Objective To study the incidence of malposition of catheter at different body positions during the operation of peripherally inserted central catheter (PICC),and then select the optimum position to increase the success rate of insertion. Methods 155 patients were randomly divided into the horizontal position group (55 cases),the semi-reclining position group (49 cases) and the sitting position group (51cases).They all used chest X-ray to conffirm the position of top end of the catheter after insertion and then comparing the incidence rate of malposition of catheter among three groups. Results After insertion,11 patients' catheters were found malposition.Among them,8 patients were in the semi-reclining position group (incidence rate 16.3％),2 patients were in the horizontal position group (incidence rate 3.6％) and only one patient was in the sitting position group (incidence rate 1.9％ ).Incidence rate of catheter malposition in the semi-reclining position group was significantly higher than other two groups. Conclusions The best position for PICC is the horizontal position.If the patient has expiratory dyspnea or need to adjust the malposition catheter,sitting position can be used.Semi-reclining position should be avoided in the operation of PICC.

To explore the utility of apparent diffusion coefficient(ADC)histogram analysis for differentiating genetic subtypes of diffuse lower-grade gliomas. A total of 55 patients with WHO grade Ⅱ/Ⅲ diffuse lower-grade gliomas who underwent preoperative routine brain magnetic resonance imaging and diffusion weighted imaging in our center were retrospectively evaluated.Among whom there were 14 patients with isocitrate dehydrogenase(IDH)wild-type gliomas(IDH group),19 patients with IDH-mutant 1p19q intact gliomas(IDH 1p19q group),and 22 patients with IDH-mutant 1p19q co-deleted gliomas(IDH 1p19q group).The whole-lesion ADC values derived from histogram analysis(including ADC,ADC,ADC5%,ADC10%,ADC25%,ADC50%,ADC75%,ADC90%,ADC95%,ADC,mode,range,skewness,kurtosis,standard deviation,inhomogeneity,and entrophy)were measured for each patient.All parameters between the different genetic subtypes were compared by using the Student's test or Mann-Whitney test.Receiver operating curve(ROC)analysis was used to assess the diagnostic performance of ADC histogram in distinguishing the different genetic subtypes. Compared with IDH group,the ADC75%(=0.021),ADC90%(=0.015),ADC95%(=0.014),ADC (=0.035),range(=0.009),standard deviation(=0.001)and inhomogeneity(=0.001)were significantly lower in IDH group;in contrast,the ADC (=0.031)and kurtosis(=0.020)of IDH group were significantly higher than those in IDH group.The ADC(=0.010),ADC5%(=0.016),ADC10%(=0.012),ADC25%(=0.007),ADC50%(=0.005),ADC75%(=0.015),and mode(=0.002)were significantly higher in IDH 1p19q group than in IDH 1p19q group.Inhomogeneity achieved the highest area under ROC(AUC)(0.811)in differentiating IDH gliomas and IDH gliomas,with a cutoff value of 0.229;the sensitivity and specificity were 85.7% and 73.2%.The mode achieved the highest AUC(0.744)in differentiating IDH 1p19q gliomas and IDH 1p19q gliomas,with a cutoff value was 1448.75×10 mm /s;the sensitivity and specificity were 57.9% and 90.9%. ADC histograms analysis may be helpful to differentiate genetic subtypes in lower-grade gliomas.
Brain Neoplasms ; Diffusion Magnetic Resonance Imaging ; Glioma ; Humans ; ROC Curve ; Retrospective Studies

Objective To assess the liver histopathological characteristics of chronic hepatitis B (CHB) patients with alanine aminotransferase(ALT)lower than 2 times the upper limit of normal (ULN) through liver biopsy, and try to provide subjective evidence for clinical anti-viral treatment.Methods From October 2005 to August 2010, patients accepted liver biopsy in department of infectious disease, Sichuan provincial people's hospital were enrolled. The criteria for liver biopsy was as follow, (1) HBsAg-positive for more than 6 months, (2) HBeAg-positive patients with HBV DNA ≥103 copies/ml or HBeAg-negative patients with HBV DNA≥ 104copies/ml, (3) ALT was lower than 2 times ULN for more than 6 months,and without any hepatic protectants, (4) never accepted any antiviral treatment before, including IFN or nucleoside analogues, (5) willing to accept liver biopsy. Before liver biopsy, routine blood test, prothrombin time, liver function test, hepatitis B antigen and antibody test, HBV DNA quantification were examined. The biopsy position was located under routine ultrasound, liver biopsy were performed to assess the grading of inflammation and necrosis and the degree of fibrosis. The correlation between all the factors and liver inflammation and fibrosis were analyzed. Results Totally 383 cases (240 males and 143 females) met the diagnostic criteria, aged from 16 to 59 years old and the mean age was 28.0 years old. Cases of liver inflammation in G0, G1, G2, G3andG4 grade was 2 cases (0.5％), 165 cases (43.1％), 191 cases (49.9％), 25 cases (6.5 ％ ) and 0 cases (0 ％ ) respectively, cases≥G2 grade accounted 56.4 ％ of total. Meanwhile,stage of fibrosis in S0, S1, S2, S3 and S4 was 103 cases (26.9％), 265 cases (69. 2％), 13 cases (3.4％), 2 cases (0.5％) and 0 cases (0％) respectively, percentage of liver fibrosis in S2stage and over was only 3.9％. The occurrence of serious liver inflammation was associated with age, ALT levels, HBV DNA levels and HBeAg status (P＜0.05). There was no obvious association between HBV DNA level and liver fibrosis (P＞0.05). Conclusions There were obvious liver inflammation and different degree of liver fibrosis in CHB patients with alanine aminotransferase(ALT)lower than 2 times ULN. The degree of liver injury assessed by liver biopsys is recommended as an evaluation for the necessary of anti-viral therapy.

ObjectiveTo explore a minimally invasive,reliable,and efficient method for endotracheal intubation to instill lipopolysaccharide (LPS) for preparation of acute lung injury (ALI) in mice.MethodsA total of 80 BALB/C mice was randomly selected into LPS group ( n =40) and control group (Normal saline,NS; n =40).After a successfully endotracheal intubation,each mouse was instilled by LPS (3 mg/kg) in LPS group,and NS ( 1.5 ml/kg) in NS group,respectively.The one-time success rate and final success rate of the endotracheal intubation,and survival rate were recorded.After 24 hours,the total number of cells in bronchoalveolar lavage fluid (BALF) of left lung was counted with light microscope.The cells were classified and counted after Wright's stain.Total protein concentration in BALF was assayed with a BCA kit.Wet/dry value was calculated after the lung became dry.Artery blood PaO2 was tested and the oxygenation index was counted.ResultsCompared to NS group,the LPS group had the one-time success rate 92.5％,and the final success rate 100％,survival rate 100％,the total number of cells [ ( 10.82±3.51) ×105/mlvs (0.72±0.52)×105/ml.t =-6.294 P ＜0 01]the rate of polymorphonulear leukocytes in total cells [ (93.93 ± 1.77) ％ vs (2.2 ± 0.91 ) ％,t =- 105.565,P ＜ 0.01 ],the rate of mononuclear leukocytes in total cells[ (6.07 ± 1.77)％ vs (97.8 ±0.91 )％,t =- 105.565,P ＜0.01 ],total protein concentration[ (0.49 ± 0.13 ) mg/ml vs (0.29 ± 0.11 ) mg/ml,t =- 2.823,P ＜ 0.05 ],W/D ratio(4.60 ±0.18 vs 4.16 ±0.25,t =-4.793,P ＜0.01 ),PaO2[ (68.57 -±7.23)％ vs(87.00 ±6.33 )％,t =4.571,P ＜ 0.01 ],and oxygenation index [ (326.53± 34.43 )mmHg vs (414.29 ± 30.16)mmHg,t =4.571,P ＜0.01 ].ConclusionsImproved method for endotracheal intubation has high success rate and minimal injury,and instillation of LPS (3 mg/kg)can induce mice ALI successfully.

AIM:To compare the clinical effects of 25G+ and 27G+ transconjunctival sutureless vitrectomy in treating idiopathic macular hole.METHODS: We retrospectively reviewed the clinical outcomes of 56 eyes (56 patients) with idiopathic macular hole which were treated with micro-incision vitrectomy from June 2015 to September 2016.Patients were divided into two groups, 28 patients (28 eyes) were treated with 25G+ vitrectomy and the rest (28 eyes) were treated with 27G+ vitrectomy.The operative time and intraoperative complications were recorded and patients were followed up for 3-6mo.During the follow up period, best correct vision acuity (BCVA), intraocular pressure, macular hole healing and postoperative complications were documented and statistically analyzed.RESULTS: BCVA in two groups were significantly improved after surgery(P<0.001) and there was no significant difference between the two groups(P=0.84).No serious complications occurred.No statistically significant difference was found between the two groups in surgical time and healing rate of macular hole (P=0.57, 0.64).The incidence of low intraocular pressure (IOP<10mmHg) in 27G+ group was lower than that in 25G+ group on the first day after surgery(P=0.31).There was no significant difference between preoperative and postoperative intraocular pressure at 1wk after operation in both groups (P=0.72, 0.92).CONCLUSION: Both 25G+ and 27G+ vitrectomy are safe and effective technique in treating idiopathic macular hole.Besides, 27G+ showed better superiority on the maintenance of intraocular pressure and reduce the trauma.

Alkaloids ; pharmacology ; Animals ; Liver Neoplasms, Experimental ; enzymology ; prevention & control ; Quinolizines ; pharmacology ; Rats ; Selenium ; pharmacology ; Telomerase ; metabolism ; Yeast, Dried ; pharmacology

Objective To explore the risk factors of recurrent low hemoglobin(RLH) level among students from 6 to 13 years old, and to formulate strategies and policies in this regard. Methods Surveillance on hemoglobin concentration was conducted among 71 742 students aged from 6 to 13y between 2013-2014 based on the annual physical examination for primary and middle school in Minhang District.Of those students, 670 were diagnosed with low hemoglobin level according to WHO criteria.A 1 ︰ 1 matched case-control study was conducted based on gender, age and school type.Questionnaire surveys for data collection were analyzed using Cox′s proportional hazards regression. Results Factors as pregnancy anemia(OR=2.32, 95%CI:1.49-3.63), non-pregnancy anemia(OR=4.65, 95%CI:1.22-17.69), maternal anemia(OR=2.51, 95%CI:1.50-4.21), drinking strong tea(OR=2.56, 95%CI:1.27-5.13) and dietary bias(OR=1.94, 95%CI:1.45-2.59) were risk factors of recurrent low hemoglobin level.Chewing pencils(OR=1.80, 95%CI:1.25-2.59) or toys(OR=1.79, 95%CI:1.10-2.86) and wasting(OR=3.37, 95%CI:1.11-10.21)might be the risk factors. Conclusion The risk factors of recurrent low hemoglobin level among students aged from 6 to 13 years are related to maternal anemia status and their dietary habits.We should strengthen education for women of child-bearing age, and help to develop healthy eating practices for their babies.Emaciated students should be focused on in this regard.

[Objective] To observe the effects of autophagy induced by different doses of ultraviolet B (UVB) irradiation on the apeptosis in human skin fibroblasts.[Methods] Skin fibroblasts were isolated from the circumcision specimen of a 23-year-old healthy male,and subjected to a primary culture.After 3 to 10 passages,the cells were collected and applied in the following experiment.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation of some fibroblasts treated with different concentrations (0,0.5,2.0,5.0and 10.0 mmol/L) of 3-methyladenine (3-MA).To qualitatively and quantitatively detect the autophagy in fibroblasts treated with different concentrations of 3-MA and in fibroblasts treated with 3-MA of 0.5 mmol/Lfollowing UVB irradiation,monodansylcadaverine (MDC) staining was carried out,and immunofluorescence was used to detect the expression of microtubule-associated protein 1 light chain (LC3).Some fibroblasts were classified into 8 groups to remain untreated,be irradiated with UVB of 30,50 and 100 mJ/cm2 alone,treated with 3-MA of 0.5 mmol/L alone,or treated with 0.5 mmol/L 3-MA following irradiation with UVB of 30,50 and 100 mJ/cm2,respectively,then,cell apoptosis was qualitatively detected by Hoechst and propidium iodide (PI)staining,and quantitatively detected by flow cytometry with annexin V and PI.[Results] The percentage of autophagic cells was (63.037 ± 5.876) ％ in fibroblasts treated with starvation condition,significantly decreased to (34.425 ± 5.183) ％ in fibroblasts treated with 3-MA of 0.5 mmol/L.The expression of LC3 showed a gradually increasing trend from untreated fibroblasts,to fibroblasts irradiated with UVB of 30,50 and 100 mJ/cm2,while the increase was attenuated by the 4-hour treatment with 3-MA immediately after the irradiation.Compared with the other concentrations,the 3-MA of 0.5 mmol/L showed the least influence on the viability of fibroblasts.The addition of 3-MA of 0.5 mmol/L increased the percentage of cells both positive for Hoechst and PI staining in fibroblasts irradiated with UVB of 50 mJ/cm2,but decreased that in fibroblasts irradiated with UVB of 100 mJ/cm2.Similarly,the percentage of middle and late apoptotic cells was significantly higher in fibroblasts irradiated with UVB of 50 mJ/cm2 followed by treatment with 3-MA of 0.5 mmol/L than in those irradiated with UVB of 50 mJ/cm2alone ((10.933 ± 0.839) ％ vs.(7.267 ± 0.473) ％,t =5.20,P＜ 0.05),but lower in fibroblasts irradiated with UVB of 100 mJ/cm2 followed by treatment with 3-MA of 0.5 mmol/L than in those irradiated with UVB of 100 mJ/cm2alone ( (7.100 ± 0.781 ) ％ vs.( 1 0.133 ± 0.681 ) ％,t =6.29,P ＜ 0.05 ).[Conclusion]s The irradiation with UVB of 50 mJ/cm2 may protect fibroblasts by inducing autophagy and suppressing apoptosis,while the high level of autophagy induced by UVB of 100 mJ/cm2 may lead to autophagic cell death in fibroblasts.

Objective To initially investigate the mechanism of COX-2 inhibitor inducing cell apoptosis through the observation of celecoxib (CXB),a specific COX-2 inhibitor,inducing apoptosis of cyst lining epithelial cells of human polycystic kidney.Methods (1)Primarily cultured cell was divided into control group and CXB group to evaluate the proliferative state by Brdu assay.(2)The cell apoptosis was observed by transmitted electronic microscope after being cultured in CXB 2?10~(-5) mol/L for 24,48 hours.(3)The cell apoptosis and apoptotic rate were detected by TUNEL assay.(4) The cell apoptotic rate were measured by AnnexinV,PI-labeled flow cytometry after being cultured in CXB 2?10~(-5) mol/L for 0,24,48 hours.(5)Protein expression of Bax,Bcl-2,caspase 3 was examined by Western blotting.Results (1)The Brdu assay revealed that CXB inhibited cell growth in a concentration-dependent manner,with the maximum growth inhibition ratio of 63.9% when treated by CXB 2?10~(-5) mol/L for 24 h.(2)Typical morphological changes of apoptotic cell were apoptotic body, nuclear concentration,chromatin aggregation,endochylema vacuolization and ravinement under eletrou microscope.(3)TUNEL assay showed that the apoptotic rate was (2.8?0.2)% in control group,and (28.5?1.6)%,(48.5?1.2)% in CXB group for 24,48 hours respectively,with significant differences to control group(P＜0.05).(4) AnnexinV,PI-labeled flow cytometry showed that,in 0,0.5,1,2?10~(-5) mol/L CXB group,the apoptotic rates were (3.15?0.05)%,(7.15?0.11)%,(7.76?0.08)%, (12.15?0.07)% for 24 hours respectively,and (13.53?0.21)%,(18.36?0.17)%,(24.87?0.25)%, (53.66?0.32)% for 48 hours respectively.Significant differences were found among corresponding groups(all P＜0.01 ).(5) Extracted total cell protein in every group and more protein of Bax,Bcl-2 expressed in CXB-treated group was detected by Western blotting than that in control group. Conclusions CXB can inhibit the proliferation of cyst liner epithelial cells in a time- and concentration- dependent manner,and induce cell apoptosis through increasing the ratio of Bax/Bcl-2.CXB is hopeful to become an effective drug to treat ADPKD.