Objective To assess the clinical significance of three different noninvasive airway inflammatory indices in induced sputum and exhaled breath condensate ( EBC ) from persistent asthmatic patients.Methods Moderate and severe asthmatic patients were prescribed inhaled corticosteroids combined with long-acting β2 agonists for a month.The symptom scores and percentage of predicted value of forced expiratory volume in one second ( FEV1 ) ( FEV1% pred) were measured while the concentrations of H2O2,NO3-/NO2-,and cysteinyl-leukotriene E4(LTE4) in induced sputum and EBC were detected before and after therapy.Results A total of twenty-five subjects with moderate and severe asthma were enrolled.By combined therapy for one month the asthma aymptoms relieved and FEV1% pred improved significantly (P<0.01).The concentrations of H2O2,NO3-/NO2- arid LTE4in induced sputum and EBC declined significantly(P<0.01) although the concentrations were still higher than those at normal baseline.More marked reduction of H2O2 and NO3-/NO2- compared to LTE4was observed.It was revealed that the concentrations of H2O2 and NO3-/NO2- but not of LTE4in EBC were negatively correlated with FEV1% pred (P <0.01) and positively with symptom scores.Such correlations were also found in H2O2 in induced sputum with FEV1 % pred and symptom scores as well as NO3-/NO2- in induced sputum with FEV1 % pred.The improvement of FEV1 % pred after treatment was positively correlated with the reduction of H2O2 and NO3-/NO2- both in induced sputum and EBC.Correlation analysis also demonstrated three inflammatory indices were equivalent in induced sputum and EBC( correlation coefficient of H2O2,NO3-/NO2- and LTE4,0.759,0.826 and 0.653,respectively.P < 0.01 ).Conclusions (1) Combined therapy with inhaled corticosteroid plus long-acting β2 agonist significantly improves the clinical symptoms and lung function of patients with moderate and severe asthma companied with marked suppression of airway inflammation.(2) Both of EBC and induced sputum sampling are valuable noninvasive procedures for detecting asthma airway inflammation,however,EBC technique is superior in safety and reproducibility.(3) H2O2 and NO3-/NO2- seem to be more sensitive indices in diagnosis and monitoring asthma compared to LTE4.

The effects of exopolysaccharides from Aphanothece halophytica(.EAH) on immunological function were studied by immunological techniques. The results showed that EAH could not only enhance the mitogenic response of mice's thymus cells, murine bone marrow cells proliferation,murine mixed lymphocyte reaction and the activity of NK cells in mice,but promote the interleukinl(IL-1)production and increase the activity of 1L-2 as well. The study suggests that EAH can improve the immunological function of mice.

Objective To explore the expression and clinical significance of Twist. E-cadherin and N-cadherin in gallbladder carcinoma. Methods From 2000 to 2008, in Zhejiang Provincial People's Hospital, the expression of Twist, E-cadherin and N-cadherin protein were detected in 79 surgically removed gallbladder carcinoma tissue specimens in paraffin blocks and 20 normal gallbladder tissue specimens by tissue microarray technique and immunohistochemistry. Results Compared with normal gallbladder tissues, the expression of Twist and N-cadherin was up-regulated in gallbladder carcinoma tissues and the positive percentage was 68.3％ and 49.4％ respectively, while which both were 1/20 in normal gallbladder tissues. The percentage of high E-cadherin expression in gallbladder carcinoma tissues was only 27.8 ％, which was significantly lower than that in normal gallbladder tissues (20/20;X2 ＝29.31, P＜0. 05). The expression of Twist was correlated with T classification, lymph node metastasis, distant organ metastasis, hepatoduodenal ligament invasion, lymphatic invasion and UICC stage of gallbladder carcinoma (P＜0.05). The expression of E-cadherin was correlated with T classification, distant organ metastasis, hepatoduodenal ligament invasion, differentiation degree and UICC stage of gallbladder carcinoma (P＜0.05). The expression of N-cadherin was only correlated with lymphatic invasion of gallbladder carcinoma (P ＜0.05 ). There was significant negative correlation between Twist and E-cadherin expression (P＜0. 01). All the 79 gallbladder carcinoma patients were followed up after the surgery, the mean follow-up time was 30.6±14.3months. The 3-year survival rates of patients with low or high Twist expressions were 66％ and 7％ respectively,there was significant difference between the two groups(P＜0. 01). The 3-year survival rates of patients with low or high E-cadherin expressions were 25 ％ and 86 ％ respectively, the difference of two groups was significant(P＜0.01). The 3-year survival rates of patients with low or high Ncadherin expressions were 39％ and 41％ respectively, there was no significant difference between the two groups(P＞0.05). The multivariate analysis indicated that the Twist expression was one of independent prognostic factors of gallbladder carcinoma. Conclusion The abnormal expression of Twist and E-cadherin was correlated with the development and progression of gallbladder carcinoma,and Twist expression was one of the independent prognostic factors of gallbladder carcinoma.

Objective To assess the effect of three different liver vascular exclusions on prognosis of patients undergoing hemihepatectomy.Methods Clinical data of 216 patients undergoing hemihepatectomy were analyzed retrospectively.Ninety-eight out of 216 patients received Pringle maneuver during hepatectomy in group A,71 patients of selective liver inflow and outflow vascular exclusions in group B,47 patients using liver hanging maneuver combining with selective liver inflow and outflow vascular exclusions were in group C.Results There was no difference in operation time between the three groups ( t =0.72,0.83,and 0.67,P ＞ 0.05 ).The intraoperative blood loss and transfusion in group B and C were less than that in group A (t =3.72,3.83 and 4.11,4.07,P ＜0.05).Serum albumin level on day 1 and day 3 in group B and C were higher than that in group A (t =3.65,3.77,and 3.90,3.74,P ＜0.05 ).Serum total bilirubin level on day 3 and 5 in group B and C were lower than that in group A ( t =4.13,5.01,and 4.09,3.99,P ＜0.05).Serum alanine aminotransferase on day 1,3 and 5 in group B and C were lower than that in group A ( t =5.36,6.14,and 5.70,7.01,and 4.94,3.98,P ＜ 0.05 ).Postoperative complication rate in group A was higher than that in group B and C ( x2 =13.71 and 23.56,P ＜ 0.05 ).The 3-year survival rate of patients with malignant tumor in the three groups were not significantly different (t =2.38,P ＞ 0.05 ).Conclusions Intraoperative blood loss and transfusion and postoperative complication rate can be reduced,and liver injury can be diminished in hemihepatectomy using selective liver inflow and outflow vascular exclusion alone and or in combination with a liver hanging maneuver.

Objective     To share the clinical experience of video-assisted thoracoscopic surgery (VATS) anatomic basal segmentectomy by single-direction method. Methods     The clinical data of 352 patients who underwent VATS anatomic basal segmentectomy in West China Hospital between April 2015 and April 2021 were retrospectively reviewed, including 96 males and 256 females with a median age of 50 (range, 26-81) years. All basal segmentectomies were performed under thoracoscopy, through the interlobar fissure or inferior pulmonary ligament approach, and following the strategy of single-direction and the method of "stem-branch". Results    All patients underwent basal segmentectomy successfully (49 patients of uniportal procedure, 3 patients of biportal procedure and 300 patients of triportal procedure) without addition of incisions or conversion to thoracotomy and lobectomy. The median operation time was 118 (range, 45-340) min, median intraoperative blood loss was 20 (range, 5-500) mL, median drainage time was 2 (range, 1-22) d and median postoperative hospital stay was 4 (range, 2-24) d. The postoperative complications included pneumonia in 6 patients, prolonged drainage (air leakage duration>5 d or drainage duration>7 d) in 18 patients, cerebral infarction in 1 patient and other complications in 2 patients. All patients were treated well and discharged without main complaints. No perioperative death happened. Conclusion    VATS anatomic basal segmentectomy is feasible and safe. It can be performed in a simple manner following the strategy of single-direction.

Objective To study the epidemiology of mycoplasma pneumonia (MP) infection in children and its relationship to meteorological conditions in Guilin. Methods Total of 1 342 hospitalized children with respiratory tract infections from Janu-ary 2011 to December 2012 were recruited, and the serum levels of mycoplasma pneumoniae antibody Ig (MP-Ig) were measured. Meanwhile, monthly meteorological conditions were collected. The relationships between the MP-Ig detection rates and meteoro-logical conditions were analyzed by multiple linear regression analysis. Results The total detection rate of MP-Ig was 23.2%with positive rates as 5.51%, 28.99%, 37.31%and 44.97%for 0-1, 1-3, 3-6 and>6 year-old groups respectively (P<0.01). The positive rate of female was higher than that of male with signiifcant difference (30.08%vs 19.05%, P<0.01). The positive rate of spring, summer, autumn and winter were 18.89%, 17.39%, 23.83%and 33.05%individually (P<0.01). Negative correlation was found be-tween detection rate of MP-Ig and monthly mean air temperature (P=0.001). Conclusion MP is one of the commonest pathogens of respiratory tract infection in children and mostly seen in elder female children with a higher incidence in winter. The main me-teorological factor is the low temperature that affects MP prevalence.

As there are a number of ankle arteries and some of them can not be blocked completely under higher pressure from the external inflate cuff, we can not accurately identify the starting point of the pulse wave, so the errors of lower limb systolic blood pressure measurement take place and affect the accuracy of ankle-brachial index in diagnosing vascular disease. In this paper, we constructed delay vectors from the data we already collected from lower limb pulse wave and formed an embedding matrix; thus solving the problem of inadequate sensor dimensions. We extracted a single arterial pulse wave through the blind signal separation on the basis of embedding matrix, and we identified the lower limb systolic blood pressure corresponding to the starting point. Simulation and clinical experiments show the method can be used to separate the wave signals of ankle artery which contains information of systolic blood pressure. It improves the accuracy of lower limb systolic blood pressure measurement and hence provides accurate data for the clinical diagnosis of arterial disease.
Algorithms ; Ankle ; blood supply ; Blood Pressure ; Blood Pressure Determination ; methods ; Brachial Artery ; physiology ; Humans ; Leg ; blood supply ; Pulsatile Flow ; physiology ; Signal Processing, Computer-Assisted

Objective To evaluate the result of multiple segmentectomy under selective occlusion of hepatic inflow for complicated intrahepatic cholangiolithiasis. Methods In this study 12 cases of complicated intrahepatic cholangiolithiasis receiving multiple segmentectomy under selective occlusion of hepatic inflow during 2004. 1 - 2010. 10 were reviewed retrospectively. The short-term and long-term outcomes of the patients were analyzed. Results There was no surgical mortality in this group. The segmentectomy performed were Ⅱ + Ⅲ + Ⅴ in 1 case; Ⅱ + Ⅲ + Ⅵ in 2 cases; Ⅱ + Ⅲ + Ⅴ + Ⅵ in 1 case;Ⅱ +Ⅲ+Ⅵ +Ⅶ in4 cases; Ⅱ +Ⅲ +Ⅳ +Ⅵ in 3 cases and Ⅱ + Ⅲ +Ⅳ +Ⅵ +Ⅶ in 1 case. The average intraoperative blood loss was 560 ± 291 ml. Postoperative complications were wound infection in 2 cases, bile leakage in 1 case, abdominal infection in 1 case. There were no liver failure, intrabdominal hemorrhage or hemobilia; stone clearance rate at 10 days after operation was 83% (10/12) and 92%(11/12) at 6 weeks after operation following postoperative choledochoscopic lithotripsy. 92% (11/12) cases were followed-up with the median follow-up period of 31 months. The result was excellent or good in 92% (11/12) cases. Conclusions Multiple segmentectomy was the choice for complicated intrahepatic cholangiolithasis, and the procedure could be safely performed under selective occlusion of the hepatic inflow.

Objective To evaluate right hepatic veins exclusion in the prevention of massive bleeding and air embolism during the resection of huge hepatic cavernous hemangioma near the second hepatic portal. Method This is a retrospective study on the clinical data of 12 hepatic hemangioma patients at the Live Surgery Department of Zhejiang Provincial People's Hospital from 2004. 1 to 2010.3. In all patients the huge hepatic cavernous hemangioma was adjoining the second hepatic portal. Block webbing or vascular clamp were used to exclude the right hepatic veins. Among the 11 patients without hepatic cirrhosis Pringle maneuvre was applied in 5 cases and selective hepatic inflow occlusion in 6 cases. Patients with hepatic cirrhosis used hemi-hepatic blood inflow occlusion. Results During the surgery no rupture of right hepatic vein happened. Nine patients used vascular block webbing and 3 patients used vascular clamp.Six patients without cirrhosis used the complete hepatic inflow occlusion and other patients without cirrhosis used hemi-hepatic blood inflow occlusion. Cirrhotic patients used hemi-hepatic blood inflow occlusion. All the operations were successful. Intraoperative blood loss ranged from 200 - 5800 ml, averaging 680 ml. Three patients needed not blood transfusion. There was no right hepatic vein rupture or air embolism. Conclusion Right hepatic veins exclusion is a useful technique to prevent massive bleeding and air embolism caused by the rupture of right hepatic vein during the resection of huge hepatic cavernous hemangioma.