Athletes ; Humans ; Physical Conditioning, Human ; physiology ; Running ; physiology

Objective To evaluate the clinical value of multi-slice spiral CT in diagnosing tracheobronchial foreign bodies in chil-dren.Methods 139 patients with airway foreign body confirmed by bronchoscopy were examined with 128-slice spiral CT,and then the CT data was reconstructed by using multiple-planar reconstruction(MPR),curved planar reconstruction (CPR),volume render-ing(VR),minimum intensity projection(MinIP)and virtual endoscopy (VE).The CT results were compared with bronchofibersco-py findings.Results Among the 139 cases,the foreign bodies located at trachea in 13 cases,right bronchia in 75 cases,left bronchia in 48 cases,and bilateral bronchia in 3 cases.137 cases (98.6%)were correctly diagnosed,and 2 cases (1.4%)were missed on CT.Although the difference of the results at trachea and right main stem bronchus was statistically significant (P <0.05),the over-all results was not significant difference between CT and bronchoscopy examination (P =0.340).Associated findings included em-physema in 74 cases,pneumonia in 48 cases,atelectasis in 22 cases,mediastinal displacement in 57 cases,lung interstitial emphyse-ma in 4 cases,pneumomediastinum and pneumoderma in 4 cases,bronchiectasis in 2 cases,and pleural effusion in 4 cases.Conclu-sion MSCT and its postprocessing techniques can accurately and intuitively display the tracheobronchial foreign body and complica-tions,which has important value for clinical application.

OBJECTIVETo evaluate the prognostic effects of neoadjuvant chemotherapy (NAC) in patients with local advanced gastric cancer.

METHODSWe retrospectively analyzed prognosis in 191 patients with advanced gastric cancer, of whom 71 were treated with NAC and 120 received surgery only between February 2007 and July 2013. Postoperative complication rate was recorded. Survival by clinicopathological features, pathological T and N stages, and histopathological tumor regression was retrospectively compared between the two groups.

RESULTSAccording to Response Evaluation Criteria in Solid Tumors, none of the 71 patients in the NAC followed by surgery group showed complete response, 36 showed partial response, 25 had stable disease, and 10 had progressive disease. The chemotherapy response rate was 50.7%; the disease control rate was 85.9%. Grade 3/4 adverse events were seen in less than 20% patients, with acceptable toxicities. No difference was found in the overall postoperative complication rates between the two groups (7 versus 22 cases, P=0.18). Median survival time was significantly different, at 54 months in the NAC combined with surgery group and 25 months in the surgery-only group (P=0.025).

CONCLUSIONIn patients with operable gastric adenocarcinomas, NAC can significantly improve overall survival without increasing surgical complications.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; mortality ; pathology

OBJECTIVETo investigate the role of Xuebijing injection(XBJI, traditional Chinese medicine), in inhibiting TLR4--NF-kappaB--IL-1beta pathway of myocardial hypoxia/reoxygenation in rats.

METHODSThirty six male SD rats (280 +/- 30) g were randomly divided into six groups (n = 6): normal group (N group), balanced perfusion group (BP group), model group (M group), low dose XBJI group (XBJI(L) group), middle dose XBJI group (XBJI(M) group), high dose XBJI group (XBJI(H) group). By Langendorff isolated heart perfusion device to establish the model of myocardial hypoxia/reoxygenation in rats. ELISA was used to detect the concentration of interleukin-1beta (IL-1beta); Western blot was used to detect the expression of nuclear factor kappa B p65 (NF-kappaB p65) protein and toll like receptor 4 (TLR4) protein; and RT-PCR to determine the expression of NF-kappaB p65 mRNA and TLR4 mRNA;To observe microstructure changes of hypoxia/reoxygenation myocardial by light microscopy.

RESULTSCompared with M group, the IL-1beta concentration, NF-kappaB p65 and TLR4 protein,NF-kappaB p65 and TLR4 mRNA of XBJIL group, XBJI(M) group, XBJI(H) group expression decreased in varying degrees,and decreased most obviously all in XBJI(M) group (P < 0.05, P < 0.01); Myocardical structural damage was serious in M group, and improved after treatment XBJI, the most obvious was the XBJI(M).

CONCLUSIONDifferent dose of XBJI can inhibit TLR4--NF-kappaB--IL-1beta signal transduction pathway and reduce several inflammatory reaction after myocardial hypoxia/reoxygenation injury, the 4 ml/100 ml of XBJI is the best.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Heart ; drug effects ; Inflammation ; Interleukin-1beta ; metabolism ; Male ; Myocardium ; pathology ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; drug therapy ; Signal Transduction ; Toll-Like Receptor 4 ; metabolism ; Transcription Factor RelA ; metabolism

OBJECTIVETo investigate the relationship between TCM syndrome type and laboratory indexes in patients with systemic lupus erythematosus (SLE).

METHODSThree hundred and eighty-three SLE patients were differentiated into six syndrome types based on the "toxin" sydrome differentiation of TCM, Type 1, the heat-toxin flourishing type; Type 2, the stasis heat with toxin type; Type 3, the turbid toxin congested type; Type 4, the general deficiency with evil stay type; Type 5, the heat-toxin burning yin type; Type 6, the Gan-stagnant with toxin convergency type. The indexes, including complement C3 (C3), immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin G (IgG), alanine aminotransferase (ALT), 24 h urinary protein quantitation, white blood cell (WBC) and platelet (PLT) count, were determined, and the SLEDAI score was calculated.

RESULTSLevels of IgA and IgM in all patients were basically normal. Level of IgG was higher than the normal range in patients of type 1 and 2, being 18,713.81 mg/L and 23,131.54 mg/L respectively, showing significant difference between the Type 2 and Type 3 (P < 0.05); the lowest mean value of C3 presented in patients of type 1 (586.32 mg/L), and that in patients of type 4 was significantly different to that in patients of other types (P < 0.05); count of WBC and PLT was lower in patients of type 5 and significantly different to that in the other five types (P < 0.05); level of 24 h urinary protein quantitation was higher than normal in all the patients and the highest level (2.78 g/24 h) was found in patients of type 3; and the highest level of ALT (112.75 U/L) appeared in patients of type 6 as compared with that in patients of other types.

CONCLUSIONDifferent variations of laboratory indexes present in SLE patients of different syndrome types, there are certain relationship between the TCM syndrome types and the laboratory indexes, and these rules may provide reference for evaluating clinical therapeutic effects.

Complement C3 ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Lupus Erythematosus, Systemic ; blood ; diagnosis ; urine ; Male ; Medicine, Chinese Traditional ; Proteinuria ; urine ; Syndrome

OBJECTIVETo investigate the long-term efficacy of integrative medicine in treating systemic lupus erythematosus (SLE).

METHODSAdopting randomized grouping method, the SLE patients were assigned to two groups, 74 in each group, the treatment group treated by combined hormonotherapy with Chinese drugs for detoxifying, and the control group treated by hormonotherapy alone. The period of the stable phase and active phase, clinical manifestations, 24-h urinary protein, systemic lupus erythematosus disease activity index (SLEDAI) score and complement 3 (C3), etc. were observed.

RESULTSAfter 5-year treatment, the clinical manifestations, including arthritis, hydrohymenitis and fever revealed between groups were significantly different (P < 0.05). Comparison between groups in the 5th year of observation showed that the treatment group had a longer time of the stable phase (305.41 +/- 14.32 days); lower SLEDAI scores (8.28 +/- 4.12) and 24-h urinary protein (0.18 +/- 0.01)g, and a higher level of C3 (0.98 +/- 0.35 g/L) than those in the control group (190.22 +/- 15.43 days, 12.79 +/- 5.43 scores, 0.31 +/- 0.06 g and 0.73 +/- 0.34 g/L), respectively, with statistical significances (P < 0.05). Adverse reactions occurred in 15 cases in the treatment group and 62 cases in the control group, also with significant difference between groups (P < 0.05).

CONCLUSIONThe combined therapy of Chinese and Western medicine can prolong the stable phase time and shorten the lasting period of SLE in patients, which embodies the view of "treating disease before its onset".

Adolescent ; Adult ; Aged ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Integrative Medicine ; Lupus Erythematosus, Systemic ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Prednisone ; therapeutic use ; Treatment Outcome ; Young Adult

Objective To investigate the changes of Th1/Th2 cells and related cytokine levels in chronic hepatitis B (CHB) fibrosis.Methods Forty-six patients with CHB fibrosis underwent liver biopsy during March and October,2011.According to the stage of fibrosis,the patients were divided into S0-1 group (n =15),S2-3 group (n =20) and S4 group (n =11).Ten healthy subjects served as controls.The frequencies of circulating Th1,Th2 cells were detected by flow cytometry.The expressions of interferon-γ (IFN-γ) and interleukin 4 (IL-4) mRNA in peripheral blood mononuclear cells (PBMCs) were detected by real-time quantitative PCR.The serum IFN-γand IL-4 concentrations were determined by enzyme-linked immunosorbent assays.Intrahepatic expressions of IFN-γ and IL-4 were detected by immunohistochemical staining.Differences between groups were analyzed using non-parametric Kruskal-Wallis H test,followed by Mann-Whitney U test for multiple comparisons.Logistic regression was used for multivariate analysis.Results With the degree of liver fibrosis exacerbations,the peripheral Th1/Th2 cells frequencies ratio,IFN-γ/IL-4 mRNA ratio in PBMCs,serum IFN-γ/IL-4 ratio and intrahepatic IFN-γ/IL-4 ratio were declined (x2 =36.259,40.822,26.321 and 31.852,respectively,all P ＜ 0.05).Serum and intrahepatic IFNγ/IL-4 ratio were negatively associated with the stage of liver fibrosis (r =-0.616 and-0.531,P ＜0.01).Logistic regression analysis showed that AST,PT and the serum IFNγ/IL-4 ratio were the risk factors for significant liver fibrosis (S2-4) (OR =5.933,95％ CI:1.324-26.586,P =0.02; OR =12.866,95％CI:1.746-94.788,P =0.01; OR=4.755,95％CI:1.034-21.862,P =0.04).Conclusions The CHB patients has imbalanced Th1/Th2 ratio.With the degree of liver fibrosis exacerbations,Th1/Th2 cytokines drift into Th2 lymphocyte sub-cluster,which suggests that Th1/Th2 imbalance may be involved in the pathogenesis of CHB fibrosis.

The isolate GN52 of Riemerrella anatipestifer was passaged on the Martin Medium successively according to the optimum condition. The experiments included Gram staining, biochemical test, drug sensitivity test and animal experiments were carried out on the bacteria of 3rd, 11th, 21st, 31st, 41st, 51st and 61st generations. It indicated that the bacterial morphs, biochemical character, drug resistance of the strain had no obvious change, but the virulence showed a trend of reduction.

Intraoperative awareness is a very serious complication of general anesthesia.Several studies have evaluated the potential association between bispectral index (BIS) and intraoperative awareness,however,the results obtained were controversial.Therefore,we performed a meta-analysis to further assess the association between the BIS monitoring and the incidence of intraoperative awareness.A comprehensive search was conducted to identify all eligible studies from the online literature databases published prior to Feb.2017.A total of five studies with 17 432 cases and 16 749 controls were included.An odds ratio (OR) and a 95％ confidence interval (CI) were calculated to examine the strength of the association.The results showed that in the overall analysis,the association between the BIS monitoring and the incidence of intraoperative awareness was not significant (OR=0.58,95％ CI=0.22-1.58,P=0.29).A stratified analysis by comparing different anesthesia methods revealed that BIS monitoring group showed a lower incidence of intraoperative awareness in patients with intravenous anesthesia when compared with non-BIS monitoring group (OR=0.20,95％ CI=0.08-0.49,P=0.0004),whereas there was no statistically significant difference in the incidence of intraoperative awareness between BIS and non-BIS monitoring groups in patients with inhalation anesthesia (OR=1.13,95％ CI=0.56-2.26,P=0.73).In conclusion,our meta-analysis showed that BIS monitoring had no appreciable advantage in the reduction of the intraoperative awareness incidence in inhalation anesthesia,while showed a remarkable superiority in intravenous anesthesia.

Background Keratoconus is a bilateral,noninflammatory,gradually progressive corneal disorder characterized by progressive thinning and steepening of the central cornea.It is significant to investigate keratoconusrelated pathogenic gene for elaborating the pathogenesis and establishing early diagnosis standard and taking clinical measurement.Objective The aim of the study was to explore the relationship of visual system homeobox gene (VSX1) polymorphism and the risk of sporadic keratoconus.Methods This study was approved by Ethic Commission of First Hospital of Xi' an.Written informed consent was obtained from each subject prior to enrollment.A case-controlled study was conducted.One hundred and one Han nationality patients with sporadic keratoconus were included in this study.These keratoconus patients were clinically diagnosed by slit lamp examination and corneal tomography.Single nucleolide polymorphism (SNP) of VSX1 gene was assayed and classified using the MassARRAY SNP technique.Demography and relevant risk factors were collected from each subject by questionnaire.Eighty healthy volunteers served as controls.Chi-square test and Binary logistic regression were used to evaluate the difference in the distribution of allele frequency and genotype frequency and to analyze the association with keratoconus risks.Results SNP of two genes was found in the Chinese Han population (rs743018 (c.843+140 C＞T) and rs6138482(R217H C＞T)).There were no significant differences in the genotype frequency and allele frequency of the SNP of two genes in the keratoconus group in comparison with the normal control group (P＞0.05).After adjustment by age and sex,SNP of two genes was not significantly associated with the risk of keratoconus (regression model:rs743018 (C＞T) adjusted:P=0.35,OR=0.72,95％ CI:0.37-1.43 ;rs6138482 (C＞T) adjusted:P =0.48,OR=0.76,95％ CI:0.35-1.64).Conclusions Gene polymorphisms of rs743018(c.843+140 C＞T) and rs6138482(R217H C＞T) in the Chinese Han population is not associated with the risk of keratoconus.Due to the racial difference in genotype and allele frequency,the role of the VSX1 gene in the pathogenesis of keratoconus still remains controversial,and further study needs to be developed.