Objective To investigate the therapeautic effects of ulinastatin on ulcerative colitis(UC) and it's possible mechanism.Methods Forty adult Wistar rats were randomly divided into four groups;normal group(group A),UC group(group B),SASP(salicylazosulfapyridine) therapeautic therapeutic group(group C),ulinastatin(UTI) therapeautic group(group D). UC models were induced by trinitrophenylmethylnitramine(TNBS), Group A and Group B received 0 9% saline solution instead of ulinastatin and SASP as a control.Serum level of tumor necrotic factor-?(TNF-?),malondialdehyde(MDA),superoxide dismutase(SOD) and pathological change were measured respectively after drugs treatment for two weeks.Results Both UTI and SASP decreased the level of serum TNF-?,MDA ,increased the level of serum SOD ,and relieved mucosa lesion and pathological change in UC rats . UTI was better than SASP in the treatment of UC.Conclusions UTI has apparent therapeautic effects.The mechanism may be associated with inhibition of pro-inflammatory cytokines and clearance of free radicals.

Objective To explore the distribution and drug resistance of pathogens isolated from patients with cholesteatoma otitis media so as to provide guidance for clinical use of antibiotics.Methods This survey analyzed the spectrum of organisms causing cholesteatoma otitis media and their sensitivities to commonly antimicrobial agents from Hebei province eye hospital in 2014.Results There was 86 positive speciments were cultured from 89 samples,the positive rate was 96.6％.A total of 90 strains of pathogens have been isolated,including 52 strains of gram-positive coccus (57.8％),35 strains of gram-negative bacilli (38.9％),3 strains of gram-positive bacilli (3.3 ％),and 0 strain of fungi.Staphylococcus epidermidis,Staphylococcus aureus and Staphylococcus chromogenes ranked the top three species of pathogens,accounting for 20.0％,16.7％,and 12.2％,respectively.The gram-positive cocci were susceptible to vancomycin,rifampicin and amikacin,and showed higher drug-resistancerate to penicillin,amoxicillin and azithromycin.When applied to gram-negative bacilli,the drugs with best resistance were penicillin and cefazolin,and the drugs with the highest sensitivity were levofloxacin and pipercillin/ sulbactam.Conclusion Staphylococcus is the predominant pathogens of cholesteatoma otitis media in hospital,and the bacteria have a high antibiotic resistance.Enhanced monitoring on pathogenic bacteria distribution and drug resistance analysis of cholesteatoma otitis media could benefitthe guide of clinical rational use of antimicrobial agents.

Summary: Structural nasal obstruction（SNO） is a series of diseases caused by congenital or acquired structural anatomical abnormalities of nasal airway and its surrounding tissues, which leads to increased nasal ventilation resistance. The effect of medication drugs for SNO is poor and surgical intervention is often needed. However, the abnormal structure of nasal airway is very complex, including the periphery of nasal airway, internal nasal airway, the front and rear of nasal airway and complex factors. These abnormal structures may interfere with the nasal airflow mechanics by changing the nasal ventilation volume and disrupting the symmetry of the bilateral nasal cavity, and finally lead to subjective feeling of nasal obstruction. In addition, the structure of nasal airway has plasticity. After the abnormal structure appears, the corresponding compensation of nasal airway can occur to ensure normal nasal ventilation and bilateral nasal cavity symmetry. Therefore, the SNO is the result of the failure of nasal airway remodeling after the appearance of abnormal structures. The etiology of SNO is complex, involving original structural abnormalities, nasal symmetry changing and nasal airway structure remodeling. Therefore, accurate identification of the main factors leading to SNO is the vitalpremise of making personalized nasal ventilation surgery.

Objective To study the diagnostic evaluation of spiral CT for acute pulmonary embolism(PE).Methods 24 patients with PE were scanned with SCT(Philips AVEL.)pre-and post-injection of 100 ml contrast medium(Ultravist or Omnipaque 300 mgI/ml)from elbow vein.Enhanced CT scans were started after injection of 15 and 30 seconds respecting.Results The indirect signs on plain CT image were:lung-making sparse in 12 cases;lesion of pulmonary infarction in 11 cases;pulmonary hypertension signs in 3 cases;pleural thickening in 4 cases;pleural effusions in 8 cases.The direct signs on enhanced CT images were:Intraluminal filling defect (mural filling defect in 32 vessels;partial filling defect in 30 vessels;total occlusion in 92 vessels and central filling defect that was railway-track sign in 15 vessels)and smaller caliber of pulmonary artery in 14 vessels.Conclusion Enhanced pulmonary SCT angiography is the safe,quick and effective imagilogic examination for acute PE.

Objective To investigate whether lipids and reagents would interfere the results when serum total bile acid(TBA) was measured by enzymatic cycling assay.Methods The serum TBA was measured by enzymatic cycling assay.The carry-over contaminations of high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),cholesterol(TC),and triglyceride(TG)rea-gents were evaluated.In order to reduce the interference and carry-over contaminations,different washing procedures and detection sequence were set.Results By measuring the levels of TBA in pooled serums with low and high levels of lipids,the results showed that there was statistically significant difference between the groups with and without the addition of cleaning process before and af-ter TBA measurement(P <0.01).Cleaning with water might be more effective on reducing interference than those with acid solu-tion.Moreover,the mean of TBA levels in HDL-C,TC,TG and LDL-C reagents were (476.06 ± 1.88 ),(127.78 ± 1.18 ), (121.05±1.08),and (2.23±0.51)μmol/L,respectively.The stability of TBA level was greatly affected by HDL-C regents,fol-lowing by TC and TG reagents,and was little affected by LDL-C reagent.Setting up proper detection sequence and flushing proce-dures could obviously reduce the interference(P <0.01),but not completely rule out.Conclusion Analysis sequence and flushing procedures of biochemical analyzer as well as exogenous substance from reagents may seriously affect the accuracy of determination results.To ensure the accuracy and reliability of the results,it is necessary not only to set up reasonable irrigation and reaction se-quence,but also to master the instrument operation,to know the principle of test reaction and the components of reagents as well as equipment maintenance.

Objective To study intraoperative neural electrophysiological monitoring applied in lumbosacral spinal cord tumor resection.Methods We retrospectively reviewed the clinical data of 212 patients undergoing lumbosacral spinal cord tumor resection with or without intraoperative neural electrophysiological monitoring in our hospital.The patients were divided into two groups:124 patients in the monitored group received intraoperative neural electrophysiological monitoring while 88 ones in the control group did not.The monitoring was performed by recording the cortical somatosensory evoked potential (CSEP),dermatomal somatosensory evoked potential (DSEP) and electromyography (EMG).The patients were followed up for 3-6 months and their postoperative outcome was analyzed.Results There were significant differences in the outcome (P <0.05),but no difference was found in the incidence of complications between the monitored group and the control group.The sensitivity of CSEP +DSEP+EMG was 100%,and the specificity was 55.9% in the former group.Conclusion Combined monitoring with CSEP,DSEP and EMG during lumbosacral spinal cord tumor resection is valuable in protecting the spinal nerve roots and ensuring better operation safety.

Objective:To investigate the blood supply pattern and characteristics of bilobate anterolateral thigh flaps, and to summarize the clinical experience.Methods:Date of 102 cases of limb wounds repaired by bilateral anterolateral thigh perforator flaps from March 2014 to July 2019 were retrospectively analyzed. There were 80 males and 22 females with an average age of 40.7 years (range, 9-66 years). All of the patients suffered from limb trauma with complex tissue defects, among which 29 cases had two adjacent and discontinuous wound surfaces on the same limb, and the area ranged from 5 cm×5 cm to 30 cm×18 cm, while the other 73 cases remained a single wound with the area ranged from 12 cm×11 cm to 27 cm×15 cm. Ultrasonic Doppler was used to locate the perforating branches. According to different patterns of blood supply, flaps of different types were designed and applied respectively. For those who with perforating branches of common trunk type or fascial type, the wound surface can be covered by the flap directly; for those who with perforating branches of double trunks type or mixed type, the turbocharging technique was performed after dissection of the pedicles of the flap, while the wound was repaired by reconnection. All the donor sites were sutured directly.Results:Total of 105 bilobed flaps were designed in 102 patients, including 43 flaps of common trunk type, 30 flaps of double trunks type, 24 flaps of fascial type and 8 flaps of mixed type. The single harvested flap area ranged from 6 cm×5 cm to 20 cm×9 cm. One patient's one piece of the bilobed flap repairing two wounds suffered an arterial crisis at 17 h after surgery. The surgery confirmed there was an intractable arterial spasm and the crisis was relieved after a vein trans-plantation. Then about 4 cm×3 cm superficial necrosis appeared in the most distal part of the flap and healed in secondary after dressing changes. Two cases with single wounds suffered from a vein crisis at 48 h after operation. After removing the suture and blood letting, the flaps survived a week later. The average healing time was 19 days (range, 8-83 days). All the thigh donor sites healed by first stage. All the cases were followed-up for an average period of 16 month (range, 6-70 months). The latest follow-up showed that the flaps were of good color and texture, and the sensation of the flaps recovered partially. According to the British Medical Research Council sensory rating scale: 21 cases were grade S2 and 81 cases were grade S3. According to the revascularization assessments of digital replantation standard by Hand Surgery Branch of Chinese Medical Association, the results were excellent in 91 cases, good in 11 cases, with excellent and good rate of 100%. Linear scars were left in most donor sites and the VAS scores were all zero. 5 cases had a large scar area which the width was more than 3 cm, but there was no scar contracture or pain. 9 cases had an abnormal sensation in the donor area in the early stage and recovered gradually 3 months later without any movement disorder.Conclusion:The use of the bilobed anterolateral femoral perforator flap with different blood supply patterns to repair the wounds of extremities could overcome the lack or deficiency of blood supply caused by perforators with different sources. To clarify the blood supply types is conducive to the flap cutting and leaf splitting during the operation, which greatly improves the survival rate of the flap.

Objective To investigate the species and hosts of Paragonimus and its infection rate in eastern part of Zhenghe County,Fujian Province,so as to determine the local foci of Paragonimus. Methods The snails,crabs and stools of wild cats were collected for the examinations of cercariae,metacercariae and eggs of Paragonimus. The geographical and environmental conditions of the areas were also investigated. Results A total of 4 890 Pseudobythinella jianouensis snails and 1 035 Semisul?cospira liberlina snails were examined,and the cercariae of Paragonimus were only found in P. jianouensis,with an infection rate of 0.10%(5/4 890). Bottapotamon zhengheensis sp. nov. as the second intermediate host of P. skrjabini,were examined, and the infection rate was 85.29%(29/34)and the average numbers of metacercariae per crab and per gram of crab tissues were 3.85 and 0.62,respectively. Thirty?six Sinopotamun fujianensis crabs,as the second intermediate host of P. westermani,were examined,and the infection rate was 38.89%(14/36)and the average numbers of metacercariae per crab and per gram of crab tissues were 6.43 and 0.03,respectively. The eggs of Paragonimus were detected in 1 of 2 muck specimens of wild cats. Conclu?sion The data suggest that there is a focus of middle?to?high level of infection caused by P. westermani and P. skrjabini in the eastern part of Zhenghe County.

Objective The NDRG4 gene methylation in stool is a candidate biomarker for non?invasive diagnosis of colorectal cancer. However, the traditional methods for methylation detection could not be well applied to stool samples due to the low sensitivity and low specificity. The aim of this study was to develop a highly sensitive and specific method for quantifying the methylated NDRG4 gene in stools. Methods Forty one stool samples were collected from 12 colorectal cancer patients, 4 adenoma patients and 25 nor?mal persons. The invasive reaction was combined with real?time PCR and the relative quantification was performed by 2-ΔCT method to develop the highly sensitive and specific methylated DNA detection method, which was used for detecting NDRG4 methylation levels in 41 of stool samples. Results The sensitivity of the method was as low as 10 copies of methylated NDRG4 gene fragments. The specificity was high enough to distinguish 0.01% of methylated fragments from un?methylated fragments and 105 copies of unmethylated NDRG4 fragments gave noamplification signals. The detection results from 41 of stool samples showed that detection rate of the NDRG4 gene in stool from adenoma and colorectal cancer groups had a significant difference comparing to that from the normal group. Conclusion The 2-ΔCT method could accurately quantify the methylation levels of the NDRG4 gene in stool samples, and provide an efficient tool for non?invasive colorectal cancer detection.

Objectives: To design the mutants of peptide antibiotics hPAB ? based on its molecular structure. Methods: The three dimension structure of hPAB ? was constructed by protein homology modeling method. The mutant molecules were designed and generated by PCR and inserted into pQE CP4 expression plasmid. The recombinant plasmids were identified by PCR and DNA sequencing and then transformed into Escherichia coli JM109 to express target fusion proteins. Results:Peptide hPAB ? shows one ? helical and three ? sheet in its structure. Its ? helical regions seem play a key role in the formation of active oligomer. Aside from positioning Thr 7 and Lys 10 into contact positions, the orientation of the ? helix is conserved about the oligome core, forming a ridge around it. Additionally, the dipoles of the helices would overlap to create a positively charged region near the core. These dipoles may be offset, however, by the presence of Asp 4 at the base of the helix. Two mutant molecules, hPAB ? 38 and hPAB ? 34, were designed by deleting N or/and C terminal 2～5 amino acid residues based on hPAB ? structure. The recombinant plasmids containing the mutants gene can express interest fusion proteins in E. coli JM109 successfully. Conclusions: Design, cloning and expression of the mutants of peptide antibiotics hPAB ? lay down the foundation for screening of the mutant of shorter peptide chain and having high or same antimicrobial activity.