ObjectiveTo investigate the etiology, exacerbating factors and outcome of geriatric patients with acute renal failure (ARF) in emergency and critical internal medicine. MethodsClinical features of elderly inpatients with ARF who were diagnosed in internal medicine of our hospital during the past 10 years were retrospectively analyzed. Patients were divided into community-acquired ARF (CA-AFR) group and hospital-acquired ARF (HA-ARF) group. Comparisons between CA-ARF group and HA-ARF group, and between elderly patients and non-elderly patients with ARF in internal medicine were performed. ResultsAmong 381 elderly ARF patients in internal medicine, there were 218 (57.2%) CA-ARF patients and 163 (42.8%) HA-ARF patients. Most of the HA-ARF patients (153 cases) were distributed in medical intensive care. Compared with CA-ARF group, patients in HA-ARF group were older, with more underlying diseases, a higher ratio of infections and/or heart failure and more severe acute renal failure. Infection and heart failure/severe myocardial isehemia were the major exacerbating factors for HA-ARF. Of the 163 patients with HA-ARF, 146 patients died and 17 patients survived. Patients in the death group had more underlying diseases, a higher ratio of severe infections and heart failure/severe myocardial ischemia, a higher ratio of cases with multiple organ dysfunction syndrome(MODS) and a higher score of APACHE Ⅱ.When compared with non-elderly patients with ARF, the elderly patients had a higher proportion ofHA-ARF, a higher ratio of MODS, a higher score of APACHEⅡ and a higher mortality of ARF.ConclusionsThe elderly critical patients are susceptible to HA-ARF with more chronic underlying diseases. Infection and heart failure/severe myocardial ischemia are the major exacerbating factors.The prognosis depends on the treatment of predisposing diseases and removal of exacerbating factors.

Objective To evaluate surgical complications and outcomes based on prostate size in patients with benign prostatic hyperplasia (BPH) treated with plasmakinetic enucleation of prostate (PKEP).Methods A retrospective review was conducted of PKEP performed in 326 patients with BPH.According to the prostate size on preoperative transrectal ultrasonography measurement,patients were divided into three groups:groupl:＜40ml (n =92),group2:40～80ml (n =155),and group3:＞80ml (n =79).Intraoperative and perioperative parameters were evaluated.Patient perioperative data and postoperative outcomes were compared.Patients were followed up at 1,3,6 and 12 months after surgery.Early and late complications were recorded.Results There were significant differences among three groups regarding the mean operative time (P ＜ 0.01) and the mean resected tissue weight (P ＜ 0.01).However,enucleation efficiency (P ＜ 0.01) in gm tissue per minute increased significantly as prostate size increased.Mean hemoglobin decrease (P ＞0.05),mean serum sodium decrease (P ＞0.05),mean postoperative irrigation time (P ＞ 0.05),mean catheter time (P ＞ 0.05) and mean hospital stay (P ＞0.05) did not differ significantly among three groups.Three groups had a similar and significant postoperative improvement in international prostate symptom score (IPSS),quality of life (QOL),maximum urine rate (Qmax),and post-void residual urine volume(PVR) independent of prostate size (P ＜ 0.01),but no significant difference was found among three groups during 1,3,6 and 12-month follow-up (P ＞ 0.05).Perioperative and postoperative complications did not depend on prostate size (P ＞ 0.05).Conchsions Although patients with a larger BPH required significantly longer operation time in PKEP,prostate size did not affect perioperative and postoperative complications or micturition improvement.

Objective To observe the efficacy of Mimics finite element analysis software in the gasserian ganglion radiofrequency treatment of trigeminal neuralgia. Methods 180 cases with primary trigeminal neuralgia and VAS score ≥8 were randomly divided into 2 groups (n = 90 each): CT group (group C) and Mimics group (group M). The preoperative skull CT image of the foramen of cranial base could be analyzed in group C. The preoperative cranial CT image could be reconstructed and analyzed by Mimics finite element analysis software in group M. The puncturing success rate, complications rate and the outcomes between two groups were recorded. Results The puncturing success rates were 100% in group M and 92% in group C (P < 0.05). 6 cases with hematoma and 1 case, which were stabbed into the oral cavity were found in group C. No puncture complication was found in group G. There was no statistically significant between the two groups (P < 0.05). The VAS score was 1.6 ± 0.3 in group C and 1.3 ± 0.4 in group G, there was no statistical significance (P > 0.05) between them. Conclusions The Mimics finite element analysis software could improve the success rate of basicranial foramen ovale puncture and reduce the occurrence rate of puncture complications. Therefore , it could be safely applied to the treatment of primary trigeminal neuralgia by gasserian ganglion radio frequency.

Objective To investigate the relative motion between the femoral component and the tibial insert through the technology of fluoroscopy and digital model.Methods Sixteen female patients (16 knees) with knee osteoarthritis were performed TKA (GENESIS Ⅱ) from July 2007 to June 2008.The mean age was 66.4 years (range from 56 to 76 years).All patients were followed up 48 months to 60 months,with the mean of 56±3 months.The postoperative clinical function was evaluated by Knee Society Score (KSS).To match the digital model to the imaging data of fluoroscopy using 2D-3D automatic registration technology and reconstruct motion of the knee after TKA.The movement of contact position between femoral medial and lateral condyle and tibial insert and tibial internal rotation during flexion were measured.The contact time and range between femoral cam and tibial post were analyzed.Results The cases were statistically improved in KSS postoperatively,knee score was 93±5 and function score 88±13.The range of movement for femoral medial condyle was 8.5±2.5 mm,and the lateral condyle was 9.5±4.8 mm,the range of tibial internal rotation was 2.5°±8.4°.The contact of cam and post was observed after 30°-40° flexion of the knee,and the range was 8.0±1.8 mm.The greater tilting angle of the tibial plateau was,the later contact between cam and post happened.Conclusion The kinematics of tibiofemoral joint after TKA is different from the kinematics of normal knee.With knee flexion within 10°-30°,femoral medial condyle moves forward.When flexion is greater than 40°,medial and lateral condyle begins rollback.The time of contact of cam and post is relative to tibial prosthesis slope.

Objective To discuss the present situation and existing problems of the funded projects, especially in the gap between western region and eastern central region by analyzing the funding situation of the projects funded by the National Natural Science Foundation of China (NSFC) and the completed projects in the TCM field from 1989 to 2015. Methods The website was searched thoroughly, and data of Division Ⅹ of Health Science Department of National Natural Science Foundation of China from 1989 to 2015 (ie TCM, Chinese materia medica and integrated traditional Chinese and Western medicine) funded by the National Science Foundation for Young Scientists in China were obtained, and the projects of the National Science Foundation for Young Scientists funded by Division Ⅹ of Health Science Department of National Natural Science Foundation of China from 1989 to 2015 were included, and incomplete or inavailable items were eliminated. Relevant information according to the extracted forms was extracted. The situation of different regions and the situations of the projects have been concluded and the titles of different titles have been analyzed. Results By 2015, the number of funded projects and the amount of financing in the TCM field were increasing year by year. In the western regions, the number of funded projects and the amount of financing accounted for only 11.29% of the total number and 11.28% of the total financing. Compared with the less supporting western regions, much more were mainly in eastern and central regions. The number of SCI papers published and single cited times of the finished projects were 988 and 20.85. Compared with the developed areas in eastern and central regions, there was no statistical significance in the average number of SCI papers (P=0.493), average SCI papers cited article number (P=0.449), SCI papers in average cited frequency (P=0.589), the average CSCD papers number (P=0.579), average CSCD papers cited article number (P=0.883) and average single CSCD papers cited frequency (P=0.753) in western regions (P>0.05). Conclusion Under the stable supports of the Young Scientists Fund, scientific researches in the TCM field have achieved remarkable achievements. In addition, the ability of scientific research and innovation of the young scientific workers have been improved. The funded projects in western regions are far less than those in eastern and central regions, with great differences. However, there is no statistical significance in the research results of the items in western regions and eastern and central regions.

Objective To investigate the expression level of antisense non-coding RNA in the INK4 locus (ANRIL) in hepatocellular carcinoma (HCC) tissues and to evaluate its relation to clinicopathological features and prognosis of HCC.Methods Quantitative real-time polymerase chain reaction (qRT-PCR) method was used to detect the expression of ANRIL in HCC tissues and adiacent tissues (n =90) and to analyze its relationship with clinicopathological data.Kaplan-Meier curves and multivariate Cox proportional models were used to study the impact on clinical outcome.Small interfering RNA (siRNA) was used to silence ANRIL and to explore the effects of reduced ANRIL expression on cell growth and metastasis.Results ANRIL expression in HCC tissues was significantly higher than in the adjacent non-tumor tissues (t =13.083,P ＜ 0.05).The expression of ANRIL was remarkably associated with the histologic grade (x2 =40.724,P ＜ 0.05) and TNM stage (x2 =43.245,P ＜ 0.05).The mean survival time of the patients with high ANRIL was 18.2 months (95％ CI:14.9-21.5 months),shorter than 39.4 months (95％ CI:35.5-43.4 months) in low expression (x2 =47.590,P ＜0.05).Multivariate analysis suggested that high ANRIL expression was an independent predictor of poor prognosis (HR =2.143,95％ CI:1.083-4.243,P ＜ 0.05).Decreased expression of ANRIL could suppress the cell proliferation,migration and invasion of HCC cells.Conclusion Positive ANRIL expression is negatively correlated with the prognosis of HCC patients.

Objective To evaluate the clinical value of bedside index for severity in acute pancreatitis (BISAP) and APACHEⅡ score in predicting the severity and organ failure of acute pancreatitis (AP).Methods One hundred eighty-five patients of AP admitted to Department of Gastroenterology of First affiliated Hospital of Soochow University from January 2012 to December 2014 were studied retrospectively.According to BISAP score, patients who were ≥3 points were considered as high risk group, while ＜3 points were considered as low risk group.According to APACHEⅡ score, patients who were ≥ 8 points were considered as high risk group, while ＜ 8 points were considered as low risk group.According to the criteria of Pancreatic Diseases Group of Chinese Society of Gastroenterology of Chinese Medical Association, the patients were diagnosed as mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP).The BISAP, APACHEⅡ scores were calculated and compared between MAP group and MSAP + SAP group, respectively.The incidence of MSAP + SAP between high risk group and low risk group was also compared.The area of ROC curve (AUC) was used to evaluate the ability of BISAP and APACHEⅡ scoring system for predicting the severity of AP and the multiple organ dysfunction syndromes (MODS).Results Among 185 patients, MAP was identified in 101 patients, MSAP in 76 patients and SAP in 8 patients.Twenty-five MSAP patients developed organ dysfunction, and all the 8 SAP patients developed organ dysfunction.The BISAP scores of MSAP + SAP group and MAP group were (1.43 ± 0.89), (0.38 ± 0.61),andAPACHⅡ scores were (2.45± 1.36), (0.87± 0.62), the scores of MSAP+ SAP group were significantly higher than those in MAP group (P ＜0.01).In the 137 patients of low risk BISAP group, there were 47 MSAP + SAP patients (34.3％), while in the 48 patients of high risk BISAP group, there were 37 MSAP + SAP patients (77.0％);in the 153 patients of low risk APACHEⅡ group, there were 56 MSAP + SAP patients (36.6％), while in the 32 patients of high risk APACHEⅡ group, there were 28 MSAP + SAP patients (87.5％);the incidence of MSAP + SAP patients was significantly higher in high risk group than that in low risk group (P＜0.01).The AUC of BISAP, APACHEⅡ for MSAP+ MAP was 0.804 (95％ CI 0.738 ～ 0.870), 0.794 (95％ CI 0.725 ～ 0.863), and the AUC for organ dysfunction was 0.758 (95％ CI 0.686 ～0.830), 0.781 (95％ CI 0.710 ～0.852) , and the difference between BISAP and APACHE Ⅱ was not statistically significant (P ＞ 0.05).Conclusions The BISAP has the prediction ability for AP severity and prognosis similar to APACHEⅡ , and it consists of only 5 parameters and can be completed in the first 24 h of admission, therefore it is worth of clinical application.

In this study, endophytic bacteria were isolated from roots of P. ginseng by plate culture method, and as a result, 40 endophytic bacterial strains were isolated, Bacillus spp. and Pseudomonas spp. were predominant. By confront culture method, two antagonistic endophytic bacterial strain, ge15 (Stenotrophomonas maltophilia) and ge25 (Bacillus sp. ) against Cylindrocarpon destructans, Sclerotinia schinseng and Alternaria pana were identified. The inhibition zone of ge15 to them were 5.5, 22.0, 14.8 mm, respectively; and which were 12.7,16.5,9.0 mm for ge25. The Results indicate that endophytic bacteria have biocontrol potential on ginseng pathogens, and which can be used as a bio-control factor on ginseng soilborne diseases control.
Bacteria ; isolation & purification ; Bacterial Physiological Phenomena ; Endophytes ; isolation & purification ; physiology ; Panax ; microbiology ; Plant Roots ; microbiology

In this study, ARDRA system was established for Panax ginseng cultivated soil microbial community analysis. In the process of soil analysis we found that, ARDRA can not only distinguish soil microbial communities, proportion of each microbial type in total microorganisms can be calculated based on profiles of restricted enzyme digested 16S rDNA, also. Results indicated that, ARDRA system established was able to analyze microbial communities of P. ginseng cultivated soil samples.
DNA, Ribosomal ; genetics ; Ecosystem ; Gene Library ; Panax ; growth & development ; microbiology ; Phylogeny ; RNA, Ribosomal, 16S ; genetics ; Soil Microbiology

Objective:To construct a novel cuproptosis-related gene signature (CRGS) for prediction of prognosis, immunotherapy response and drug sensitivity in patients with hepatocellular carcinoma (HCC).Methods:Data materials for this study were obtained from the international cancer genome consortium (ICGC), the cancer genome atlas (TCGA) database and Migort210 database, and protein expression profiles were obtained from the human protein atlas image classification database. Based on the TCGA cohort, the least absolute shrinkage and selection operator algorithm was applied to construct the CRGS and calculate the risk score for each HCC patient. HCC patients were grouped according to the median risk score: HCC patients in the TCGA cohort were divided into a high-risk group TCGA and a low-risk group TCGA with 184 cases in each group; HCC patients in the ICGC cohort were divided into a high-risk group ICGC and a low-risk group ICGC with 116 cases in each group. Patients in the Migort210 cohort were divided into a responder group ( n=68) and a non-responder group ( n=230) based on their response to immunotherapy. We assessed the value of CRGS in predicting the prognosis of HCC patients in the TCGA cohort and validated whether CRGS could be used to predict the prognosis of HCC patients in the ICGC dataset. To explore the role of CRGS in predicting immunotherapy response and drug sensitivity in HCC patients based on data from the TCGA cohort, and to apply the Migort210 immunotherapy cohort to validate the clinical value of CRGS in predicting immunotherapy in malignant tumors. Results:CRGS consists of four copper death-related genes: GLS, CDKN2A, LIPT1, and DLAT. Patients in the high-risk group TCGA had lower overall survival (OS), disease-specifical survival, and progression-free interval than those in the low-risk group TCGA (all P<0.01). OS of patients in the high-risk group ICGC was lower than that in the low-risk group ICGC ( P=0.022). Multivariate Cox regression analysis showed that CRGS was an independent risk factor for poor prognosis in HCC patients (TCGA: HR=2.991, 95% CI: 1.781-5.049, P<0.001; ICGC: HR=4.621, 95% CI: 1.685-12.674, P=0.033). Risk scores were positively correlated with the expression levels of CTLA4, PDCD1, CD80 and HLLA2 (all P<0.001). Patients in the high-risk group TCGA had lower tumor immune dysfunction and rejection scores than those in the low-risk group TCGA [-0.04(-0.07, -0.02) vs. -0.02(-0.04, 0) points], and the difference was statistically significant ( P<0.001). Patients in the responder group had a higher risk score than the non-responder group [1.70 (1.56, 1.90) vs. 1.63 (1.52, 1.80)], with a statistically significant difference ( P<0.05). The half-inhibitory concentrations (IC 50) for sunitinib, rapamycin and etanercept were higher in the high-risk group TCGA than that in the low-risk group TCGA, while the IC 50 for erlotinib was lower than that in the low-risk group TCGA, and the differences were all statistically significant (all P<0.001). Conclusion:The CRGS might be served as a potential biomarker to predict the prognoses, immunotherapy response, and drug sensitivity of patients with HCC.