No abstract available.
Heart Septal Defects, Ventricular*

Objective To explore carrying rates of class 1, class 2 integrons as well as ISCR1 in Shigella isolates and their connection with drug resistance. Methods Antibiotic sensitivities were detected by K-B disk diffusion in 159 clinical isolates. Total bacteria DNA was prepared through boiling the isolates and the DNA was then used as template for PCR am?plification. PCR, ZSCR1 and sequencing analyse of integrons were applied to all of them. Results were compared by Blast and GenBank. Results Antibiotic sensitivity results showed that in the S. flexneri strains the incidence of resistance to tet?racycline and streptomycin were 88.68%and 81.13%in the S. flexneri strains while the incidence of resistant to chloram?phenicol and trimethoprim-sulfamethoxazol were both 56.60%, and the incidence of multidrug drug resistance was 77.36%. In the sonnei strains, the incidence of resistance to ampicillin, trimethoprim-sulfamethoxazo were 97.17% and 95.28%, 83.96%and 76.42%respectively, and the incidence of multidrug resistance was 98.11%. Among all isolates, 118 were class 1 integron positive , 70 were class 2 integron positive and 89 were double positives. For those 118 isolates that are positive of class 1 integron, 23 were typical while 95 weres atypical. The gene cassettes of typical class 1 integrons contains aadA2, aa?dA1, dfrⅠ, blaoxa-10 and blaoxa-1. IntI1, aadA, blaoxa-1 and IS1 were included in the gene cassetes of the atypical class 1 integrons. Class 2 integrons positive isolates carried gene cassttes which include dfrA1, satl and aadA1. No ISCR1 was found in any isolate. Integron carriage strains were closely associated with higher rate of multiple antibiobic resistance com?pared with the organisms without integrons (90.65%,50%, P<0.05). Conlusion Class 1 and class 2 integrons were widely existence in Shigella isolates and were related to the multidrug resistance.

BACKGROUND: Topoisomerase II alpha (TOP2A) has been reported to play a crucial role in the tumorigenesis of various cancer types. However, the biological role of TOP2A in gallbladder cancer (GBC) remains unknown. The current study aimed to explore the function and potential mechanism of TOP2A in GBC. METHODS: Based on Gene Expression Profiling Interactive Analysis data, we found TOP2A was significantly up-regulated in GBC tissues and resulting in shorter overall survival. Quantitative real-time polymerase chain reaction and immunohistochemistry were conducted to detect the expression of TOP2A in 45 pairs of GBC tissues and adjacent non-tumor tissues. In vitro, cell proliferation, migration, and invasion ability were examined by cell counting kit-8 and transwell assay, respectively. Epithelial-mesenchymal transition (EMT) related and phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway-related markers were measured by Western blotting. Xenograft model assay was performed to evaluate the effect of TOP2A in vivo. RESULTS: TOP2A was found up-regulated in GBC (tumor vs. normal, 12.62 vs. 0.34) and correlated with the late tumor node metastasis stage (P = 0.0032), present of lymph node metastasis (P = 0.0273), and poor prognosis in GBC patients (log-rank P = 0.028). In vitro and in vivo assays showed that knockdown of TOP2A notably inhibited cell proliferation, migration, invasion, EMT process, and tumor growth in GBC. In addition, TOP2A down-regulation significantly decreased the protein levels of phosphor (p)-PI3K, p-Akt, and p-mTOR. CONCLUSION Our study demonstrates that TOP2A was overexpressed in GBC and associated with poor prognosis in GBC patients. TOP2A promotes GBC cell proliferation, migration, invasion, EMT process, and tumor growth through activating PI3K/Akt/mTOR signaling pathway, and may serve as a novel prognostic biomarker and therapeutic target for GBC.

Objective To evaluate the efficacy of quadrates lumborum block for unilateral inguinal hernia repair in elderly patients. Methods Fifty-eight elderly patients with unilateral inguinal hernia of both sexes, aged 65-80 yr, with body mass index of 18-25 kg∕m2 , of American Society of Anesthesiolo-gists physical status Ⅱ or Ⅲ, scheduled for elective unilateral tension-free repair, were divided into 2 groups ( n=29 each) using a random number table method: iliohypogastric-ilioinguinal nerve block group (group T) and quadrates lumborum block group (group Q). Iliohypogastric-ilioinguinal nerve block with arteria circumflexa ilium profunda as a marker was carried out with 0. 33％ ropivacaine 20 ml under ultra-sound guidance in group T. The anterior approach to quadratus lumborum block was performed with 0. 33％ropivacaine 20 ml under ultrasound guidance in group Q. Operation was started after the height of sensory block was assessed by pin-prick test at 30 min after block. When the blocking effect did not meet the opera-tion requirements, an increment of 1％ lidocaine 2. 5 ml was given every time in the surgical field until op-eration requirements were met. Dexmedetomidine was intravenously infused at a rate of 0. 03-0. 07μg·kg-1 ·min-1 during surgery until the end of surgery to maintain Narcotrend index between 80 and 90. When postoperative visual analogue scale score >3, parecoxib sodium 40 mg was intravenously injected, and if marked pain relief was not found 10 min later, tramadol hydrochloride 50-100 mg was intravenously injected. The upper spread of sensory block and intraoperative requirement for additional local anesthetics were recorded at 30 min after nerve block. The requirement for parecoxib and tramadol was recorded within 48 h after operation. The development of inadvertent intravascular injection of local anesthetics, local anes-thetic intoxication and postoperative nausea and vomiting, nerve block of lower extremity and uroschesis was recorded. Results Skin pain disappeared at the plane of T11-L1 in group T and at the plane of T9-L1 in group Q. Compared with group T, the intraoperative requirement for and consumption of local anesthetics, postoperative requirement for parecoxib and tramadol, and postoperative incidence of nausea and vomiting were significantly decreased in group Q ( P<0. 05) . Conclusion Quadrates lumborum block provides bet-ter efficacy for unilateral inguinal hernia repair than iliohypogastric-ilioinguinal nerve block in elderly pa-tients.

Background::At present, a large number of chronic obstructive pulmonary disease (COPD) patients are undiagnosed in China. Thus, this study aimed to develop a simple prediction model as a screening tool to identify patients at risk for COPD.Methods::The study was based on the data of 22,943 subjects aged 30 to 79 years and enrolled in the second resurvey of China Kadoorie Biobank during 2012 and 2013 in China. We stepwisely selected the predictors using logistic regression model. Then we tested the model validity through P-P graph, area under the receiver operating characteristic curve (AUROC), ten-fold cross validation and an external validation in a sample of 3492 individuals from the Enjoying Breathing Program in China.Results::The final prediction model involved 14 independent variables, including age, sex, location (urban/rural), region, educational background, smoking status, smoking amount (pack-years), years of exposure to air pollution by cooking fuel, family history of COPD, history of tuberculosis, body mass index, shortness of breath, sputum and wheeze. The model showed an area under curve (AUC) of 0.72 (95% confidence interval [CI]: 0.72-0.73) for detecting undiagnosed COPD patients, with the cutoff of predicted probability of COPD=0.22, presenting a sensitivity of 70.13% and a specificity of 62.25%. The AUROC value for screening undiagnosed patients with clinically significant COPD was 0.68 (95% CI: 0.66-0.69). Moreover, the ten-fold cross validation reported an AUC of 0.72 (95% CI: 0.71-0.73), and the external validation presented an AUC of 0.69 (95% CI: 0.68-0.71).Conclusion::This prediction model can serve as a first-stage screening tool for undiagnosed COPD patients in primary care settings.

BACKGROUNDMagnetic anchored surgical instruments (MASI), relying on magnetic force, can break through the limitations of the single port approach in dexterity. Individual characteristic abdominal wall thickness (ICAWT) deeply influences magnetic force that determines the safety of MASI. The purpose of this study was to research the abdominal wall characteristics in MASI applied environment to find ICAWT, and then construct an artful method to predict ICAWT, resulting in better safety and feasibility for MASI.

METHODSFor MASI, ICAWT is referred to the thickness of thickest point in the applied environment. We determined ICAWT through finding the thickest point in computed tomography scans. We also investigated the traits of abdominal wall thickness to discover the factor that can be used to predict ICAWT.

RESULTSAbdominal wall at C point in the middle third lumbar vertebra plane (L3) is the thickest during chosen points. Fat layer thickness plays a more important role in abdominal wall thickness than muscle layer thickness. "BMI-ICAWT" curve was obtained based on abdominal wall thickness of C point in L3 plane, and the expression was as follow: f(x) = P1 × x 2 + P2 × x + P3, where P1 = 0.03916 (0.01776, 0.06056), P2 = 1.098 (0.03197, 2.164), P3 = -18.52 (-31.64, -5.412), R-square: 0.99.

CONCLUSIONSAbdominal wall thickness of C point at L3 could be regarded as ICAWT. BMI could be a reliable predictor of ICAWT. In the light of "BMI-ICAWT" curve, we may conveniently predict ICAWT by BMI, resulting a better safety and feasibility for MASI.

Abdominal Wall ; anatomy & histology ; Adult ; Aged ; Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Surgical Instruments ; Tomography, X-Ray Computed

ABSTRACT:OBJECTIVE To observe the differences of curative effect among superficial needle therapy,Xiakucao oral solu-tion and Vitamin E soft capsules on the breast tenderness caused by mammary glands hyperplasia and to explore the optimum therapeutic method.METHODS 105 patients with mammary glands hyperplasia were randomly divided into the superficial needling group,the Xiakucao group and the Vitamin E group,with 35 cases in every group.Patients in the superficial needling group were treated with the superficial needling retaining for 5 hours.Patients in the Xiakucao group and the Vitamin E group took medicine with oral administration.Treatment in the three groups all began from 7 ± 3 days before menstruation and stopped during menstruation.The superficial needling group was treated once every other day with total 3 times.Patients in the Xiakucao group took medicine twice a day in the morning and evening.The Vitamin E group was treated once a day.Com-pare the scores of short form McGill pain Questionnaire(SF-MPQ) before and after the treatment and after one month follow-up.Record the time needed for pain relieving in the first treatment of the superficial needling group and the adverse effects in the three groups.RESULTS After the treatment,the breast tenderness was improved obviously in the three groups (P <0.01)and the superficial needling group was superior to the other groups(P <0.01).During the one-month follow up,the su-perficial needling group showed good effects(P <0.01).It also showed fast effect on relieving the pain in the first treatment. The Xiakucao group was superior to the Vitamin E group in the improvement of the breast tenderness(P <0.05).CONCLU-SION The superficial needling therapy shows fast and lasting effects on relieving the pain of mammary glands hyperplasia, which is superior to Xiakucao oral solution and Vitamin E soft capsules.

Objective To evaluate the efficacy of intravascular ultrasound guided tranradial rotational atherectomy ( RA) followed by drug eluting stent ( DES) implantation in treating patients with heavily calcified coronary lesions.Methods Clinical characteristics , coronary angiogram , intravascular ultrasound images , peri-procedure and follow-up data ( including death , myocardial infarction and target lesion revascularization ) of 44 patients treated with RA and DES implantation under the guidance of IVUS in our department from March 2011 to March 2013 were retrospectively analyzed.IVUS examination was carried out before RA , after RA and stent implantation to guide whether further RA or post dilatation was needed.According to the arc of calcification , the patients were divided into group A (90°-270°,18 cases) and group B (271°-360°,26 cases).Results In A and B group, the arc of calcification was (195 ±71)°in group A and (345 ±23)°in group B(P<0.01), length of calcification was (34.4 ±11.8)mm in group A and (20.0 ±6.6) mm in group B ( P<0.05).Number of burrs used and size of largest burr used were similar between 2 groups (both P>0.05).Acute cross sectional area gain after RA was (0.43 ±0.32)mm2 in group A and (0.53 ±0.38)mm2 in group B (P>0.05).After RA, there was significant decrease in the arc of calcification in group B compared with baseline ( ( 324 ±52 ) °vs.( 345 ±23 ) °, P <0.05 ).The minimal lumen area and diameter were significantly increased after RA resulting in significant decrease in the plaque burden in both groups ( all P<0.05 ).The final minimal lumen area after stenting were similar between 2 groups (P>0.05).Procedure success rate was 100%(44/44) without any major complications such as death , acute myocardial infarction and coronary perforation.During the ( 16.6 ±6.3 ) months follow-up, there was 1 death in group A , 1 target lesion revascularization in group B and there was no acute myocardial infarction in the 2 groups.Conclusion Heavily calcified coronary lesions can be effectively and safely treated by transradial RA under the guidance of IVUS.

Objective To analyze the differences and feasibility of non-invasive intracranial pressure monitoring and invasive intracranial pressure monitoring in patients with subarachnoid hemorrhage (SAH) at early stage,an explore the correlation of intracranial pressure and scores of Glasgow Coma Scale (GCS) with digital electroencephalogram data (cerebral state index [CSI],eleetromyographic [EMG]) obtained by cerebral state monitoring (CSM).Methods Synchronous line of 33 parents with SAH,having 3-12 GCS scores,was chosen in our study; early invasive intracranial pressure monitoring (lumbar puncture manometry/ventricular drainage manometry) and non-invasive intracranial pressure monitoring (flash visual evoked potential [F-VEP] monitoring),and brain function condition monitoring (CSI and EMG) were performed on these patients; the difference of non-invasive and invasive monitoring and the correlation of intracranial pressure with these indicators were analyzed.Results Non-invasive and invasive intracranial pressure monitoring results showed no significant difference in patients with SAH(t=-0.069,P=0.946; t=-0.158,P=0.876).The intracranial pressure was negatively correlated with CSI (r=-0.898,P=0.000) and positively correlated with EMG (r=0.938,P=0.000); GCS scores showed positive correlation with CSI (r=0.472,P=0.011) and showed no relation with intracranial pressure and EMG (r=-0.047,P=0.814; r=-0.170,P=0.388).In addition,after intracranial pressure being controlled and GCS scores being adjusted,partial correlation analysis indicated that CSI and EMG had no correlation (r=0.288,P=0.138).Conclusion Spontaneous F-VEP monitoring results have a high correlation with the results of lumbar puncture manometry and ventricular drainage manometry; intracranial pressure has correlation with CSI and EMG; dynamic intracranial pressure monitor trends are consistent with the changes of disease condition.

After COVID-19 pandemic, there are still many public health challenges in the world. The double burden of communicable and non-communicable diseases is still heavy in many countries. Mental health and injury are crucial public health problems which are often neglected. Environmental health and food and drug safety are closely related to human health, to which further management and intervention are needed. These problems have different impacts on people at different life stages, resulting in health problems throughout the life course. The current status of public health is far from the requirements set by the Sustainable Development Goals of United Nations or the initiative of "Healthy China 2030". It is necessary for governments and related departments of all countries to consider public health in all policy development to tackle the major challenge to public health.