valvuloplasty)in the Department of Cardiovascular Surgery, Linyi People's Hospital between January 2015 and December 2022 were recruited.The last preoperative serum creatinine(SCr)level was taken as the baseline value, and AKI was diagnosed according to the Kidney Disease Improving Global Outcomes(KDIGO)criteria.Patients were divided into an AKI group and a non-AKI group according to whether AKI occurred after surgery.The clinical characteristics of the two groups were compared, and the effect of preoperative use of diuretics on CSA-AKI was evaluated by multivariate Logistic regression analysis.Results:Of 1638 patients enrolled in the study, 284 patients(17.3%)developed CSA-AKI.Compared with the non-AKI group, there were higher proportions of patients in the AKI group receiving furosemide(62.7% or 178/284 vs.46.2% or 626/1 354, χ2=25.397, P<0.001), spironolactone(70.1% or 199/284 vs.49.9% or 676/1 354, χ2=38.284, P<0.001), and hydrochlorothiazide(8.1% or 23/284 vs.3.5% or 47/1354, χ2=12.288, P<0.001). The number of diuretics in the AKI group was higher than in the non-AKI group[2(0, 2) vs.1(0, 2), Z=-6.381, P<0.001], and the proportion of patients using ≥2 diuretics was higher in the AKI group than in the non-AKI group(70.1% or 199/284 vs.49.0% or 664/1354, χ2=41.652, P<0.001). Multivariate Logistic regression analysis showed that, after adjusting for hypertension, diabetes mellitus, hypoalbuminemia, NYHA functional class Ⅲ/Ⅳ, cardiopulmonary bypass during surgery, operative duration≥6 h, postoperative blood transfusion>600 ml, postoperative use of >3 vasoactive drugs and other variables, preoperative use of ≥2 diuretics remained an independent risk factor for CSA-AKI in elderly patients( OR=1.580, 95% CI: 1.042-2.396, P=0.031). Conclusions:AKI is a common complication after cardiac surgery in elderly patients.Preoperative use of ≥2 diuretics used may be an independent risk factor for CSA-AKI.

Objective To investigate the relationship between Kirsten rat sarcoma viral oncogene homolog(KRAS),neuroblastoma viral oncogene RAS homolog(NRAS),V-raf murine sarcoma viral oncogene homo-log B(BRAF),human epidermal growth factor receptor 2(HER2)gene mutations and microsatellite instabili-ty(MSI)status and clinicopathological features in patients with colorectal cancer.Methods The clinical data of 226 patients with colorectal cancer treated in the hospital from October 2019 to March 2022 were collected.Next-generation sequencing technology was used to detect KRAS,NRAS,BRAF,HER2 gene mutations and MSI status.Immunohistochemistry was used to evaluate the mismatch repair system(MMR)status.Multiva-riate Logistic regression analysis was used to analyze the relationship between KRAS,NRAS,BRAF,HER2 gene mutations and clinicopathological features.Results Among 226 colorectal cancer patients,the mutation frequencies of KRAS,NRAS,BRAF and HER2 were 54.89％,5.3％,8.4％and 1.8％,respectively.The fre-quency of KRAS mutation in mucinous adenocarcinoma was higher than that in common adenocarcinoma(P＜0.05).The risk of KRAS mutation in right colon cancer was increased(OR=2.145,P=0.012).NR AS gene mutation was more frequent in left colon and rectal cancer(P＜0.05).The frequency of BRAF gene mu-tation was higher in poorly differentiated and microsatellite instability-high(MSI-H)colorectal cancer(P＜0.05),and the risk of BRAF gene mutation in the right colon was increased(OR=2.844,P=0.042).HER2 gene amplification mutation showed distant metastasis(P＜0.05).KRAS mutations were mutually exclusive with NRAS,BRAF and HER2 amplification mutations(P＜0.05).MSI-H was more frequent in the right co-lon(P＜0.05).Of the 226 cases,10 cases were defective mismatch repair(dMMR)/MSI-H,8 cases were dM-MR/microsatellite stable,and 5 cases were proficient mismatch repair/MSI-H.There was a moderate agree-ment between dMMR and MSI-H(Kappa=0.575).Conclusion KRAS,NRAS,BRAF,HER2 and MSI sta-tus are associated with clinicopathological features in patients with colorectal cancer.Combined detection of KRAS,NRAS,BRAF,HER2 and MSI can provide more accurate and effective data to guide the treatment and prognosis of patients.