To determine the role of biopterin in acute lung injury in scald rats with infection, and to observe the therapeutic effect of GTP-cyclohydrolase I(GTP-CHI) inhibitor on postburn sepsis, 56 male Wistar rats were randomly divided into four groups: normal controls (n=10), scald control group(n=10), postburn sepsis group(n=20) and 2,4-diamino-6-hydroxy-pyrimidine (DAHP) treatment group (n=16). Tissue samples from lungs were collected to determine GTP-CHI and inducible nitric oxide synthase (iNOS) mRNA expression, meanwhile biopterin, nitric oxide (NO), tumor necrosis factor-?(TNF-?) and interferon-? (IFN-?) levels in lungs were also measured. The results showed that after scald injury followed by Staphylococcus aureus challenge, GTP-CHI gene expression and biopterin levels significantly elevated in lungs, so did the values of iNOS mRNA expression and NO induction (P

Objective To explore the feasibility and clinical efficacy of entirely mastoscopic axillary lymph node dissection for patients with breast cancer. Methods To analyze the clinical data and the procedure of the Breast cancer cases with entirely mastescopic axillary lymph node dissection. Results All the operations of those cases re-ceived entirely mastoseopic axillary lymph nodes dissection were successful, the average operating duration was 97min,and average of 5 ～ 14 lymph nodes were removed;2 cases had the positive lymph node. The procedure of those operations went well ,and there was no operation complication. After the operation the shoulder mobilization had unlim-ited, and no cancer cell was transplanted in operations holes. Conclusion Entirely mastoscopic axillary lymph node dissection can be carried out in grass-root hospitals and can be taken as one of the usual operation methods.

Objective To analyze the outcome in advanced age patients with obstruction of the left colonrectal cancer treated by intraoperative cavage method.Methods From 1998 and 2004,37 senile patients with acute obstruction for cancer underwent surgery.The patients were treated with intraoperative lavage,resection and primary anastomosis.Results All patients,no anastomotic leakage occurred.The patients got a well recovery post-operation.Conclusion One-stage emergency surgery for left obstructing colonic cancers is safe with the regard of intraoperative lavagation methods.

Objective To evaluate the effect of anterior minimally invasive plate osteosynthesis (MIPO) for treatment of middle humeral shaft fracture.Methods From November 2011 to March 2014,10 cases of middle humeral shaft fracture were treated using MIPO via the anterior approach (MIPO group).Another 26 cases treated by open reduction and internal fixation (ORIF) of the middle humeral shaft fracture between October 2010 and March 2014 were included as controls (ORIF group).Fracture fixation using the 4.5 mm locking compression plate (LCP) was performed in both groups.Parameter measurements included operative time,intraoperative fluoroscopy times,grafting rate,intraoperative blood loss,postoperative drainage,hospital stay,bone healing time and complications.Results MIPO and ORIF groups differed significantly with respect to intraoperative blood loss [(93.5 ± 25.6) ml vs (325.3 ± 158.3) ml],intraoperative fluoroscopy times [(13.2 ± 6.1) vs 4.0 (0-6.0)] and hospitalization [(11.9 ± 1.7)days vs (18.0 ±4.7)days] (P ＜0.05).Bone grafting and drainage were not performed in MIPO group,while bone grafting rate was 54％ and postoperative drainage volume was (120.4 ± 69.6) ml in ORIF group (P ＜0.05).MIPO and ORIF groups were comparable with respect to operative time [(79.0 ± 22.0) min vs (97.5 ± 30.8) min],bone healing time [(15.2 ± 2.5) weeks vs (18.2 ± 4.8)weeks] and postoperative complications (10％ vs23％) (P＞0.05).Conclusion Anterior MIPO is an effective procedure for treatment of middle humeral shaft fracture,with advantages of small trauma,less bleeding,low risk of nerve injury and high rate of fracture healing.

BACKGROUND:The non-specific immune suppression method is generaly used for treatment of systemic lupus erythematosus, but poor prognosis, such as infection and high recurrence rate, exists.
OBJECTIVE:To evaluate the therapeutic effect of bone marrow mesenchymal stem cel transplantation on systemic lupus erythematosus in mice.
METHODS:Sixteen mice with systemic lupus erythematosus were equivalently randomized into control and experimental groups, or then subjected to passage 3 bone marrow mesenchymal stem cel transplantation or the equal volume of normal saline via the tail vein, respectively. Mouse urine samples were colected to detect urine protein levels by Bradford method. Blood samples from the tip of the mouse tail were extracted to detect serum anti-ds-DNS antibody concentration by radioimmunoassay. Mouse kidney tissues were taken and observed pathohistologicaly through hematoxylin-eosin staining and immunohistochemistry staining under microscope. Flow cytometry was used to detect the expression of CD4+CD25+T cels in the inner canthus blood, fresh spleen and thymus.
RESULTS AND CONCLUSION:Within 10 weeks after cel transplantation, the urine protein levels in the two groups were gradualy increased, and the rising velocity was higher in the control group than in the experimental group. From the 4th to 10th week, the urine protein levels in the experimental group were significantly lower than those in the control group (P < 0.05). In the control group, lymphocyte infiltration was visible in the kidney tissues with a few of plasmocytes, and pathological findings showed the mice presented with interstitial nephritis; in the experimental group, the mice had no pathological changes in the kidney. In the two groups, immune complexes were found in the mesangial area, which showed a patch-like distribution in the control group and a punctate distribution in the experimental group; the relative proportion of the occupied area in the experimental group was significantly lower than that in the control group. The expression level of CD4+CD25+T cels in the blood and thymus were significantly higher in the experimental group than the control group (P < 0.05), and the expression level of CD4+CD25+T cels in the spleen was slightly higher in the experimental group than the control group with no significant difference (P > 0.05). The serum anti-ds-DNA antibody concentration in the experimental group was significantly lower than that in the control group (P < 0.05). Taken together, bone marrow mesenchymal stem cel transplantation can improve the pathological damage in systemic lupus erythematosus mice, and has a certain therapeutic effect on systemic lupus erythematosus.

Objective To study the theraputic effect of cyclophosphamide,glucocorticoid combined with sildenafil on pulmonary hypertension in systemic lupus erythematosus(SLE?PAH) patients,and to analyze the prognosis adverse factors. Methods Forty?six cases patients with SLE?PAH from Tangshan Gongren Hospital from January 2009 to January 2015 were selected as research subjects. All patients were treated with prednisone, cyclophosphamide and sildenafil,and the course of treatment was 24 weeks. The treatment effect was observed, the systemic lupus erythematosus disease activity score(SLEDAI),6 minutes walk distance and heart function before and after the treatment were compared. The effective and uneffective patients'clinical and test information were compared,and the prognosis adverse factors were analyzed. Results After 24 weeks treatment,the total ef?fective rate was 78. 3%(36/46). Pulmonary artery systolic pressure(PASP) dropped from (59±16) mmHg be?fore treatment to (45±15) mmHg after treatment,there was significant statistical difference(t=-4. 539,P<0. 01). SLEDAI dropped from (6. 6±2. 3) points to (2. 4±0. 8) points,,there was significant statistical differ?ence(t =11. 680,P<0. 01). The 6 minutes walk distance rose form (402±96) minutes to (465±97) minutes, there was significant statistical difference( t=-3. 137,P<0. 01) . Cardiac function improved significantly,there was significant statistical difference( P<0. 01) . There were 10 cases uneffective and deterirated patients,with the age of (42±6) years,36 cases effective patients with the age of (33±4) years,the difference was statistically significant( t=-5. 423, P<0. 01 ) . Uneffective and deterirated patients' anti?RNP antibody positive rate was 90. 9%( 9/10 ) , significantly higher than the effective patients ( 52. 8%( 19/36 ) ,χ2 = 4. 552, P<0. 01 ) . Conclusion Cyclophosphamide, glucocorticoid combined with sildenafil has obvious effect on patients with SLE?PAH. PASP,heart function and 6 minutes walk distance are the important indicators of prognosis. Anti?RNP antibody and age are the adverse prognostic factors.

Objective To assess the clinical efficacy of a modified complete retroperitoneal laparoscopic nephroureterectomy via 3 port approach.Methods From August 2013 to February 2016,23 patients with complete retroperitoneal laparoscopic renal and ureteral sleeve resection were treated with modified three port approach,including 15 males and 8 females.The average age was 67 years old (ranging 44-83 years old).All patients had complained about the hematuria before operation and urine exfoliated cells showed moderate to severe nuclear atypia.All patients accepted the abdominal CT and urography CTU examination,pre-operatively.All of them was diagnosed localized upper urinary tract malignant tumors based on those images,including 13 cases in the pelvis,and 10 cases in the upper segment of the ureter.No chemotherapy,radiotherapy or immunotherapy was performed before surgery.No patients have the history of severe basic disease or upper urinary procedure.The operations were performed under general anesthesia,patients take the contralateral back 30 degrees slope,low elevation head foot,waist bridge,side waist stretch.In the anterior superior iliac spine perpendicular to the line 2 cm parallel to the lower intersection of the rib border were disposed into the 12 mm trocar.Above the anterior superior iliac spine two cross finger level with the intersection of the anterior axillary node,we placed into the 10 mm trocar placement lens.Laparoscopic placement of third casing form an isosceles triangle with the first two casing.The renal fascia was incised with an ultrasonic knife from the renal dorsal side,and the renal hilum was isolated from the kidney by suction aspirator.The renal artery and vein were separated and closed by hem-o-lok.Along the psoas muscle surface to ureter,ureteral clipping by hem-o-lok but not to cut off the free distal ureteral,the lens is composed of first casing into,using ultrasonic knife to free ureter to the bladder wall segment,with 30 mm endoscopic stapler ureter and bladder wall cut off part.Operation time,blood loss and postoperative recovery were recorded in 23 cases.Results All 23 cases were successfully operated without related the operative complication.The operative duration ranged from 3.5 to 6.1 h (mean 4.8 h),the blood loss was 30-880 ml (mean 304 ml),and the postoperative stay was 8-30 d (mean 17.8 d).There are 3 cases of positive lymph node by postoperative pathological reports.Within 2 to 30 months following up,2 patients died of tumor progression in 6 months after surgery.4 patients were diagnosed with bladder cancer in 15 months,15 months,21 months,24 months after surgery,respectively.And the transurethral resection of bladder tumor was performed.Conclusion The modified complete retroperitoneal laparoscopic nephroureterectomy via three ports is safe and reliable.

Objective To explore the predictive values of the levels of procalcitonin (PCT) and thyroid hormone on the prognosis in patients with systemic inflammatory response syndrome (SIRS) complicated with euthyroid sick syndrome (ESS) and their values on differential diagnosis of ESS. Methods A total of 238 patients with SIRS hospitalized in the Emergency Department, Jiangsu Provincial Hospital of Integration of Chinese and Western Medicine, Jiangsu Branch of China Academy of Chinese Medical Sciences from July 2012 to December 2014 were divided into two groups: death group (31 cases) and survival group (207 cases), 182 patients being complicated with ESS and 56 patients without ESS. The differences in the levels of PCT, free triiodothyronine (FT3) and acute physiology and chronic health evaluation (APACHE Ⅱ) score in patients with different clinical outcomes were analyzed. The effects of the inflammatory mediators including levels of PCT, interleukin-6 (IL-6), C-reactive protein (CRP), and thyroid function such as free thyroxine (FT4) and thyroid stimulating hormone (TSH) on clinical outcomes and their predictive values on death of emergency patients with SIRS were also studied. Furthermore, the correlations between APACHEⅡscore and PCT, IL-6, CRP, thyroid hormone were analyzed. Results The level of PCT and APACHE Ⅱ score in death group were significantly higher than those in survival group [PCT (ng/L): 8.38 (13.88) vs. 1.04 (3.57), APACHEⅡscore:27.42±6.88 vs. 16.35±6.72, both P<0.01], while FT3 level was obviously lower in death group (pmol/L: 2.19±0.58 vs. 3.07±0.94, P < 0.05). No significant differences in levels of IL-6, CRP, FT4 and TSH were observed between the two groups (all P>0.05). The mortality was increased markedly in patients with higher PTC level and lower FT3 level compared with normal PCT level and normal FT3 level [18.8% (30/160) vs. 1.3% (1/78), 17.1%(31/181) vs. 0 (0/57), both P<0.05]. However, the abnormalities of IL-6, CRP, FT4 and TSH levels did not contribute to patient's mortality (all P>0.05). PCT was positively correlated with APACHEⅡscore (r>0.33, P<0.001), while FT3 was negatively correlated with APACHEⅡscore (r<-0.33, P<0.001). There were no correlations between IL-6 (r = 0.319, P < 0.001), CRP (r = 0.161, P < 0.05), FT4 (r = -0.170, P < 0.01), TSH (r = -0.057, P = 0.385), and APACHEⅡscore. The levels of PCT, IL-6 and CRP and APACHEⅡscore in patients with ESS were significantly higher than those in patients without ESS [PCT (ng/L):2.54 (5.90) vs. 0.20 (0.43), IL-6 (ng/L):98.62 (351.20) vs. 16.85 (33.60), CRP (mg/L):88.00 (110.50) vs. 25.50 (48.00), APACHEⅡscore:17.62±8.17 vs. 10.98±4.97, all P<0.01]. The cut-off values for predicting patient's death of these indexes showed by receiver operating characteristic curve (ROC curve) analysis were as follows: PCT: cut-off value ≥ 1.755 ng/L, sensitivity: 87.1%, specificity: 58.0%, area under the ROC curve (AUC): 0.802; FT3: cut-off value ≤ 2.92 pmol/L, sensitivity: 93.5%, specificity: 54.1%, AUC: 0.785;APACHE Ⅱ score: cut-off value ≥ 21.5, sensitivity: 83.9%, specificity: 88.4%, AUC: 0.920. Conclusions The levels of serum PCT, FT3 and APACHEⅡscore are prognostic factors in patients with SIRS. Meanwhile, the levels of serum PCT, IL-6, CRP and APACHE Ⅱ score should be taken into consideration in differential diagnosis of ESS in patients with SIRS.

A new animal model of multiple system organ failure (MSOF) in rabbits is used in this experiment. The purpose of the current study is to observe dynamically the changes in the intestinal flora, the relationship between the changes and bacterial translocation to various organs and endotoxemia. The results show that there is no obvious alteration in population of Bacteroides, but a significant increase in enteric bacilli population in the contents of the ileocecum is found. Changes in the intestinal micro-flora correlate to the positive bacterial culture of the blood, viscera, and the level of endotoxin in the plasma. The results of our work suggest that ecological imbalance in the intestinal flora may promote-the gut-derived septic process and the development of MSOF.

Objective To observe the expression law of cytokine signaling suppressors (SOCSs) mRNA in burn rats with Staphylococcus aureus sepsis and investigate their potential role in the pathogenesis of postburn sepsis. Methods Wistar rats were inflicted with 20% TBSA Ⅲ? scald, followed by Staphylococcus aureus challenge. Then, the expressions of SOCS1, SOCS2 and SOCS3 mRNA and interferon-? (IFN-?) levels in the liver and lungs were determined. Results With Staphylococcus aureus challenge after burn, IFN-? levels in the liver and lungs were significantly elevated and reached peak at the 0.5th and 6th hours, respectively (P