BACKGROUND: Intestinal tract factors, especially intestinal ischemiareperfusion, can induce the injury of remote organ. Chinese herb, rhubarb,can clear oxygen free radical to promote the proliferation of beaker cell in intestinal mucous membrane, inhibit excessive multiplication of bacterium and endotoxin absorption in the intestinal tract, activate blood circulation and remove blood stasis, improve microcirculation and other ways to protect intestinal mucous membrane barrier, so as to prevent and treat pulmonary injury.OBJECTIVE: To observe the preventing and treating effect of rhubarb on intestinal ischemia/reperfusion-induced pulmonary injury and the effect of rhubarb on tumor necrosis factor and phospholipase A2 (PLA2).DESIGN: A randomized controlled observation.SETTING: Department of Emergency, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA.MATERIALS: This experiment was carried out in the Second Military Medical University of Chinese PLA from February to July 2003. Totally 80SD rats were selected and randomly divided into intestinal ischemia/reperfusion group (n=24), sham operation group (n=46), treatment group (n=24) and normal saline group (n=16).METHODS: In the intestinal ischemia-reperfusion group, rats were fasted before operation. They were anesthetized and given a median abdominal incision. Superior mesenteric artery was isolated and occluded by vascular clamp without wound, and then the incision was sutured; 45 minutes later,vascular clamp was taken out to recover blood supply. For the treatment group, modeling was the same as that in the intestinal ischemia/reperfusion group, 600 mg/kg suspension of rhubarb extract was gastrointestinally perfused into the rats 30 minutes before recovering blood supply. For the normal saline group, modeling was the same as that in the intestinal ischemia/reperfusion group; same dosage of normal saline was gastrointestinally perfused into the rats 30 minutes before recovering blood supply. For the sham operation group, occlusion of superior mesenteric artery was omitted. Taking pathological change and 125I-labeled bovine serum albumin pulmonary uptake index as the index to evaluate pulmonary injury, TNF content and serum of pulmonary tissue and PLA2 activity of lung and intestinal tissue of animals in each group were measured respectively at different time points.MAIN OUTCOME MEASURES: 125I labeled bovine bovine serum albumin uptake index, tumor necrosis factor content of blood and pulmonary tissue, and PLA2 activity of serum, lung and intestinal tissue RESULTS: ① Pathological and morphological change of pulmonary tissue: There was no obvious abnormality in the sham operation group; In the intestinal ischemia-reperfusion group, 6 hours later, pulmonary interstitial edema, neutrophile infiltration appeared and alveolar edema was also found, and there were a little haemorrhage and exudation of fibrin. Only mild pulmonary interstitial edema and a small quantity of neutrophiles were found in the treatment group. ② Ultramicro-pathological change of pulmonary tissue: There was no obvious change in the sham operation group. In the intestinal ishcemia/reperfusion group, 6 hours later, pulmonary capillary endothelial cells were swelled and neutrophilic granulocyte leaked into pulmonary stroma and alveolar space. There were no above changes in the treatment group. ③ Change of tumor necrosis factor of pulmonary tissue in the sham operation group or treatment group (reperfusion for 30 minutes) was significantly lower than that in the intestinal ischemiareperfusion group (reperfusion for 30 minutes) (0.235±0.114,1.374±0.550,16.315±4.587,P ＜ 0.01). ④125I-BSA pulmonary uptake index in the treatment group was significantly lower than that in the intestinal ischemiareperfusion group and normal saline group (P ＜ 0.01), without significant difference in comparison with sham operation group (P ＞ 0.05).CONCLUSION: Early application of rhubarb is helpful to prevent and treat lung injury following small intestine ischemic reperfusion, so as to inhibit tissue disease course to deve1op multiple organ dysfunction syndrome,which might be implemented through inhibiting the release of TNF and PLA2 and other media.

Objective:To study the different effect of fused gene IL-2/Fc administrated at different time on immune responses induced by HBV preS_2S genetic vaccine.Methods:BALB/c mice were immunized with purified recombinant plasmids at 0, 2, 4 weeks. Two groups were designed. One group were injected with pcDNA3.1S_2S at first, then pcDNA3.1IL-2/Fc was administrated after three days. While the other group were injected two plasmids at the same time. We compared the immune responses through detecting the anti-HBs titers, CTL cytotoxicity level, proliferation of lymphocytes and cytokines levels secreted by cultural splenocytes.Results:The data demonstrated that the humoral and cellular immune responses induced by pcDNA3.1IL-2/Fc as adjuvant and administrated after HBV preS_2S DNA vaccine 3 days mice were dominant higher than other groups.Conclusion:Genetic adjuvant administrated after Ag priming can enhance its effect.

Objective: To explore the feasibility and advantage of the drones in a county emergency medical service system. Methods: The study was conducted in Changxing County, Zhejiang Province from January to September 2018. The Changxing County People's Hospital and the health centers within its radius of 25 km were included in the study. Three types of indicators were obtained by using commercial drones to transfer simulated first-aid medical supplies from health centers to county people's hospitals: (1)The flight time of the drone; (2) The road traffic time measured by Baidu map and Tencent map software of the above-mentioned route at midnight; (3) The road traffic time measured by Amap software of these routes at 0: 00, 8: 00, 10:00, 12:00, 14:00, 16:00, 18:00, 20:00. The road traffic time at different time points measured by map softwares and drones flight time were compared. Wilcoxon symbolic rank test was used for statistical analysis, and P value of < 0.05 was considered statistically significant. Results: (1) A total of 10 health centers were involved in this study, the air straight-line distance between them and the county people's hospital was (10.97±3.59) km, and the road traffic distance was (13.61±4.95) km. (2) The flight time of drone was (16.35±5.15) min, less than road traffic time measured by Amap, Baidu and Tencent map software, which were (21.40±5.15) min, (22.50±6.11) min, (22.00±5.23) min, respectively (P< 0.01). (3)The road traffic time measured by Amap software was longer than that of drones from 0:00 to 20:00 (P< 0.01), with the maximum time of (27.80±6.12) min at 18:00, and the minimum time of (21.40±5.15) min at midnight. Drones could save up 14.07 min at most and 2.8 min at least, with an average save of (7.98±1.32) min. Conclusions Drone might be used to transfer first aid medical supplies between health centers in a county area, which is faster than road transportation. It has a better application prospect and is worth to further study.

Objective:To explore the correlation between single nucleotide polymorphisms (SNPs) in Homo sapiens longevity assur-ance homologue 2 (LASS2) gene 3′-untranslated regions (UTR) and susceptibility of bladder cancer among residents of Yunnan, China. Methods:A total of 105 bladder cancer patients (bladder cancer group) and 100 nonbladder cancer patients (control group) were se-lected. PCR method and sequence for LASS2-3′-UTR were performed to identify the SNPs correlated with bladder cancer. The relation-ships between the LASS2-3′-UTR polymorphisms and bladder cancer risk were analyzed. Results:An SNP (rs8444) was identified in LASS2-3′-UTR, and the T/C allele frequencies and genotype distributions of rs8444 largely differed between the bladder cancer and control groups (χ2=10.267, P=0.006;χ2=10.634, P=0.001). Individuals that carry the rs8444 C allele or CC genotype had a remarkably lower risk of bladder cancer compared with those that carry the T allele or TT genotype (OR=0.489, 95%CI:0.309-0.772, P=0.002;OR=0.258, 95%CI:0.081-0.827, P=0.023). No significant correlations were observed between the T/C allele frequencies and genotype distri-butions of rs8444 and TNM stage, as well as histological grade and distant metastasis in bladder cancer (P>0.05). Conclusion: The rs8444 C allele or CC genotype located within LASS2-3′-UTR can lower the susceptibility of bladder cancer among the residents of Yun-nan, China. However, it is not associated with the TNM stage, histological grade, and distant metastasis.

OBJECTIVE To evaluate the efficacy and safety of teicoplanin on the patients with severe infection in ICU.METHODS Thirty cases were observed and the dosage of drug was 400mg once a day for injection.The duration of the treatment was 7-10 days.RESULTS The total cure rate was 70.00%,the total response was 83.33%,and the bacterial clearance rate was 86.67%.CONCLUSIONS Teicoplanin is both effective and safe for patients with severe infection in ICU.

OBJECTIVE: To evaluate the effect on the inflammatory indexes of septic gastrointestinal dysfunction treated with acupuncture at Jiaji (EX-B 2). METHODS: A total of 118 patients of septic gastrointestinal dysfunction were randomized into an observation group and a control group, 59 cases in each one. In the control group, mosapride citrate was prescribed for oral administration, 5 mg each time, 3 times a day, bifidobacterium triple viable capsules, 420 mg each time, twice a day, intravenous drip with omeprazole, 40 mg, twice a day. Additionally, the antibiotics and the symptomatic treatment were selected rationally for maintaining the functions of the important organs, e.g. heart, lung, brain and kidney, and water-electrolyte balance. In the observation group, on the routine management as the control group, acupuncture at Jiaji (EX-B 2, T-T) was added, the needles were retained for 30 min in each treatment, once a day, 10 days as one course and 1 course was required. Separately, on the 1st, 3rd, 6th and 10th days of treatment, the white blood cell (WBC) count, the levels of hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) were observed, the enteral nutrition feeding dose and gastrointestinal dysfunction score before and after treatment as well as the clinical effect were assessed in the two groups. RESULTS: The differences were not significant in the indexes mentioned above on 1st and 3rd days of treatment between the two groups (>0.05). On the 6th and 10th days of treatment, regarding the gastrointestinal dysfunction score and inflammatory indexes count, the results in the observation group were lower than the control group (all <0.05), and feeding dose in the observation group was higher than the control group (<0.05). After treatment, the gastrointestinal dysfunction scores and inflammatory indexes count were all reduced and feeding dose was increased as compared with those before treatment in the patients of the two groups (all <0.05). After treatment, the total effective rate was 91.5% (54/59) in the observation group, higher than 76.3% (45/59) in the control group (<0.05). CONCLUSION Acupuncture at Jiaji (EX-B 2) points achieves the satisfactory effect on septic gastrointestinal dysfunction and reduces the inflammatory indexes count.
Acupuncture Points ; Acupuncture Therapy ; Case-Control Studies ; Chlorophenols ; therapeutic use ; Gastrointestinal Diseases ; therapy ; Humans ; Needles ; Sepsis

Objective To compare the clinical effect of 2D and 3D laparoscopic radical prostectomy and summarize surgical experience of laparoscopic radical prostectomy of early prostate cancer.MethodsThe clinical data of 34 cases of prostate cancer treated in our institute from November 2015 to April 2016 were collected and analyzed retrospectively. The patients in observation group (11 cases) were treated by 3D laparoscopic radical prostectomy, while those in control group (23 cases) were given 2D laparoscopic radical prostectomy. The operation time, intraoperative bleeding volume, postoperative drainage time, quantity of drainage fluid within 24 hours postoperatively, indwelling catheter time, hospital time, positive surgical margin rate, potence rate, 30d-urinary continence rate and complications were compared between the two groups.Results All operations were successfully performed. There were no signiifcant differences in operation time, intraoperative bleeding volume, postoperative drainage time, quantity of drainage lfuid within 24 hours postoperatively, indwelling catheter time, hospital time, positive surgical margin rate, potence rate, 30d-urinary continence rate and complications between the two groups (P > 0.05). In observation group, the operation time was (153.52 ± 30.47) min and the potence rate was 50.0 %, 4 cases with uroclepsia (36.4 %), 1 case with urine leakage (9.1 %), no patient had urethral stricture or positive surgical margin, the 30d-urinary continence rate was 72.7 %. In control group, the operation time was (164.73 ± 28.65) min and the potence rate was 38.9 %, 13 cases with uroclepsia (56.5 %), 4 cases with urine leakage (17.4 %), 1 case with urethral stricture (4.3 %), 2 cases with positive surgical margin (8.7 %), 30d-urinary continence rate was 60.9 %.ConclusionLaparoscopic radical prostectomy is a safe, effective and less invasive method for treating early prostate cancer patients. Also 3D laparoscopic radical prostectomy play the similar functional results compared with 2D laparoscopic radical prostectomy, but 3D laparoscopic has the advantage in three dimensions space sense and accurate operation, it is worthy of promoting clinical application.

Objective:To detect mutations in a pedigree containing two brothers with oculocutaneous albinism (OCA) by whole-exome sequencing and Sanger sequencing.Methods:Clinical data were collected from a pedigree with OCA, and DNA was extracted from peripheral blood samples obtained from the proband and other family members. The whole-exome coding region of the proband was directly sequenced by whole-exome sequencing technology to identify potential pathogenic mutations, and Sanger sequencing was conducted to verify the gene mutations.Results:Both the proband and his younger brother presented with generalized white skin, golden-yellow hair, bilateral nystagmus, photophobia, translucent iris, conjunctival congestion, and refractive errors of both eyes. The proband′s parents, grandparents, maternal grandparents, and children were all phenotypically normal, and his parents′ marriage was non-consanguineous. Three heterozygous mutations were identified in the OCA2 gene of both the proband and his younger brother, including a nonsense mutation c.1290T>A, and 2 missense mutations c.1363A>G and c.1204T>C. The mutation c.1204T>C has not been previously reported, and was a novel gene mutation in the OCA2 gene. In addition, 1 heterozygous mutation c.1204T>C was identified in the OCA2 gene in the proband′s father and daughter, 2 heterozygous mutations c.1290T>A and c.1363A>G were found in the OCA2 gene in the proband′s mother, and 1 heterozygous mutation c.1290T>A was identified in the OCA2 gene in the proband′s son and the daughter of the proband′s younger brother.Conclusions:Three gene mutations were identified in the OCA2 gene in the 2 patients with OCA, and the nonsense mutation c.1290T>A may be the pathogenic mutation causing the clinical phenotype of this family. These findings expand the pathogenic mutational spectrum of the OCA gene.

Due to the special anatomic structure of optic nerve,the optic nerve sheath diameter( ONSD) increases along with the elevated intracranial pressure(ICP). The normal value or cut?off point of ONSD has not been unified in adults and children. The change of ONSD in children is different from that of adults as the children are at the stage of growth. With the deep understanding of ONSD,ultrasonic measurement of ONSD has a wide range of applications in adults and children.

Objective To analyze the relationship between the optic nerve sheath diameter (ONSD) and the scoring of Glasgow Coma Scale(GCS)or CT score(Rotterdam CT score or Helsinki CT score).Methods Sixty-three adult patients with traumatic brain injury in our emergency room were enrolled.All the patients were presented with the data of GCS and the classification of cranial CT,as well as ONSD measured by ultrasound.The correlation between ONSD and classification of cranial CT scores or GCS was analyzed by Spearman correlation analysis.Patients were divided into mild group,moderate group and severe group based on GCS or CT scores.One-way Analysis of Variance (ANOVA) was used to discover the difference in mean ONSD among different groups on account of scoring of GCS or cranial CT scores.The intergroup comparisons were analyzed by the least-significant-difference (LSD) tests.Results ONSD measurements were strongly correlated with GCS(r=-0.540,P＜0.01)or classification of Rotterdam CT scores (r=0.654,P＜0.01) and Helsinki CT scores (r=0.663,P＜0.01).The mean ONSD of the mild,moderate and severe group were (3.89±0.70)mm,(4.50±0.65)mm and (4.81±0.72) mm,respectively.The mean ONSD of the mild group was significantly shorter than that of severe group (P＜0.01) and moderate group(P＜0.05).The same results were found when comparing mean ONSDs among different groups classified by Rotterdam CT scores (low group (3.74±0.64)mm vs.middle group (4.3 l±0.73)mm vs.high group (5.09±0.57)mm,P＜0.01 or P＜0.05) or classified by Helsinki CT scores (low group (3.54±0.61)mm vs.middle group (4.46±0.73)mm vs.high group (5.16±0.37)mm,P＜0.01.Conclusions Ultrasonography used to measure ONSD is significantly correlated with both GCS and classification of head CT including Rotterdam CT score and Helsinki CT score.The results indicate that ultrasonography measurement of ONSD is helpful for early bedside assessment in patients with traumatic brain injury.