Lipocortin represents a family of similar Ca++ depentent phospholipid-binding proteins capable of blocking the activity of phospholipase A2 (PLA2) in vitro. Generally, these proteins are believed to inhibit the release of arachidonic acid from photopholipids and the formation of lipid mediators such as prostaglandin, leukotriene, and platelet activating factor. Lipocortin 1, initially identified as a glucocorticoid- responsive protein in macrophages and neutrophils has been implicated in transmembrane signal transduction during growth factor-mediated cell proliferation and transformation. To define the synthesis and its regulation, we investigated the expression of lipocortin 1 in both the mRNA and protein level in U937 cell line in the presence of several differentiation factors. The results were as follows. 1. The expression of lipocortin 1 and its mRNA was increased during TPA-induced differentiation of U937 cells to maximum of 2-fold and 5-fold respectively. Both the protein and mRNA levels decreased after 48 hours. 2. With the treatment with IFN-gamma, the expression of CD16 was increased. However, the protein and mRNA levels of lipocortin 1 were, not changed significantly. 3. Neither the dexamethasone or hydrocortisone have any effects on the expression of lipocortin 1 in both TPA-differentiated and undifferentiated U937 cells. The results from this study would give a light on defining the functional role of lipocortin 1 in macro-moncycle cell lineage and possibly some informative clues for the pathogenic mechanisms of the inflammatory diseases.
Annexin A1* ; Annexins* ; Arachidonic Acid ; Cell Lineage ; Cell Proliferation ; Dexamethasone ; Humans ; Hydrocortisone ; Macrophages ; Neutrophils ; Phospholipases A2 ; Platelet Activating Factor ; RNA, Messenger ; Signal Transduction ; U937 Cells*

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii* ; Acinetobacter* ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated* ; Sulbactam*

Objective: To investigate the effect of Twist, β-catenin and E-cadherin on the recurrence and metastasis of hepatocellular carcinoma (HCC) and its correlation with clinical prognosis.Methods; Immunohistochemical staining (SP) was conducted to detect the expression of Twist, β-catenin and E-cadherin in 97 hepatocellular carcinoma patients (49 with recurrence and metastasis and 48 without recurrence and metastasis).Results: The recurrence and metastasis of HCC were correlated with clinical stage (P=0.000), but were not correlated with sex or age (P=0.424, P=0.738).The abnormal expression of Twist and β-catenin in the recurrence and metastasis group was higher than that in the group without recur-rence or metastasis (,0=-0.000, P=0.000).The positive ratio of E-cadherin in the recurrence and metastasis group was lower than that in the group without recurrence or metastasis (P=0.027).The mean survival was 28.880±3.285 months in patients with positive expression of Twist and 31.477±3.359 months in patients with positive expression of β-catenin.The median survival time of them was 26 and 28 months, respctively.The mean survival was 44.603±3.521 months in patients without Twist expression and 42.009±3.720 months in patients without β-catenin expression.The median survival time of them was 49 and 45 months, respectively.The survival of patients with positive expression of Twist and β-catenin was shorter than that in patients without expression of Twist and β-catenin (P=0.002, P=0.029).The mean survival time and median survival time of patients with Twist and β-catenin expression were 44.514±3.447 months and 49 months, respectively, significantly higher than those in patients without Twist and β-catenin expression (P=0.002), which were 29.110±3.581 months and 25 months, respectively.Conclusion: The overexpression of Twist and β-catenin as well as decreased expression of E-cad-herin may play critical roles in the recurrence and metastasis of HCC and indicate poor prognosis.

A case of infectious mononucleosis was presented. She was admitted to the hospital with the anterior cervical lymphadenopathy. Erythematous skin rashes on both low extermities, and splenomegaly. Her chief complaints were fever and sore throat. She showed atypical lymphocytes in peripheral blood smear with relative lymphocytosis. Mono-spot test was positive. She received symptomatic therapy and discharged without any complications. So, we report this case and review the brief literatures of infectious mononucleosis with the respect to etiology, clinical course, and histological characteristics of the disease.
Exanthema ; Fever ; Infectious Mononucleosis ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Pharyngitis ; Splenomegaly

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.
Acinetobacter baumannii ; Acinetobacter ; Anti-Bacterial Agents ; APACHE ; Diagnosis ; Humans ; Medical Records ; Mortality ; Pneumonia, Ventilator-Associated ; Sulbactam

Background: In this study, we aimed to investigate whether opioid-sparing anesthesia (OSA) reduces postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic gynecological surgery. Methods: Adult patients undergoing elective laparoscopic gynecological surgery were randomly assigned to either the opioid-using anesthesia (OUA) or the OSA groups. In the OUA group, remifentanil was administered as an opioid during general anesthesia. In the OSA group, apart from a single dose of 5 μg/kg of alfentanil for tracheal intubation, no other opioids were used. In both groups, a multimodal intravenous non-opioid analgesic regimen was used preferentially in the post-anesthesia care unit (PACU). The primary outcome was the incidence of PONV, assessed by symptoms until the postoperative day 1. Results: A total of 120 patients were included in this study. The incidence of nausea in the PACU was significantly lower in the OSA group compared to in the OUA group (31.7% in the OSA group vs. 51.7% in the OUA group, P = 0.026). Pain scores and the incidence of opioid analgesic administration were lower in the OSA group during PACU stay, resulting in a significantly lower number of patients requiring rescue opioid analgesics (3.3% vs. 18.3%, P = 0.008). There were no significant differences in intraoperative vital signs, hemodynamic interventions, or duration of PACU and hospital stay between the two groups. Conclusions OSA significantly reduced postoperative nausea, pain scores, and the need for rescue analgesics in the PACU without increasing hemodynamic instability in patients undergoing laparoscopic gynecological surgery.

Background: In this study, we aimed to investigate whether opioid-sparing anesthesia (OSA) reduces postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic gynecological surgery. Methods: Adult patients undergoing elective laparoscopic gynecological surgery were randomly assigned to either the opioid-using anesthesia (OUA) or the OSA groups. In the OUA group, remifentanil was administered as an opioid during general anesthesia. In the OSA group, apart from a single dose of 5 μg/kg of alfentanil for tracheal intubation, no other opioids were used. In both groups, a multimodal intravenous non-opioid analgesic regimen was used preferentially in the post-anesthesia care unit (PACU). The primary outcome was the incidence of PONV, assessed by symptoms until the postoperative day 1. Results: A total of 120 patients were included in this study. The incidence of nausea in the PACU was significantly lower in the OSA group compared to in the OUA group (31.7% in the OSA group vs. 51.7% in the OUA group, P = 0.026). Pain scores and the incidence of opioid analgesic administration were lower in the OSA group during PACU stay, resulting in a significantly lower number of patients requiring rescue opioid analgesics (3.3% vs. 18.3%, P = 0.008). There were no significant differences in intraoperative vital signs, hemodynamic interventions, or duration of PACU and hospital stay between the two groups. Conclusions OSA significantly reduced postoperative nausea, pain scores, and the need for rescue analgesics in the PACU without increasing hemodynamic instability in patients undergoing laparoscopic gynecological surgery.

Background: In this study, we aimed to investigate whether opioid-sparing anesthesia (OSA) reduces postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic gynecological surgery. Methods: Adult patients undergoing elective laparoscopic gynecological surgery were randomly assigned to either the opioid-using anesthesia (OUA) or the OSA groups. In the OUA group, remifentanil was administered as an opioid during general anesthesia. In the OSA group, apart from a single dose of 5 μg/kg of alfentanil for tracheal intubation, no other opioids were used. In both groups, a multimodal intravenous non-opioid analgesic regimen was used preferentially in the post-anesthesia care unit (PACU). The primary outcome was the incidence of PONV, assessed by symptoms until the postoperative day 1. Results: A total of 120 patients were included in this study. The incidence of nausea in the PACU was significantly lower in the OSA group compared to in the OUA group (31.7% in the OSA group vs. 51.7% in the OUA group, P = 0.026). Pain scores and the incidence of opioid analgesic administration were lower in the OSA group during PACU stay, resulting in a significantly lower number of patients requiring rescue opioid analgesics (3.3% vs. 18.3%, P = 0.008). There were no significant differences in intraoperative vital signs, hemodynamic interventions, or duration of PACU and hospital stay between the two groups. Conclusions OSA significantly reduced postoperative nausea, pain scores, and the need for rescue analgesics in the PACU without increasing hemodynamic instability in patients undergoing laparoscopic gynecological surgery.

Background: In this study, we aimed to investigate whether opioid-sparing anesthesia (OSA) reduces postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic gynecological surgery. Methods: Adult patients undergoing elective laparoscopic gynecological surgery were randomly assigned to either the opioid-using anesthesia (OUA) or the OSA groups. In the OUA group, remifentanil was administered as an opioid during general anesthesia. In the OSA group, apart from a single dose of 5 μg/kg of alfentanil for tracheal intubation, no other opioids were used. In both groups, a multimodal intravenous non-opioid analgesic regimen was used preferentially in the post-anesthesia care unit (PACU). The primary outcome was the incidence of PONV, assessed by symptoms until the postoperative day 1. Results: A total of 120 patients were included in this study. The incidence of nausea in the PACU was significantly lower in the OSA group compared to in the OUA group (31.7% in the OSA group vs. 51.7% in the OUA group, P = 0.026). Pain scores and the incidence of opioid analgesic administration were lower in the OSA group during PACU stay, resulting in a significantly lower number of patients requiring rescue opioid analgesics (3.3% vs. 18.3%, P = 0.008). There were no significant differences in intraoperative vital signs, hemodynamic interventions, or duration of PACU and hospital stay between the two groups. Conclusions OSA significantly reduced postoperative nausea, pain scores, and the need for rescue analgesics in the PACU without increasing hemodynamic instability in patients undergoing laparoscopic gynecological surgery.

Background: The purpose of this study was to investigate the effect of salad dressings on the flowable composite resin surface and the erosion-inhibitory effect of calcium. Methods: The experiment included six groups: oriental dressing, balsamic dressing, lemon-garlic dressing, lemon-garlic dressing supplemented with 3% calcium, mineral water as a negative control group, and orange juice as a positive control group. pH and titratable acidity were measured. The prepared specimens were immersed in the experimental solutions for 1, 3, 5, 15, and 30 minutes. The surface microhardness was measured using the Vickers hardness number before and after the treatment, and the surface of the specimens was observed using a scanning electron microscope (SEM). Results: The pH values of the experimental groups in increasing order were as follows: lemon-garlic dressing (2.49±0.03), balsamic dressing (3.12±0.06), lemon-garlic dressing ＋3% calcium (3.27±0.09), oriental dressing (3.75±0.03), orange juice (3.82±0.02), and mineral water (7.32±0.16). The largest surface hardness reduction value was shown in lemon-garlic dressing (−9.61±1.16), followed by balsamic dressing (−9.17±1.63), oriental dressing (−8.62±1.09), orange juice (−8.19±1.36), lemon-garlic dressing +3% calcium (−6.76±1.23), and mineral water (−1.63±2.47). According to the SEM findings, the experimental and positive control groups showed rough surfaces and micropores, whereas the negative control group showed a smooth surface. Moreover, the lemon-garlic dressing with +3% calcium showed fewer micropores and a smoother surface than the lemon-garlic dressing. Conclusion The intake of salad dressings at a low pH could weaken the surface microhardness of the flowable composite resin. However, adding calcium to these salad dressings can reduce the risk of microhardness reduction on the flowable composite resin surface.