Objective To investigate the clinical safety of preoperative lymphatic chemotherapy in the treatment of reetal cancer.Methods The regional and systemic symptoms,postoperatwe stoma healing,haematogenesis.functions of hean,liver and kidney after lymphatic chemotherapy,and the level of CD3+,CD4+,CD8+,CD4+/CD8+,CD(16+56)+in blood 30 minutes before and 48 hours after lymphatic chemotherapv were detected.Results There were no significant effects of lymphatic chemotherapy on the regional and systemic symptoms,postoperative stoma healing,haematogenesis and the functions of heart,liver and kidney.The level of CD4+/CD8+48 hours after lymphatic chemotherapy was significantly increased(t=7.145,P＜0.05),while no significant changes of CD3+,CIM+,CD8+,CD(16+56)+were detected(t=1.782,1.151,1.184,0.955,P＞0.05),when compared with those 30 minutes before lymphatic chemotherapy.Conclusions Preoperative lymphatic chemotherapy is safe and can enhance patients'immunity in early stage.

Objective To investigate the differential expression of hepatocyte growth factor activator (HGFA) and its inhibitors (HAI-1,HAI-2) during cirrhotic and normal liver regeneration after partial hepatectomy,and to explore the causes of the delayed liver regeneration after partial hepatectomy in cirrhotic rat model.Methods We used 40％ CCl4 subcutaneous injection to establish the cirrhotic rat model,and then performed 70％ liver resection for the experimental group together with no operation for the healthy rats as control group.Rats in each group after 3 hours,6 hours,12 hours,24 hours and 48 hours were randomly sacrificed and specimens were collected.The serum HGFA was detected by enzyme-linked immunosorbent assay (ELISA),and we used RT-PCR to detect the mRNA expressions of HAI-1 and HAI-2 in splenic tissue.Results The serum HGFA level in cirrhotic rats at each time point was all significantly lower than that in the control group (P ＜0.05).The expression of HAI-1 mRNA in cirrhotic rats was sustained at a higher level than that in the control group (P ＜ 0.05),but there was no significant difference on the HAI-2 mRNA expression between the two groups (P ＞ 0.05).Conclusions The synthesis of HGFA during the liver regeneration after partial hepatectomy in cirrhosis rats is lower compared with healthy rats,which may lead to the insufficient activation of HGF precursor,eventually causing the slow liver regeneration.HAI-2 may not be involved in the healing process of liver.

BACKGROUND:Studies have shown that the reason of the slower liver regeneration in individuals of cirrhotic liver after partial hepatectomy compared with healthy liver may be related to the delayed synthesis and secretion of hepatocyte growth factor during liver regeneration, but the cause of this phenomenon is not clear. The hepatocyte growth factor activator inhibitor found in recent years can indirectly inhibit the activation of hepatocyte growth factor, but there is little research to explore the expression of hepatocyte growth factor activator inhibitor in the regeneration process after partial hepatectomy in cirrhotic liver and its relationship with the liver regeneration. OBJECTIVE:To investigate the expression of hepatocyte growth factor activator inhibitors (HAI-1, HAI-2) during cirrhotic and normal liver regeneration after partial hepatectomy through establishing the cirrhotic rat model, and to explore the biological effects of HAI-1, HAI-2 in cirrhotic liver during the liver regeneration after partial hepatectomy. METHODS:We used 40%CCl4 subcutaneous injection to establish the cirrhotic rat model, then we performed 70%liver resection for the experimental group. The rats in the control group only received ordinary water feeding and 70%liver resection. Rats in each group were randomly sacrificed before surgery and at 3 hours, 6 hours, 12 hours, 24 hours and 48 hours after surgery, and samples were col ected. We used RT-PCR technology to detect the expression of HAI-1 mRNA, HAI-2 mRNA in splenic tissue. RESULTS AND CONCLUSION:The expression levels of HAI-1 mRNA of two groups after partial hepatectomy were increased firstly and then decreased. The expression of HAI-1 mRNA in cirrhotic rats was sustained higher than that of the control group (P<0.05), there was no significant difference between the two groups of the expression of HAI-2 mRNA (P>0.05). The expression of HAI-1 mRNA in liver cirrhosis rats after resection was consistently higher than that in healthy rats, which may lead to the insufficient synthesis and secretion of hepatocyte growth factor activator in cirrhotic rats, then hepatocyte growth factor precursor may not be activated enough, eventual y leading to slow liver regeneration. HAI-2 may not be involved in the wound repair process of liver.

Attention was gradually paid by biologists to the using of RNA secondary structure in the classification of microbiology and phylogenetic relationship analysis in recent years. The development around the research was summarized here briefly. And more emphasis was given to the part introducing the application of RNA secondary structure to the analysis of phylogenetic relationship.

Objective To analyze the distribution and drug resistance of 130 clinical strains of acinetobacter (A ) .baumannii in 2012 .Methods The bacterial identification and the susceptibility test were performed by using the micro-organisms identification and susceptibility plate produced by the Zhuhai Deere Company .The data were collected and statistically analyzed by the SPSS 17 .0 software .Results 130 strains of A .baumannii were isolated from 1 391 clinical samples during 2012 ,the detection rate was 9.35% .Thesamplesweremainlyderivedfromsputum(89.23% )andthedepartmentwasmainlydistributedinICU(46.15% ).A. baumannii isolates showed the lowest resistant rates to cefoperazone-sulbactam and polymyxin B ,which were 6 .9% and 7 .7% re-spectively .The drug resistance rate against the third-generation of cephalosporin commonly used in clinic was more than 70% .The resistant rates to imipenem and meropenem were 44 .6% and 58 .5% respectively .The drug resistance rates of A .baumannii isolates to 13 usual antibacterial drugs in ICU were significantly higher than those in non-ICU departments(P<0 .05) .Conclusion The re-sistance of A .baumannii to antibacterial drugs is gradually serious ,which should be paid high attention to in clinic ,and at the same time the comprehensive measures of prevention and control of hospital infection should be adopted to reduce the spread of drug-re-sistant bacteria .

Asian Continental Ancestry Group ; China ; Chronic Disease ; Humans ; Rhinitis ; diagnosis ; Sinusitis

Objective To evaluate the clinical outcome of mono-segment transpedicular fixation of type B thoracolumbar fracture.Methods A retrospective analysis was conducted on 40 cases suffering from type B thoracolumbar fracture treated with mono-segment transpedicular fixation from May 2003 to October 2012.According to the AO classification,13 cases were identified with type B1.1,11 type B1.2,11 type B2.2,2 type B3.1,2 type B3.2,and 1 type B3.3.Radiological results were evaluated by measuring compression rate of the fractured vertebra and Cobb' s angle of the vertebra adjacent to the fractured segment.Clinical results were assessed using Frankel classification for spinal cord injury and visual analogue scale (VAS) for pain.Results Mean operation time was 71 minutes and mean intrao perative blood loss was 105 ml.Mean period of follow-up was 47.5 months (range,24-82 months).Mean Cobb' s angle of the vertebra adjacent to the fractured segment and compression rate of the fractured vertebra revealed great correction at one week post-operation compared with preoperative ones (6.2° vs 20.1° and 10.1％ vs 38.9％ respectively,P ＜0.05) and there was no significant correction loss at the last follow-up (6.9° and 10.8％ respectively,P ＞ 0.05).Mean VAS was 8.6 points before operation,but mean VAS was 2.4 points at final follow-up (P ＜ 0.05).Neurological performance improved in 37 cases (93％).No cases experienced neurological deterioration.Conclusions Mono-segment transpedicular fixation has small incision,short operation time,few bleeding and decreased motor function loss.The procedure is indicated for most type B thoracolumbar fracture and clinical results are satisfactory.

Objective To investigate the clinical role of central venous pressure(CVP) to evaluate fluid responsiveness in septic shock patients. Methods 66 septic shock patients were studied, every patient was administered a volume challenge, before and after it, CVP, intrathoracic blood volume index (ITBVI),global end-diastolic volume index(GEDVI), cardiac index(CI), stroke volume index(SVI) were measured by PiCCO method. All the obtained values were analyzed by statistics method. Results Initial CVP in responders is significantly different from that in nonresponders; △ITBVI, △GEDVI, △CI, △SVI, △HR (△:changes) before and after volume challenge in responders were significantly different from those in nonresponders; the significance of △ITBVI, AGEDVI to predict volume responsiveness was strong indicated by high values of areas under the receiver operating characteristic curves (0.674 and 0.700, respectively).If patients were regrouped by CVP≤11 mm Hg(1 mm Hg=0.133 kPa) and CVP > 11 mm Hg, initial ITBVI and GEDVI in responders were not significantly different from that in nonresponders; △ITBVI,△GEDVI, △CI, △SVI before and after volume challenge in responders were significantly different from those in nom'esponders. Conclusion In septic shock patients, CVP play a guidance role to predict and evaluate volume responsiveness and when CVP was > 11 nun Hg, a positive response will be less likely. Initial volumetric parameters(intrathoracic blood volume and global end-diastolic volume) play a questionable role in predicting and evaluating volume responsiveness, changes before and after volume challenge maybe helpful.

Objectlve To research and analyze the hemod)rnamic status of refractory septic shock associated cardiac dysfunction.Methods 70 refractory septic shock patients were studied.In the duration of pulmonary artery catheter(PAC)-directed hemodynamic optimization,the patients were divided into a cardiac dysfunction group and a control group.Hemodynamic parameters,arterial blood lactate concentration and APACHE II scores were obtained instantly after the placement of a PAC,then lactate clearance in 24 hours was surveyed and calculated.Subsequently the two groups of patients were regrouped by nonsurvivor and survivors respectively.All the obtained values were analyzed with statistic methods.Results 37% of the refractory septic shock patients was complicated with cardiac dysfunction.The age of the patients complicated with cardiac dysfunction was significantly higher than that of the patients of the control group.Central venous pressure(CVP),pulmonary artery obstruction pressure(PAOP),pulmonary artery pressure (PAP),systemic vascular resistance index(SVRI),pulmonary vascular resistance index(PVRI)and oxygen extraction ratio(O2ext)in the cardiac dysfunction group were significantly different from those in the control group.Cardiac output(CO),cardiac index(CI),oxygen delivery index(DO2I)and mixed venous oxygensaturation(S-v O2)were significantly lower than those of the patients in the control group.S -v O2 had a strong correlation witIl CI.If the patients were regrouped by nonsurvivors and survivors.in the patients complicated with cardiac dysfunction APACHE II scores were significantly higher in the nonsurvivors than survivors:the lactate clearance in 24 hours(median-25%)of the nonsurvivors was significantly lower than that of nonresponders(median 22%),P＜0.05.Conclusion (1)In refractory septic shock patients,cardiac dysfunction maybe the main reason leading to bad outcome.(2)Higher CVP and PAOP and lower S -v O2 indicate the onset of cardiac dysfunction.(3)The patients with significantly high initial arterial blood lactate level and the low lactate clearance in 24 hours had bad outcome.

Objective To compare the treatment effects between lymphatic chemotherapy and regional extended release chemotherapy (RERC) for rectal cancer lymph node metastasis. Methods The lymph nodes at or beside colon (first station), beside (second station) and at the root of mesentery blood vessel (third station) of the patients with rectal cancer in control group (20 cases), lymphatic chemotherapy group (20 cases) and RERC group (20 cases) were removed to compare proliferation index (PI), apoptotic index (AI) and AL/PI of cancer cells in the lymph nodes. Results The PI, AI, and AI/PI of cancer cells in correspondent lymph nodes were not statistically different between lymphatic chemotherapy group and the other 2 groups (F=4.973-7.394, 5.372-8.694, 4.527-5.436, P<0.05; t=3.128-7.688, 3.388-9.615, 6.518-13.180, P<0.05). The PI, AI, and AI/PI of cancer cells in the first and second station lymph nodes in RERC group were significantly different from those in control group (t=5.103, 4.927; 6.938, 6.450; 8.839, 9.021; P<0.05), and from those in the third station lymph nodes in RERC group (F=6.572, 8.964, 5.845, P<0.05; t=3.505, 3.353; 5.397, 4.701; 9.039, 8.629; P<0.05). Sorted by the treatment effects for cancer cells in lymph nodes, the first is each station of the lymphatic chemotherapy group, followed by the first and second station of the RERC group, and then the third station of the RERC group which was almost equal to any station of the control group. Conclusion Lymphatic chemotherapy is better than RERC in the treatment of rectal lymph node metastasis in the aspect of scale and degree.