Objective To explore the relationship between subclinical hypercortisolism (SH) and osteoprosis.Methods MEDLINE,BIOSIS Previews,High Wire Wanfang Database,and Vip Database were retrieved for articles about the relations of SH and osteoporosis.Searches were limited to Chinese/English-language publications.The clinical outcomes evaluated in this study included bone mineral density,biochemical markers of bone turnover,prevalence of osteoporosis,and incidence of fracture.Meta-analysis was carried out by RevMan5 among articles suitable for the inclusion and exclusion criteria.Results Fifteen studies were included,containing 6retrospective studies,6 prospective studies,and 3 intervention studies.Retrospective studies suggested that bone mineral density level in subclinical hypercortisolism group (SH + group) was significantly lower than that in the nonsubclinical hypercortisolism group (SH-group),meta-analysis of prospective studies showed that the level of bone mineral density at lumbar spine and femoral neck was significantly lower in SH+ group than that in the SH-group(all P＜0.01).Both retrospective studies and prospective studies showed no significant difference between the biochemical markers of bone turnover in both SH+ and SH-groups.Data from intervention studies showed that the prognosis in SH patients with surgical intervention was not improved.Conclusions SH reduces bone mineral density at lumbar spine and femoral neck,and increases the prevalence of osteoporosis and incidence of fracture.Whether surgical intervention is beneficial in SH patients remains uncertain.

OBJECTIVE To survey the Escherichia coli infection in our hospital in the field of flora distribution,structure and status quo resistance in order to guide the rational use of antibiotics.METHODS From Nov 2005 to Dec 2006 247 E.coli strains were isolated from 2940 samples with conventional method identification,K-B method was used for bacterial susceptibility,and resistance test.RESULTS The top six susceptible antibiotics were cefoperazone/sulbactam(86.84%),nitrofurantoin(55.56%),chloramphenicol(43.25%),amikacin(40.43%),ceftriaxone(27.41%),and cefoperazone(27.16%).The top six resistant antibiotics were sulfamethoxazole/trimethoprim Co-trimoxazole(93.33%),ampicillin(93.18%),amoxicillin(92.00%),cefalotin(86.67%),cefradine(85.03%),and cefuroxime(81.25%).CONCLUSIONS Strengthening antibacterial drug sensitivity test,and conduct ing timely the effective treatment and corresponding measures could guide the clinician to provide a reasonable use of antibiotics.

OBJECTIVE To give details of the resistance of Staphylococcus aureus infection to various types of drugs.METHODS The laboratory data of resistant S.aureus from Nov 2005 to Dec 2006 were investigated and analyzed and compared the results to the standard sample.RESULTS The sequence of the antibacterial agents resistant to the S.aureus in decreasing order was azithromycin(91.66%),penicillin(88.57%),ceftazidime(87.50%) and amoxicillin(73.53%) with the age distribution of the sufferers from 31-40 years old. It was found 23.86% patients(42 samples) had the positive rate in prostatic fluid of 32.95%.CONCLUSIONS Based on the patient conditions,provide the appropriate drug treatment would avoid the occurrence of resistant S.aureus.

BACKGROUND: At present, the researches on murine model of acute radiation encephalopathy are still in investigation, and mature model making method is not clear.OBJECTIVE: To establish a murine model of acute radiation encephalopathy in order to provide a good foundation for further researches of radiation encephalopathy(REP) mechanism and therapy.DESIGN: Randomized controlled study based on the experimental animals.SETTING: Animal laboratory in a university hospital. The Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: The experiment was completed in the Laboratory of the Second Affiliated Hospital of Sun Yat-sen University from June 2001 to August 2002. Totally 30 female and 30 male SD rats, weighted(300 ± 30) g, were selected from the Animal Experiment Center of Sun Yat-sen University, and randomly divided into blank control group with 20 rats and experimental group with 40 rats.METHODS: Fourty rats' brain received 60Co γ-ray irradiation with the dosage of 7 Gy/time per day for 6 consecutive days with the total dosage of 42 Gy. The amount of ingestion and drinking, general activities, central nervous system(CNS) symptoms and signs were recorded every day. The hairs and skin of irradiated field and weight were checked and recorded weekly. On the 3rd, 7th, 14th, 30th days after radiation, the brain tissue was collected and the histopathologic changes were examined.Histopathologic changes after radiation.RESULTS: Since the third day, the ingestion and drinking amount of irradiated rats were decreased. The general activities were increased for the first two days, but decreased without abnormal nervous signs on the 3rd day. The rats in experimental group had a slower weight gain than those of control group, and the difference between them was of no statistical significance. All rats had slight alopecia and neuronal necrosis 2 weeks after irradiation.CONCLUSION: The irradiation method is reliable, practical and good for modeling REP process, which can be used in preventing or reducing the harm effect of radiation therapy on brain tissue.

Objective To investigate the protective effects of intra-peritoneal fluid resuscitation on small intestinal mucosa in rats with hemorrhagic shock. Method Fifty Sprague-Dawley (SD) rats were randomly (random number) divided into five groups, namely sham operation group (group I ), hemorrhagic shock group (group Ⅱ ), intra-venous fluid resuscitation group (group Ⅲ ) . intravenous fluid resuscitation plus intra-peritoneal saline resuscitation (group Ⅳ ) and intravenous fluid resuscitation plus intra-peritoneal PD-2 solution resuscitation group (group Ⅴ ). The rats of 5 groups were processed with cannulations of right common carotid artery, right femoral vein and left femoral artery with systemic heparinization. The rat models of hemorrhagic shock were established with modified Wigger' s method by which the blood exsanguinated from left femoral artery. The rats of group Ⅲ were resuscitated with shed blood plus twice equal volume of Ringer's solution after modeling of hemorrhagic shock.The rats of group Ⅳ and group Ⅴ were administered intra-peritoneally with 30 mL saline and 30 mL of 2.5% PD-2 solution, respectively as adjuncts to those used in the group Ⅲ . The specimens of blood and small intestine of rats of all groups were collected 60-120 minutes after modeling and resuscitation. The activity of plasma diamine oxidase (DAO) was determined with chromatometry, the level of plasma D-lactic acid (D-LA) with spectorophotometry and the level of plasma lipopolysaccharide (LPS) with nephelometry. The histopathological and ultrastructure changes of small intestine tissue of rats were observed under light microscope and electronic microscope. Results There were remarkable differences in activity of DAO, and the levels of D-LA and IPS in rats between those ingroup Ⅱ and group I (P <0.01), and between those in group V and groups Ⅱ , Ⅲ or Ⅳ (P <0.05 or P < 0.01) The pathomorphology and ultra-structure of small intestine tissues were severely damaged in group Ⅱ compared with those in group Ⅰ , and those markedly lessened in group V compared with groups Ⅱ , Ⅲ and Ⅳ . Conclusions Intraperitoneal fluid resuscitation with PD-2 solution can significantly protect the integrity of intestinal mucosa and the normal permeability of intestinal wall, and blunts the histopathological changes, and restrains bacterial translocation from gut and reduces the level of plasma endotoxin.

Objective:To study the effects of cryptotanshinone on proliferation and apoptosis of human bladder carcinoma J82 cells in vitro and its mechanisms.Methods:The J82 cells were treated with cryptotanshinone of different concentrations including 0, 0.5, 1.0, 2.0, 3.0, 4.0, 5.0 and 8.0 μmol/L.After 48-hour treatment, the proliferation of J82 cells was determined by CCK-8 assay method.Flow cytometric analysis with Annexin V-FITC/PI staining was used to evaluate the apoptosis of J82 cells, and Western blotting was adopted to observe the protein expressions of p65, caspase-3, caspase-8 and caspase-9 related to proliferation and apoptosis.Results:CCK-8 results showed that the A values of 450nm-wavelength were as following: the control group (1.77±0.06), 0.5μmol/L group (1.78±0.08), 1.0μmol/L group (1.64±0.05), 2.0μmol/L group (1.48±0.12), 3.0μmol/L group (1.20±0.07), 4.0μmol/L group (0.93±0.10), 5.0μmol/L group (0.76±0.02), 8.0μmol/L group (0.05±0.01), and the A values were significantly different among the three groups ( F=329.83, P=0.00), there were statistically significant differences between any two groups except the 0.5 μmol/L group(all P<0.05). The early and total apoptosis rates were both significantly different among the three groups ( F=32.49, P=0.00; F=6.39; P=0.03), the early apoptosis rates of 3.0, 1.0μmol/L group were higher than that of the control group(all P<0.05), and the early apoptosis rate in the 3.0 μmol/L group was higher than that in the 1.0μmol/L group[(11.83±1.12)% vs.(7.01±1.84)%, t=3.73, P<0.05]. The expression of p65 protein decreased, while both the expressions of caspase-3 and caspase-9 proteins increased after treatment with cryptotanshinone. Conclusion:Cryptotanshinone can significantly inhibit proliferation and induce apoptosis of human bladder carcinoma J82 cells in vitro, probably via suppressing NF-κB signal pathway and activating mitochondrial pathway, respectively.

Objective:To summarize the application of phage therapy in patients with urinary tract complicated pandrug-resistant Klebsiella pneumoniae infection, and analyze its feasibility and effectiveness.Methods:To retrospectively analyze the clinical data of a patient with complicated urinary tract complex pan-resistant Klebsiella pneumoniae treated by phage from August to September, 2019 in Shanghai Public Health Clinical Center. The female patient, 65 years old, was admitted to the hospital on August 6, 2020. The patient repeated with frequent micturition and urgent micturition half a year before admission. These symptoms were not accompanied by back pain, fever, chills, dysuria, gross hematuria. Urinary culture results in outpatient hospital was pan-resistant Klebsiella pneumoniae. After the patient discontinued application of cefoperazone sulbactam, levofloxacin and other drugs, symptoms such as frequent urination could be relieved after treatment, but appeared repeatedly. In August 2019, the center innovatively applied phage therapy to treat this patient with urinary tract pandrug-resistant bacteria infection.Results:For the first time, we applied 117, 135, 178, GD168 phage mixed solution once a day, for 5 days of continuous bladder infusion. At the same time, meropenem and amikacin was intravenous administration to strengthened the anti-infection treatment. Urine culture was negative for two consecutive times after treatment. However, half a month after the end of the bladder infusion, the patient experienced discomfort such as frequent urination. Urine culture: pan-resistant Klebsiella pneumoniae. The second time, we applied a mixture of three phage strains 130, 131, 909, once a day, for 5 days of continuous bladder infusion. And in the afternoon of the third day of treatment, the renal pelvis was retrogradely intubated and perfused with the above three strains of phage mixture. During the second treatment follow-up until March 30, 2020, the patient's urine culture was reviewed once a month. As a result, no pan-resistant Klebsiella pneumoniae was found, and the patient no longer experienced frequent urination and other symptoms of urination. The treatment process was successful and without severe complications and side effects.Conclusions:Phage urinary tract perfusion is an effective method for the treatment of pan-resistant Klebsiella pneumoniae urinary tract infections. The curative effect is accurate and reliable. The patient did not show obvious complications and adverse reactions during treatment. It can be used as an alternative treatment plan for complex pan-resistant Klebsiella pneumoniae infection.

Objective To study the effects of vagus nerve stimulation (VNS) on brain tissue tumor necrosis factor-α (TNF-o),interleukin-1β (IL-1β) and IL-10 levels in serum and brain tissues after blast brain injury in rabbits.Methods Twenty New Zealand white male rabbits were randomly divided into sham-operated group (n=6),traumatic brain injury (TBI) group (n=10),TBI+VNS group (n=8).Rabbit brain blast injury models of TBI group and TBI+VNS group were established; and the right cervical vagus nerves of the rabbits in TBI+VNS group were stimulated (10 V,5 HZ,5 ms,20 min).The TNF-α,IL-1β and IL-10 changes in the serum (6 h after injury) and brain tissues (24 h after injury) and the water content in the injured brain tissues were observed and recorded.Results The TNF-α and IL-1β levels in the serum and brain tissues,the water content in the brain tissues of the TBI group were significantly higher than those in the sham-operated group and TBI+VNS group (P＜0.05); the IL-10 level in the TBI+VNS group was significantly higher than that in the sham-operated group and TBI group (P＜0.05).Conclusion VNS can reduce the brain edema degree by increasing the IL-10 level and decreasing the TNF-α and IL-1 β levels,which plays a key role in brain protection effect after brain blast injury in rabbits.

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.