Objective To investigate the effect of pantoprazole (proton pump inhibitor, PPI) and gefarnate (gastric mucosa protectant) on the prevention of upper gastrointestinal bleeding in patients undergoing post-percutaneous coronary intervention (PCI) dual anti-platelet therapy.Methods This research included 1263 patients taking enteric aspirin and clopidogrel after PCI.The cases were divided into 4 groups: routine treatment group (n=332), PPI group (n=318), gastric mucosa protectant group (n=299), and PPI+gastric mucosa protectant group (n=314).A follow-up for 6 months was observed including gastrointestinal symptoms, upper gastrointestinal bleeding, major adverse cardiac events (MACE), and adverse reactions.Results There were 52 cases of upper gastrointestinal bleeding within 6 months, including 21 cases from routine treatment group, 9 from PPI group, 15 from gastric mucosa protectant group, and 7 from PPI+gastric mucosa protectant group.The incidence of upper gastrointestinal bleeding among the 4 groups within 6 months was statistically different (X2=8.883, P=0.031).The routine treatment group had significant higher rate than the PPI group and the gastric mucosa protectant group (P<0.05), while among other groups there was no significant difference (P>0.05).The upper gastrointestinal bleeding occurred within 3 postoperative months in 34 out of 52 cases (65.4%).There was no statistical significance among the four groups in regard to bleeding occurrence time (X2=4.212,P=0.648).Conclusions Patients undergoing post-PCI dual anti-platelet treatment can reduce the incidence of gastrointestinal bleeding by taking pantoprazole or combined with gefarnate.Intervention against upper gastrointestinal bleeding should start on the first day after PCI and last for a minimum of 3-6 months.

【Objective】 To explore the complication and engra ftment of human cord blood hematopoietic stem cells in utero transplantation thr o ugh abdominal cavity of fetal rats , and to establish an animal model for clini cal application. 【Methods】　Human cord blood (MNC) cells were transplanted into th e abdominal cavity of fetal rats, the complications and the outcome of pregn ancy were observed. The condition of engraftment was detected by flow cytometr y and immunohistochemistry methods after the fetus were born. 【Results】 Huma n CD3 cells were detected in rats and the engraftment rate was 64%. At 1 and 2 months of age, the mean value of human CD3 cells were 0.28%±0.05% and 0.41 %± 0.05% respectively （P＜0.05）.Human CD3 、CD20及 CD+34 ce lls were also detected in liver、spleen and thymus of rats at 2 months of age. The i ncidence of complication was significantly different between transplanted grou p and non-transplanted group. 【Conclusion】　Human cord blood cells transfused into the abdominal cavity of fetal rats were engrafted . There were some complication s occurred during operations which affected the outcome of pregnancy.

OBJECTIVETo compare the efficacy between eccentric fixation and internal fixation for treatment of intertrochanteric fractures of femur,to provide a theoretical basis for the selection of the treatment method of the intertrochanteric fractures of femur.

METHODSFrom February 2007 to January 2010,82 patients with femoral intertrochanteric fracture were treated by internal fixation including 39 cases of eccentric fixation involving 23 males and 6 females, aged from 41 to 81 years old with an average of (62.68±10.69), using the DHS or proximal femoral locking plate; 43 cases of intramedullary fixation involving 15 males, 28 females,aged from 43 to 78 years old with an average of (62.60±8.37),using PFN or PFNA fixed. The surgical incision length, operative time, blood loss and postoperative Harris score between two groups were compared.

RESULTSThe wound of two groups were primary healing without operative complications. All cases received follow-up for an average time of 18.3 months (12 to 28 months). The incision length, operative time and blood loss had a statistically significant difference between two groups (P<0.05). Harris scores of hip joint function at 1 month after operation had statistically significant difference between two groups (P<0.05), and Harris scores at 12 months after operation had no statistical significance difference between two groups. The rate of excellent and good was 89.7% in eccentric fixation group and 90.7% in intramedullary fixation group,the difference was not statistically significant (t=0.0613, P>0.05). In eccentric fixation group, there was 1 case of fracture nonunion with DHS loose and ensuing hip varus deformity. In intramedullary nail fixation group, there was no anti-rotation out,distal intramedullary nail of femoral refracture occurred in 1 case.

CONCLUSIONTwo treatment methods for the treatment of femoral fractures had a good therapeutic effect,but the intramedullary fixation had shorter operative time and less blood loss than the eccentric fixation,it prior to apply to osteoporosis and unstable femoral intertrochanteric fractures.

Adult ; Aged ; Aged, 80 and over ; Female ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Operative Time

AIM:To investigate the mechanism responsible for albumin microbubbles adherence to activated leukocytes. METHODS: In vitro studies were performed in which activated or nonactivated leukocytes were incubated with albumin microbubbles and observed under microscopy. The suspensions of leukocytes and microbubbles which contained or absented of integrins were analyzed with flow cytometry.RESULTS: A minimum of 50 cells were identified under transillumination. 5 min after microbubbles were incubated with leukocytes, the number of cells interacting with microbubbles was greater for activated cells than for nonactivated cells(20 30?2 67 vs 4 50?1 43, P

Objective To assess the immune protective effect of donor spleen perfusion on the renal allografts in specific sensitized canine recipients.Methods Male dogs were operated as donors and recipients for kidney transplantation.Eighteen dogs were previously sensitized by a method of multi-infusion of small number of lymphocytes from a paired donor and were then randomly divided into 3 groups equally.In donor specific spleen perfusion group,the artery and vein of the excised do- nor canine spleen were connected to the abdominal aortic artery and inferior vena cava of the recipient with processed fistula tubes,perfused at a speed of 18-25 ml/min for 40 min and then kidney from the same donor was transplanted to the recipient;In non-specific spleen perfusion group,the methods of excised spleen perfusion and kidney transplantation were indifferent to the above group except for the organs which removed from a non-specific donor;In control group,kidney transplantations were per- formed after an exclusion time of 40 min in the open abdominal surgery.Cross-match between paired dogs monitored by means of complement dependent cytotoxicity(CDC)and mixed lymphocyte culture (MLC)test before and after donor spleen perfusion was investigated.Rejection episodes and serum creatinine level in each group were assessed after kidney transplantation.Results Immune sensitization was successfully induced in all 3 groups after 3 to 4 times of donor lymphocyte stimulations.CDC as well as lymphocytes proliferation in MLC and CH50 of recipients was significantly declined after spe- cific spleen perfusion,and white blood cell count in peripheral blood also decreased transiently.After kidney transplantation between the paired sensitized dogs,the advanced rate of renal allograft function deterioration was slower in specific spleen perfusion group than in other two groups.The pathologic investigation suggested that severity of rejection in spleen perfusion group was milder than in other two groups.Conclusions Donor spleen perfusion can present a specific absorption efficacy for pre- formed antibodies and activated lymphocytes in sensitized recipients,as well as simultaneously deplete part of platelets in peripheral blood.So donor spleen perfusion may delay the presenting time of rejec- tion in early phase after kidney transplantation between the paired sensitized dogs,ameliorate the se- verity of rejection so as to improve the renal allograft function.

Abstract: Objective To investigate the dynamic changes and clinical significance of specific antibodies in patients with coronavirus disease 2019 (COVID-19). Methods A retrospective study was conducted to collect 141 adult COVID-19 survivors who were followed up in the Eighth Hospital affiliated to Guangzhou Medical University from February 6, 2020, to March 24, 2021. The patients were divided into severe group (severe and critical) and non-severe group (light and ordinary) according to the diagnosis at discharge. The antibody changes of the two groups were compared and analyzed at 1 week, 2 weeks, 1 month, 3 months, 6 months and 1 year after discharge. Results After discharge from hospital, the positive rate of IgG in the severe group was 95.00% after 1 week and 100.00% in the following year, in the positive rate of IgG in the non-severe group was 59.50% after 1 week, 90.08% in 6 months and 76.03% in one year. The level of serum IgG in the severe group was significantly higher than that in non-severe group (Z=-2.441, P=0.015). One-year follow-up: the serum IgG in the severe group was significantly higher than that in the non-severe group (Z=-3.410, P=0.001). The serum IgM level of the severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant (Z=-2.259, P=0.024). The serum IgG and IgM level of the non-severe group after one year follow-up was lower than that of the six months follow-up, the difference was statistically significant (Z=-7.37, P<0.01; Z=3.850, P<0.01). Conclusion The level of serum protective antibody in COVID-19 patients remained high within 6 months after discharge, and remained stable within 1 year after discharge. The antibody titers in the severe group were significantly higher than those in the non-severe group and lasted for at least one year. COVID-19 survivors receive 1 year of natural immune protection, and patients with critical conditions receive immunity for longer periods of time.

Objective To investigate the value of high-dose dobutamine stress echocardiography combined with two-dimensional strain imaging in early diagnosis of coronary artery disease. Methods Highdose dobutamine stress echocardiography was performed to 28 patients with suspected coronary artery disease. All wall movements were observed during resting condition and at all stress levels,respectively;the peak systolic longitudinal strain in each endomyocardial segment of left ventricular was measured; the sensitivity and specificity between visual method and two-dimensional strain imaging in diagnosing myocardial ischemia with high-dose dobutamine stress echocardiography were compared. The average peak systolic longitudinal strain was calculated against control group, coronary artery disease group during ischemia segments and non-ischemia segments, and a comparison was made inside each group as well as against the other groups. The area under receiver operating characteristic curve of the peak systolic longitudinal strain was used to predict the sensitivity and the specificity of myocardial ischemia. Results With dobutamine dose of 40 μg·kg-1 · min-1 ,wall motion abnormalities were diagnosed in 6 patients (20 segments) through visual method, myocardial ischemia was found in 15 patients (148 segments) through computing the peak systolic longitudinal strain. Inside the coronary artery disease group during ischemic　segments,the majority of peak systolic longitudinal strain was significantly reduced ( P＜0.05) compared to the non-ischemic segments and the control group. In diagnosing myocardial ischemia in high-dose dobutamine stress echocardiography, the sensitivity of visual method and two-dimensional strain imaging were 35.3％ and 88.2％(P＜0.01), specificity 100％ and 100％(P＞0.05), and accuracy 60.7％ and 92.8％ (P＜0.01). The cutoff value of the peak systolic longitudinal strain was less than or equal to 14.9％, its sensitivity and specificity in predicting myocardial ischemia were 83.3％ and 91.7％,respectively. Conclusions High-dose dobutamine stress echocardiography combined with two-dimensional strain imaging can increase the sensitivity of detecting myocardial ischemia and detect concealed myocardial ischemia. High-dose dobutamine stress echocardiography combined with two-dimensional strain imaging can be used in early diagnosis of coronary artery disease.

Objective To express and purify the recombinant UL7 protein of herpes simplex virus 1 (HSV-1), to prepare the corresponding UL7-specific polyclonal antibody and to preliminarily analyze the expression of UL7 protein during the proliferation of HSV-1. Methods The UL7 gene was amplified by PCR and then cloned into the pGEX-5X-1 vector for expression of UL7 protein in the prokaryotic expression system. The constructed expression plasmid, pGEX-5X-1-UL7, was transformed into E. coli BL21 (DE3) to induce the expression of UL7 protein by IPTG. The purified GST-UL7 fusion protein was used as antigen to inject the ICR mouse for the preparation of polyclonal antibody specific for UL7 protein. The titer and speci-ficity of the polyclonal antibody were analyzed by using indirect ELISA and Western blot assay, respectively. The UL7 protein-specific polyclonal antibody was used to detect the expression of UL7 protein at different time points after infecting Vero cells with HSV-1. Results The GST-UL7 fusion protein was efficiently ex-pressed in E. coli BL21 (DE3). The UL7 protein-specific polyclonal antibody was prepared with high titer (1 ∶ 105) and high specificity as indicated by the indirect ELISA and Western blot assay. The expression of UL7 protein was detected at different time points after infecting Vero cells with HSV-1. Conclusion The GST-UL7 fusion protein was obtained successfully and the UL7 protein-specific polyclonal antibody was pre-pared. Accompany with the proliferation of HSV-1, the expression of UL7 protein was detected at different time points by using the polyclonal antibody.

Objective To analyze the main clinical features of human infection with H7N9 avian influenza complicated by acute respiratory distress syndrome (ARDS).Methods A retrospective analysis of complete clinical data of 9 cases of human infection with H7N9 avian influenza complicated by ARDS admitted from March 2013 to December 2014 admitted to Department of Critical Care Medicine of the Affiliated Drum Tower Hospital of Nanjing University Medical School was conducted.Results Nine patients' mean age was (46.3±12.3) years, male accounting for 66.7% (6/9). The main clinical features: ① In the duration of acute phase, high fever, cough, hemoptysis sputum, reduction of white blood cell count (WBC) and platelet count (PLT), and myocardial enzyme elevation were the features of the disease. Chest CT showed pulmonary consolidation and ground-glass like shadows. ② On admission, all their oxygenation indexes (PaO2/FiO2) were less than 200 mmHg (1 mmHg = 0.133 kPa) of which 66.7% (6/9) was less than 100 mmHg, mean (98.9±62.8) mmHg; 55.6% (5/9) required invasive mechanical ventilatory support; 77.8% (7/9) combined with shock, and hemodynamic monitoring showed peripheral vascular resistance was decreased. ③ There were secondary bloodstream infection in 5 cases and lung infection in 4 cases, accounting for 77.8% (7/9). ④ In 22.2% (2/9) patients, the virus relapsed after the anti-virus therapy was stopped for 7 days, then immediately antiviral treatment was used again, it was still effective.Conclusion Human infection with H7N9 avian influenza complicated by ARDS has typical clinical symptoms, laboratory tests and imaging features, often associated with distributive shock, and at the late stage, secondary pulmonary or blood infection and the virus resurgence may occur.

To investigate the relationship among serum vascular endothelial cells(VE) -cadherin, advanced glycation end-products( AGE), and atherosclerotic lesion. 20 healthy subjects and 60 patients with diabetes mellitus,including 30 patients with carotid atherosclerosis (CI), were enrolled.Soluble VE-cadherin and AGE were determined using the enzyme-linked immunosorbent method (ELISA). The relationships among the concentration of soluble VE-cadherin, AGE, and the course of the disease, blood glucose, and blood lipid levels were analyzed with multivariant stepwise regression analysis. The levels of serum VE-cadherin and AGE in the patients with diabetes and CI were higher than those in control group( P＜0. 05 ). There was a significant difference in VE-cadherin between the diabetes group and the CI group( P＜0. 05 ). Serum VE-cadherin levels were positively correlated with serum AGE levels(r = 0. 69, P＜0. 01 ). AGE levels were positively correlated with the diabetes duration ( r = 0. 31, P =0. 02 ). The levels of serum VE-cadherin in diabetic patients are positively correlated with their serum AGE levels. The VE-cadherin seems to play an important role in the development of atherosclerosis caused by AGE.