Objective The practical evaluation of Rosco Disk Diffusion method on the clinical antifungal susceptibility test for yeast-like fungi. Methods The Fluconazole susceptibility test was detected by Rosco Disk Diffusion method and NCCLS M27-A broth macrodilution method with 76 yeast-like fungus strains isolated from clinical specimens. Three standard strains were used as the quality control. Results Coincidence rate of the two methods was 90.8%,The sensitive strains detected by one method didn't show resistance in another detection method, and the resistant strains detected by one method yet didn't show sensivity in another.Conclusion Rosco disk diffusion method can be used in clinical detection instead of NCCLS M27-A broth macrodilution method.

Objective To evaluate the safety and efficacy of two surgical procedures including retropubic space pathway and obturator foramen pathway in treatment of the old women with stress urinary incontinence (SUI). Methods Intravaginal Slingplasty (IVS) procedure by retropubic space pathway was performed in 52 cases with simple SUI from June 2003 to June 2005. And the modified Transobturator Vaginal Tape Inside-Out (TVT-O) procedure was carried out in 112 cases with simple SUI from October 2005 to October 2008, using self-tailed polypropylene mesh and helical needles. The comparative retrospective study was performed between these two groups. Results The cure rate was 80.8% (42/52) and the improvement rate was 13.5% (7/52) in IVS group. And the corresponding data were 84.8% (95/112) and 11.6% (13/112) in modified TVT-O group. The 3 (5.8%) cases failed in IVS procedure and 4 (3.6%) cases failed in modified TVT-O procedure at 1 month's follow-up. All of the 7 patients received the 'Tong's hammock procedure' and no cases failed at 6 and 12 month's follow-up. One case of vaginal erosion was found in each group although good effect of continence was observed. Meshes were removed in these two patients and then the 'Tong's hommock procedure' was performed which turned out to be good outcome. Bladder injuries were found in 3 cases when route cystoscopy was performed. No significant difference in efficacy was found between these two groups(P＞0. 05). In modified TVT-O group, operative duration, blood loss and medical cost were significantly reduced as compared with IVS group (P＜0. 01). Conclusions Both of the two surgical procedures of modified TVT-O versus IVS are simple, safe and mini-invasive procedures with high efficacy. However, the modified TVT-O procedure is more easy to be adopted by patients due to short operative time and lower medical cost.

Objective To evaluate the efficacy and safety of modified total pelvic reconstruction for pelvic organ prolapse in elderly women.Methods 105 patients required operation for treatment of pelvic organ prolapse were enrolled in this study.Patients were divided into experimental group (n =68,treated with the modified total pelvic reconstruction) and control group (n=37,receiving prolift procedure).Objective indexes including bleeding volume,operative time,residual urine volume,postoperative complications,medical expenses,hospitalization time were recorded.Clinical efficacy and follow-up results were recorded and compared between the two groups at 6 months after operation.Results Bleeding volume and hospitalization costs were lower in experimental group than in control group (both P＜0.05),while the operative time,residual urine volume,time out of bed,anal exhaust time,the maximum body temperature,mean postoperative hospital stay showed no significant differences between the two groups (all P＞0.05).Vaginal perforation was observed in 7 cases,with 4 cases in experimental group and 3 cases in control group.No serious complications such as bladder and rectum perforation were observed.According to pelvic organ prolapse quantitation (POP-Q) score,64 cases (94.1％) were cured and 4 cases (5.9％) were invalid in experimental group,while 36 cases (97.3％) were cured and 1 case (2.7％) was invalid in control group.The noninferiority test showed that clinical efficacy in experimental group was non-inferior to that in control group (u=2.252,P＜0.05).Conclusions Modified total pelvic reconstruction is an effective and safe minimally invasive surgery,which is similar to prolift surgical operation,but it is relatively inexpensive,which is easier to be accepted by Chinese patients,with a great perspective in clinical application.

Objective To discuss the treatment efficacy and radiotherapy side effects of the preoperative long-course radiochemotherapy and preoperative short-course radiotherapy.Methods 64 patients with local advanced middle and low rectal cancer who got the treatment from April 2004 to April 2010 were analyzed retrospectively.40 patients got the preoperative long-course radiochemotherapy under the dose of DT 45-50 Gy/25 F,1.8-2.0 Gy/F,5 F/W,combining with the synchronous capecitabine chemotherapy (1 650 mg/m2,2 F/d,d1-14/d21-35),and accepted operation 4-6 weeks after the radiotherapy.The rest 24 patients underwent the preoperative short-course radiotherapy under the dose of DT 25 Gy/5 F,5 Gy/F,5 F/W,and got the operation in 2 weeks after the radiotherapy.Results The radical and anus reservation rates in preoperative long-course radiochemotherapy group [85.0 ％ (34/40),65.0 ％ (26/40)] were higher than those in preoperative short-course radiotherapy group [58.3 ％ (14/24),33.3 ％ (8/24)] (x2 =5.689,P =0.019;x2 =6.040,P =0.041).There were no significant differences between the two groups on the index of remission rates,radiation injury,surgical complications,and overall survival rate of 1,3,5 years (all P ＞ 0.05).Conclusions The remission rate and overall survival time between the preoperative long-course radiochemotherapy group and preoperative short-course radiotherapy have no significant difference.But the preoperative long-course radiochemotherapy may improve the anus reservation rate and the radical resection rate,without increasing the radiation injury and surgical complications.

BACKGROUNDTo observe the protective effect of hepatitis E virus (HEV) ORF2 recombinant protein expressed in prokaryote cell cynomolgus macaques (cynos) against challenging with wild-type HEV.

METHODSCynos were immunized with HEV ORF2 recombinant protein and then challenged with wild-type HEV, the unimmunized cynos were used as control. Blood samples were collected and tested to see if there were dynamic changes of ALT and antibody to HEV before and after challenge with wild-type HEV.

RESULTSAll the five unimmunized cynos re-presented hepatitis 3 weeks after challenging with wild-type HEV. However, all the five immunized cynos showed no hepatitis and pathological changes.

CONCLUSIONSCynos can be efficiently protected by immunization with HEV ORF2 recombinant protein against wild-type HEV. This protein can be a promising candidate for HEV vaccine.

Animals ; Female ; Hepatitis Antibodies ; blood ; Hepatitis E ; immunology ; prevention & control ; Hepatitis E virus ; immunology ; Macaca mulatta ; Male ; Recombinant Proteins ; immunology ; Viral Proteins ; immunology

Objective:To investigate the risk factors associated with lymph node posterior to right recurrent laryngeal nerve (LN-prRLN) metastasis in papillary thyroid carcinoma (PTC) , and analyze the clinical value of surgical dissection of LN-prRLN.Methods:Clinical data of 140 PTC patients admitted to the same treatment group from Jun. 2014 to Oct. 2015 (all patients underwent LN-prRLN area dissection, group A) were retrospectively analyzed. Univariate analysis and multivariate logistic regression analysis were used to analyze high-risk factors for LN- prRLN metastasis, and another 171 cases without LN-prRLN area dissection (group B) were collected as the control group. The total number of lymph nodes dissected in the central area on the right was compared to analyze the proportion of lymph nodes in the LN-prRLN area.Results:Of the 140 patients in group A, the right cervical lymph node metastasis rate was 64.3% (90/140) , the central zone lymph node metastasis rate was 63.6% (89/140) , and the LN-prRLN regional lymph node metastasis rate was 17.9% (25/140) . Univariate analysis showed that tumors>1 cm, multiple tumors, capsule invasion, clinical lymph node staging cN1,VI-1 and cervical lymph node metastasis were correlated with LN-prRLN metastasis ( P<0.05) . Multivariate analysis showed that capsule invasion ( OR=4.599, P=0.037) and cervical lymph node metastasis ( OR=3.505, P=0.036) were risk factors for LN-prRLN metastasis. By comparison with the control group, the total number of lymph node dissections in the right central area of group B was significantly less than that of group A ( P<0.01) . Conclusions:PTC patients have a high rate of lymph node metastasis in the right central area, and lymph nodes in the LN-prRLN area occupy a certain proportion. RN-prRLN should be routinely cleaned to ensure the completeness and thoroughness of the dissection, and to minimize the possibility of performing a second operation due to recurrence of residual lymph nodes after operation. More importance should be attached to LN-prRLN dissection when the tumor is more than 1 cm, the tumor is multiple, the capsule is invaded, in clinical lymph node stage cN1, VI-1 and with cervical lymph node metastasis.

Present study aimed to investigate the eff ect of curcumin-pretreatment on intestinal I/R injury and on intestinal mucosa barrier. Thirty Wistar rats were randomly divided into: sham, I/R, and curcumin groups (n=10). Animals in curcumin group were pretreated with curcumin by gastric gavage (200 mg/kg) for 2 days before I/R. Small intestine tissues were prepared for Haematoxylin & Eosin (H&E) staining. Serum diamine oxidase (DAO) and tumor necrosis factor (TNF)-alpha levels were measured. Expression of intestinal TNF-alpha and tight junction protein (ZO-1) proteins was detected by Western blot and/or immunohistochemistry. Serum DAO level and serum and intestinal TNF-alpha leves were signifi cantly increased after I/R, and the values were markedly reduced by curcumin pretreatment although still higher than that of sham group (p<0.05 or p<0.001). H&E staining showed the significant injury to intestinal mucosa following I/R, and curcumin pretreatment signifi cantly improved the histological structure of intestinal mucosa. I/R insult also induced significantly down-regulated expression of ZO-1, and the eff ect was dramatically attenuated by curcumin-pretreatment. Curcumin may protect the intestine from I/R injury through restoration of the epithelial structure, promotion of the recovery of intestinal permeability, as well as enhancement of ZO-1 protein expression, and this eff ect may be partly attributed to the TNF-alpha related pathway.
Amine Oxidase (Copper-Containing) ; Animals ; Blotting, Western ; Curcumin* ; Eosine Yellowish-(YS) ; Immunohistochemistry ; Intestinal Mucosa ; Intestine, Small ; Intestines ; Permeability ; Rats, Wistar ; Reperfusion Injury* ; Tight Junctions* ; Tumor Necrosis Factor-alpha* ; Zonula Occludens-1 Protein*

Objective:To investigate the patterns and risk factors of central lymph node metastasis in node-negative neck (cN0) papillary thyroid carcinoma located in the isthmus. To discuss different operation methods and the postoperative complications to find out the appropriate surgical approach and scope.Methods:Forty-eight patients with cN0 papillary thyroid carcinoma located in isthmus for surgery at the First Hospital of Chongqing Medical University from Jan. 2013 to Dec. 2019 were reviewed retrospectively. They were divided into two groups: the lymph node metastatic group and the lymph node non-metastatic group. The metastatic lymph node group was further divided into the group with the number of lymph node metastasis ≤5 and the lymph node metastasis > 5. The clinical features, including gender, age, number and size of tumor, extrathyroidal extension, and whether combined with Hashimoto’s thyroiditis, the incidence of central lymph node metastasis and related factors, the scope of surgery, postoperative complications and recurrence were analyzed. SPSS 21.0 statistical software was used for statistical analysis, t test was used for measurement data, and χ2 test was used for counting data. Results:Among 48 patients, 27 had lymph node metastasis, with a metastatic rate of 56.25% (27/48) . Lymph node metastasis in pretracheal, prelaryngeal, left and right paratracheal lymph node was present in 47.9%, 22.9%, 20.8% and 16.7% of the patients respectively. The proportion and risk of lymph node metastasis were significantly increased in patients with tumor size>1 cm ( P=0.014, OR=6.78, 95% CI:1.59-28.95) . In patients with the number of lymph node metastasis > 5, the incidence of tumor size > 1 cm, prelaryngeal, left and right paratracheal lymph node metastasis was significantly higher than that of patients with lymph node metastasis ≤5 ( P=0.008, P=0.033, P=0.025, P=0.027) . There was a higher proportion of pretracheal or prelaryngeal lymph node metastasis in patients with left paratracheal lymph node metastasis ( ( P=0.008, P=0.007) . Multivariate analyses of risk factors associated with paratracheal lymph node metastasis indicated that the paratracheal lymph node metastasis correlated with the metastasis of pretracheal and (or) prelaryngeal lymph node ( P=0.016, OR=5.92, 95% CI:1.39-25.3) . In 48 patients with cN0 isthmic PTC, 43 cases underwent total thyroidectomy plus bilateral central lymph node dissection, and 5 patients reseived extended isthmus resection plus prelaryngeal and pretracheal lymph node dissection. 21 (41.8%) patients in total thyroidectomy group had PTH reduction, which was a transient hypoparathyroidism. 48 patients were followed up for 1-6 years without recurrence or metastasis. Conclusions:cN0 isthmic papillary thyroid carcinoma has a high incidence of central lymph node metastasis. Pretracheal and prelaryngeal lymph node are the most common metastatic location. For patients with tumor size>1 cm, a total thyroidectomy plus bilateral prophylactic central lymphadenectomy is needed. However, for patients without capsular invasion, tumor size≤1 cm, without pretracheal and prelaryngeal lymph node metastasis confirmed by intraoperative fast-frozen pathology, extended isthmus resection plus prophylactic pretracheal and prelaryngeal lymphadenectomy can be selected for reducing the complications of operation.

OBJECTIVETo study the effects of the ingredients from Chinese herbs with the nature of cold or hot on the expression of TRPV1 and TRPM8.

METHODThe effects of ingredients from herbs on primary culture DRG neurons are observed in vitro. The expression quantity of gene is detected by the method of real time PCR. the 2 (-deltadeltaCT) method is applied to analyze the data.

RESULTIngredients from herbs with the nature of cold up-regulate the expression level of TRPV1 and down-regulate that of TRPM8, especially under the temperature condition of 39 degrees C; while ingredients from herbs with the nature of hot up-regulate the expression level of TRPM8 and down-regulated that of TRPV1, which is more significant under the temperature condition of 19 degrees C.

CONCLUSIONThe regulatory changes of TRPV1 and TRPM8 mRNA expression induced by the chemical ingredients might be related to the cold and hot natures of the herbs from which the ingredients are extracted. And this could be one of the therapeutic mechanisms for the treatment of Chinese herbal medicines to cold- and heat-related diseases.

Animals ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; Gene Expression ; drug effects ; Male ; Rats ; Rats, Sprague-Dawley ; TRPM Cation Channels ; genetics ; metabolism ; TRPV Cation Channels ; genetics ; metabolism

Objective To explore the effect of supplemental parenteral nutrition (SPN) combined with early enteral nutrition (EN) for enhanced recovery in postoperative liver cancer patients.Methods From June 2015 to June 2018,liver cancer patients admitted to our hospital were randomly divided into two groups with 47 patients receiving SPN combined with early EN in the study group and 45 patients receiving early EN in the control group.Results There were no significant difference in bilirubin recovery,liver enzyme recovery,postoperative exhaust and defecation time and complication rate between the two groups (P ＞ 0.05).In study group prealbumin (PAB) synthesis recovered faster (F =7.89,P =0.006),albumin use was significantly lower (t =-2.29,P =0.0024),and postoperative hospital stay was shorter (t =2.46,P =0.016).Conclusion In ERAS patients with liver cancer,the combination of SPN and early EN provide reasonable energy support to improve nutritional status and accelerate patient recovery.