Bacteria ; isolation & purification ; Community-Acquired Infections ; etiology ; microbiology ; virology ; Humans ; Pneumonia ; etiology ; microbiology ; virology

Carcinoma, Adenosquamous ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Jejunal Neoplasms ; metabolism ; pathology ; surgery ; Jejunum ; surgery ; Keratins ; metabolism ; Male ; Middle Aged

Objective To study the effect of nutrition supports in aged mechanically ventilated patients fol-lowing thracic trauma. Methods 48 aged mechanically ventilated patients following thracic trauma were randomly divided into two groups,patients in treatment group( n = 24) received EEN and PN,control group( n = 24) only re-ceived TPN. Compared the nutritional index, time of mechanical ventilation and compared the complications such as windy,intestine paralysis, alimentary tract heorrhage, second heavy infection, hypohepatia and high blood glucose.Results The nutritional index between treatment group and control group had no statistical difference,but the time of mechanical ventilation and the ratio of the complications in control group were higher than that in-treatment group (P < 0.01). Conclusion EEN and PN can improve nutritional condition, have less complieations, promoting the pa-tient recovers form illness.

Chronic cerebral hypoperfusion is a common pathological state. Cognitive impairment is its main manifestation in early stage, and it will eventually result in persistent or progressive cognitive impairment and neurological deficits. Chronic cerebral hypoperfusion caused neuronal damage, synapse abnormity, energy impairment and the function defects of central cholinergic system and monoaminergic system are its pathophysiological mechanisms resulting in cognitive impairment.

Objective Prepare biomimetic muitilayered scaffold which has similar structure of natural cartilage.Method By lyophilizing the scaffolds which were prefrozen at-20℃ and in liquid nitrogen successively,we prepared double-layered spongy scaffolds.By partially thawing the prefrozen samples and refreezing them in liquid nitrogen before the final liyophilization,we prepared biomimetic multilayered scaffolds with about 2mm thickness.XRD and FT-IR were used to confirm the interaction between collagen and chitosan.SEM was used to observe the morphologies of the scaffolds.The mechanical properties of pure chitosan scaffolds,pure collagen scaffolds,composite single-layered scaffolds and biomimetic multilayered scaffolds were compared both in dry and wet conditions.Results There was chemical interaction between collagen and chitosan.Composite materials will form better pore structure.The biomimetic multilayered scaffolds have upright pores,round pores and a dense layer from bottom to top of the scaffolds.The scaffolds have quite different mechanical properties between dry and wet state.Under wet state,the different layers of the biomimetic muitilayered scaffold have different mechanical properties.Results The biomimetic structure of the multilayered scaffold is very close to that of the natural articular cartilage,and the different layers of the biomimetic muitilayered scaffold had different mechanical properties under wet state.These are hopefully beneficial to help maintain the phenotypes of chondrocytes and promote the repairing effect of cartilage defects.

Objective To investigate the role of M3 receptor in the effect of penehyclidine hydrochloride(PHC) upregulating β-arrestin-1 expression in lipopolysaccharide(LPS)-induced human pulmonary microvascular endothelial cell(HPMVEC) injury.Methods.M3 shRNA transfected HPMVEC and normal HPMVEC cells were randomly divided into LPS group(A),LPS+pHC group(B),LPS+ M3 shRNA transfection group(C) and PHC+ LPS+ M3 shRNA transfection group(D).The cytoskeleton change was observed by laser scanning confocal.The LDH level in cellular supernate was detected.The VCAM 1 protein expression was examined by immunofluorescence chemistry.β-arrestin-1 protein expression was determined by Western blot and β-arrestin-1mRNA expression was measured by real-time PCR.Results Compared with the group A or C,F-actin cytoskeleton arrangement in the group B or D was neat,the LDH level and VCAM-1 protein expression were decreased,and β-arrestin-1 expression was increased;compared with group A or B,F-actin cytoskeleton arrangement in the group C or D was neat,the LDH level and VCAM-1 protein expression were decreased,while the β-arrestin-1 expression had no obvious change.Conclusion Silence M3 receptor is conducive to reduce LPS-induced HPMVEC injury.But the role of PHC up-regulating β-arrestin-1 expression has no necessary connection with M3 receptor.

BACKGROUND: As a reliable marker of inflammation, intercellular adhesion molecule-1 (ICAM-1) plays an important role in atherogenesis. Recently, it is assumed in researches of recent years that chronic inflammation mediated by ICAM-1 is involved in hypertensive left ventricular hypertrophy probably, but there are still some objections reported. Tanshinone ⅡA is a kind of liposoluble extract from danshen(Radix Salviae Mitiorrhizae) . It is verified in animal experiment that it can inhibit hypertensive left ventricular hypertrophy.OBJECTIVE: To investigate the relationship between ICAM-1 and hypertensive left ventricular hypertrophy and the effect of tanshinone ⅡA on expression of ICAM-1.DESIGN:A randomized controlled observation was designed.SETTING: Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was performed in the Laboratory of Emergency Department of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from October 2002 to January 2004. Ten male WKY rats(10 WKY rats) of 12-week-old and 20 rats with spontaneous hypertension(20 SHR rats) were employed and divided into the control group(10 WKY rats), hypertension group(10 SHR rats) and tanshinone ⅡA group(10 SHR rats).injected from caudal vein for treatment and distilled water at the same dose was injected in the other two groups. Twelve weeks later, the rats were sacrificed and myocardium was collected for specimen preparation. Haematoxylin and eosin(HE) staining, VG staining, immunocytochemical staining and myocardial ED1 labeling were applied to determine myocardial macrophage infiltration degree. The reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay(ELISA) were used to determine the expressions of ICAM-1 mRNA and protein.MAIN OUTCOME MEASURES: Degree of macrophages infiltration and the expressions of ICAM-1 mRNA and protein in myocardium in each group.RESULTS: Twelve SHR and 10 WKY rats were employed in the experiment pared with the control group, ICAM-1 mRNA and protein expressions in hypertrophic myocardium were increased significantly in hypertension group (0.176±0.087,0.537±0.195;0.104±0.011,0.173±0.027, P ＜0.01or P ＜ 0.05) . Infiltration of macrophage was significant(0. 62 ±0.07,non Ⅱ A group, the expressions of ICAM-1 mRNA and protein were decreased significantly(0. 537 ±0. 195, 0.291 ±0. 106; 0. 173 ±0.027, 0. 125± 0. 014, P ＜ 0.01 or P ＜ 0. 05); the amount of macrophages infiltration was decreased(1.85 ±0. 23, 1.16 ±0. 17, P ＜ 0.05) and the degree of cardiomyocytic hypertrophy and interstitial fibrosis was remarkably relieved.CONCLUSION: Excessive expression of myocardial ICAM-1 and its mediated inflammatory cellular infiltration plays an important role in hypertensive left ventricular hypertrophy. The inhibition of tanshinone ⅡA on left ventricular hypertrophy may be contributed to decreased expression of ICAM-1 and alleviated inflammatory cellular infiltration in myocardium.

BACKGROUND: A good many researches believe that the gene polymorphism of vascular endothelia nitric oxide synthase(eNOS) correlate with diseases of heart, brain and kidney. However, it is still not clear whether eNOS Glu298Asp correlates with myocardial infarction in the elderly Chinese.OBJECTIVE: To investigate the distribution of Glu298Asp polymorphism of vascular eNOS in the elderly as well as correlation between Glu298Asp polymorphism of eNOS and myocardial infarction in the elderly Chinese.DESIGN: A case-controled study based on diagnosis.SETTING, PARTICIPANTS and METHODS: A total of 37 patients with myocardial infarction were selected into case group, which all of them were patients from either outpatient department or inpatient department of the First Affiliated Hospital of Nanjing Medical University. Thereinto, 20 cases without hypertensive history were allocated into case subgroup. Totally 172 subjects selected from the re-testees of physical checkup of our hospital were assigned into control group, of which 92 cases without hypertensive history were allocated into control subgroup. Indices like height, body mass and fasting blood sugar were detected respectively in all participants of all groups. The polymorphism of Glu298Asp of eNOS gene was assayed by polymerase chain reaction(PCR), and restriction fragment length polymorphism (RELP).MAIN OUTCOME MEASURES: The polymorphism of Glu298Asp of eNOS gene as well as the allelic frequency of 298Asp in the elderly of four groups.RESULTS: Genotype of Glu/Asp of the case group was higher than that of the control group(32.43% and 18.02% respectively) . The genotype composition of Glu298Asp polymorphism had significant difference between the case group and the control group(x2 = 3.87, P < 0. 05) . Between normotensive subgroups, Genotype Glu/Asp of the case subgroup was higher than that of the control subgroup(35.00% and 10. 87% respectively) . The genotype composition of Glu298Asp polymorphism of the eNOS gene also had significant difference between the case subgroup and the control subgroup (x2 = 7.43, P < 0.01) . The allelic frequency of 298Asp of the case group was higher than that of the control group without statistical significance (16. 22% and 9.01% respectively, P > 0. 05) . Between normotensive subgroups, the allelic frequency of 298Asp of the case subgroup was significantly higher than that of the control subgroup(17.50% and 5.43% respectively, x2 = 6.82, P < 0.01 ) ).CONCLUSION: Glu298.Asp polymorphism of the eNOS gene exists in the elderly Chinese. The genotype of Glu/Asp and allelic frequency of 298Asp might be a genetic susceptible marker of myocardial infarction in the elderly Chinese.

Objective To study spiral CT features and pathological basis of nodular goiter ,so that to improve the diagnostic accuracy of nodular goiter.Methods CT findings in 34 patients with nodular goiter confirmed by pathology were retrospectively analyzed and compared with pathological findings. Results Thyroid density in the patients with NG was lower than that in the normal. There was no statistically significant difference in the density between single and multi-NG. Most lesions(28/34) were multiple, round or oval, with different size and smooth edges. The density of majority lesions was lower than nearby normal tissue. Most lesions (27/34) were uniform in density. Central necrosis(5/34)often appeared in the bigger lesions(diameter＞3.0 cm). The CT value of the lesions was increased (47.1±42.2) HU after enhancement,but lower than surrounding thyroid tissue. Calcifications in the lesions(6/34)were puncticular,plaque or crustiform. Single or multiple cystic-solid or solid nodules could be seen in pathology, without a continuous capsule in the majority. Some patients (5/13) with single NG shown on imaging study were multi-NG in the pathology. Three cases of diffuse NG showed by CT were malignant in pathology. Conclusion There are certain characteristics for NG on spiral CT. Comprehensive evaluation may improve the accuracy of CT diagnosis.

OBJECTIVE: A retrospective analysis of the clinical efficacy on the surgery of maxillary sinus diseases via the endoscopic lateral nasal wall incision, and a discussion on the clinical application of this approach. METHOD: Eighteen cases of the maxillary sinus diseases diagnosed on the basis of the preoperative nasal endoscopy, CT scan or MRI, and pathologic finding. Among 13 patients underwent routine lateral nasal wall incision approach, including 4 of maxillary sinus hemorrhagic and necrotic polyps, 4 of maxillary sinus cyst, and 3 of the maxillary sinus fungal infection. Five patients underwent lateral nasal wall resection approach and thorough maxillary sinus lesions resection by nasal endoscope, including 3 of inverted maxillary sinus papilloma, a nasal sinus bone giant cell tumor and a spindle cell tumor. Patients were followed up for more than half a year, and the postoperative efficacy were observed. RESULT: The surgical cavity of the lateral nasal wall incision approach have luminal epithelium, well shapes of inferior turbinate, no recurrence of the lesion, and the lateral nasal wall resection patients with well luminal epithelium, without recurrence. All patients had no complications such as numbness, tears, etc. CONCLUSION Endoscopic incision of lateral nasal wall keep the nasolacrimal duct and inferior turbinate, help remove the entire sinus cavity lesion and retain the physiological function of the nasal cavity. Resection of the lateral nasal wall can reveal an ideal vision approach, which perform certain clinical value for the treatment of the inverted maxillary sinus papilloma and sinus cancer.
Cysts ; surgery ; Dissection ; methods ; Endoscopy ; Humans ; Magnetic Resonance Imaging ; Maxillary Sinus ; surgery ; Maxillary Sinus Neoplasms ; surgery ; Maxillary Sinusitis ; microbiology ; surgery ; Nasal Cavity ; surgery ; Papilloma, Inverted ; surgery ; Retrospective Studies ; Tomography, X-Ray Computed