Objective To study the effect on the extract of Astragalus polysaccharides by ultrasonic cell disrupter. Methods Astragalus polysaccharides was extracted by Ultrasonic Disrupter,boiling in water and soakage in alkali,and compared the content of polysaccharides respectively. Result The content was the highest by ultrasonic disrupter,the second was by boiling in water,the worst was by soakage in alkali. Conclusion Ultrasonic disrupter is suitable to extract Astragalus polysaccharides.

Objective To verify the validity and feasibility of national early warning score (NEWS) in evaluation of death risk in elderly patients with critical illness,in order to find out which scoring method is more suitable for elderly critical illness patients.Methods A prospective case-control study was conducted.The critical illness patients aged over 60 years old with the length of hospital stay over 24 hours,and admitted to Department of Emergency of Qingdao Municipal Hospital from January to December 2015 were enrolled.The clinical data including in emergency and the actual outcome of patients were collected,and the patients were divided into death group and survival group according to 30-day outcome.Patients in the two groups were assessed by using NEWS and risk classification according to the first results of vital signs monitoring.Multivariate logistic regression model was used to analyze the relationship between the NEWS classification and the risk of death in elderly critical ill patients.Results 1 950 emergency elderly patients with critical illness were enrolled,with 78 cases (4.0％) dead within 30 days and 1 872 survived (96.0％).Compared with the survival group,patients in death group were older (years:79.8 ± 10.8 vs.75.3 ± 8.9,t =4.335,P ＜0.001),and had higher acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (22.9± 4.6 vs.18.2 ± 4.8,t =8.487,P ＜ 0.001),lower Glasgow coma scale (GCS) score (12.2 ± 4.5 vs.13.4 ± 5.2,t =-2.007,P =0.045),higher incidence of respiratory system diseases (29.5％ vs.17.9％,x 2 =12.742,P =0.013),higher NEWS score (11.2 ± 5.5 vs.3.9 ± 2.7,t =22.063,P ＜ 0.001),as well as higher proportion of patients with NEWS classification of high risk and very high risk (65.4％ vs.15.8％,x 2 =263.125,P ＜ 0.001).With the increase of NEWS risk classification,mortality rate was also increased,and the mortality rate in the patients with low,medium,high and very high risk were 0.81％ (9/1 108),3.63％ (18/496),5.83％ (13/223),30.89％ (38/123),respectively,with statistically significant difference (x 2 =179.741,P ＜ 0.001).It was showed by logistic regression analysis that the NEWS score of elderly patients with critical illness were positively correlated with 30-day death.The 30-day death risk of patients with middle risk,high risk and very high risk was 4.600,9.052 and 54.598 folds of the patients with low risk respectively.Conclusion NEWS score can be used to assess the risk of death in emergency elderly patients with critical illness.NEWS risk classification can quantify and classify the risk of death in the elderly patients with critical illness.

Objective To evaluate the efficacy of modified quadruple therapy for patients who were failed in previous Helicobacter pylori ( Hp) eradication treatment .Methods A total of 86 patients with confirmed Hp infection and failed in previous Hp eradication treatment were collected from Qingdao Municipal Hospital during January 2012 and January 2014.Patients were randomly assigned into two group:43 patients in control group were given conventional quadruple therapy ( rabeprazole +colloidal bismuth pectin +amoxicillin +clarithromycin for 14 d ) , and 43 patients in test group were given modified quadruple therapy ( rabeprazole +colloidal bismuth pectin +amoxicillin +clarithromycin for 7 d, and lansoprazole +colloidal bismuth pectin +levofloxacin +metronidazole for 7 d).Chi square test was performed to analyze per-protocol (PP) eradication rates, intent-to-treat (ITT) eradication rates, and Hp recurrence rates between two groups .Results Among 43 patients in test group , 42 completed treatments with PP eradication rate of 100.00% and ITT eradication rate of 97.67%.All patients in control group completed treatments , and Hp eradication was observed in 24 patients , and both PP and ITT eradication rates were 55.81%.The differences in PP and ITT eradication rates between two groups were of statistical significance (χ2 =23.90 and 21.11, P<0.05).The 3-month and 6-month Hp recurrence rates in test group (14.29%and 20.00%) tended to be lower than those in control group (20.83%and 34.78%), but the differences were not of statistical significance (χ2 =0.12 and 1.68, P>0.05).Conclusion The efficacy of modified quadruple therapy for patients who were failed in the previous Hp eradication treatment is satisfactory.

OBJECTIVEThis study aims to analyze the biomechanical effects of four sutures that are related to maxillary growth during a maxillary protraction treatment cycle based on labiolingual appliance.

METHODSA three-dimensional simulation of labiolingual appliance was performed based on a three-dimensional finite-element maxillofacial model combined with solid-modeled sutures.

RESULTSThe displacement and stress distributions were calculated. The labiolingual appliance was suitable for patients with underbites or deep overbites. Sutura frontomaxillaris and sutura zygomaticomaxillaris were vital to the forward displacement and counterclockwise rotation of the maxillary. The changes in sutura zygomaticotemporalis and sutura palatine were not significant.

CONCLUSIONThe influences of the labiolingual appliance on the sutures during the treatment cycle of maxillary protraction can be effectively simulated by the three-dimensional finite-element maxillofacial model.

Biomechanical Phenomena ; Cranial Sutures ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Malocclusion, Angle Class III ; Maxilla ; growth & development ; Orthodontic Appliances ; Skull

There are few reports on the study of extraperitoneal robotic single-port laparoscopic radical prostatectomy in China. In this study, patients with localized prostate cancer were treated with extraperitoneal robotic single-port laparoscopic radical prostatectomy extraperitoneal robot-assisted single-port laparoscopic radical prostatectomy(EpRA-spRP)from April 2019 to June 2019.All patients performed EpRA-spRP successfully without adding additional auxiliary port. The operation time and blood loss were controllable, and hospitalization time was short. It is safe and feasible to perform EpRA-spRP for medium and low-risk prostate cancer. The short-term tumor control and functional recovery are satisfactory.However, the long-term effect needs further follow-up and observation.

Objective:To explore the relationship between the expression of tumor necrosis factor receptor-associated factor 5 (TRAF5) and interferon regulatory factor 5 (IRF5) in intestinal mucosa of patients with ulcerative colitis and gut microbiota and intestinal mucosal barrier function.Methods:A total of 126 patients with ulcerative colitis in Qingdao Municipal Hospital from April 2021 to April 2023 were collected, according to the condition, there were 76 patients in the active phase and 50 patients in the remission phase, another 50 patients with intestinal polyps were taken as controls, intestinal mucosal tissues were collected from patients in three groups. Immunohistochemical staining was applied to detect the expression of TRAF5 and IRF5, the relationship between the expression of TRAF5 and IRF5 in intestinal mucosa of patients with ulcerative colitis and clinical symptoms, gut microbiota, and intestinal barrier function indicators was analyzed. Spearman method was applied for correlation analysis.Results:The positive expression rates of TRAF5 and IRF5 in intestinal mucosa of patients with active phase and remission phase ulcerative colitis were higher than those of patients with intestinal polyps: 85.53% (65/76) and 80.00% (40/50) vs. 40.00% (20/50), 81.58% (62/76) and 76.00% (38/50) vs. 50.00% (25/50), and the difference was statistically significant ( P<0.05); the expression of TRAF5 and IRF5 in intestinal mucosa of patients with ulcerative colitis was related to diarrhea, abdominal pain, purulent stool, tumor necrosis factor-α (TNF-α), Interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate, Baron endoscopic score, inflammatory bowel disease questionnaire score, Mayo index score and Geboes index ( P<0.05). Compared with patients with negative expression of TRAF5 and IRF5, patients with positive expression of TRAF5 and IRF5 had fewer bifidobacteria and lactobacilli, and more enterobacteria and enterococcus: (8.72 ± 0.43) cfu/g vs. (6.85 ± 0.47) cfu/g, (9.74 ± 0.31) cfu/g vs. (8.26 ± 0.27) cfu/g, (9.73 ± 0.46) cfu/g vs. (11.06 ± 0.48) cfu/g, (7.64 ± 0.31) cfu/g vs. (8.47 ± 0.34) cfu/g; (8.82 ± 0.44) cfu/g vs. (6.73 ± 0.47) cfu/g, (9.13 ± 0.30) cfu/g vs. (8.22 ± 0.27) cfu/g, (11.09 ± 0.48) cfu/g vs. (9.87 ± 0.46) cfu/g, (7.76 ± 0.32) cfu/g vs. (8.48 ± 0.34) cfu/g, and the difference was statistically significant ( P<0.05). The levels of diamine oxidase, lipopolysaccharide and D-lactic acid in patients with positive expression of TRAF5 and IRF5 were obviously higher than those in patients with negative expression of TRAF5 and IRF5: (12.18 ± 2.75) mg/L vs. (7.56 ± 2.49) mg/L, (76.14 ± 13.86) ng/L vs. (37.57 ± 12.51) ng/L, (18.15 ± 4.83) U/L vs. (9.87 ± 3.25) U/L; (12.39 ± 2.72) mg/L vs. (7.65 ± 2.66) mg/L, (77.21 ± 13.79) ng/L vs. (40.87 ± 13.04) ng/L, (18.36 ± 4.75) U/L vs. (10.67 ± 3.86)U/L, and the difference was statistically significant ( P<0.05). The expression of TRAF5 in the intestinal mucosa of patients with ulcerative colitis was negatively correlated with the numbers of bifidobacteria and lactobacilli ( r = - 0.645 and - 0.646; P<0.05), and positively correlated with the number of enterobacteria, number of enterococcus, diamine oxidase, lipopolysaccharide and D-lactic acid ( r = 0.629, 0.589, 0.509, 0.606 and 0.596; P<0.05). The expression of IRF5 was negatively correlated with the numbers of bifidobacteria and lactobacilli ( r = - 0.701 and - 0.690; P<0.05), and positively correlated with the number of enterobacteria, number of enterococcus, diamine oxidase, lipopolysaccharide and D-lactic acid ( r = 0.690, 0.624, 0.605, 0.595 and 0.568; P<0.05). Conclusions:The positive rates of TRAF5 and IRF5 in intestinal mucosa of patients with ulcerative colitis is high, which is closely related to the imbalance of gut microbiota and the damage of intestinal mucosal barrier function.

Objective:To investigate the influence of infarct vessel diameter, blood flow before operation, blood flow status after operation, coronary artery disease, number of coronary artery lesions and other risk factors on the levels of inflammatory factors IL-1, IL-6, IL-10 in the coronary blood of patients with acute coronary syndrome (ACS), and to determine the relationship between inflammatory factors and ACS and its impact on clinical status.Methods:The peripheral blood and coronary blood of 54 patients with ACS underwent emergency interventional treatment were collected before the operation. The level of IL-1, IL-6, and IL-10 in the blood sample was detected by an automatic biochemical analyzer.Results:Postoperative adverse cardiac events were positively correlated with the patient's age, D-to-B time, and the number of coronary artery lesions (all P<0.05). The levels of IL-1, IL-6 and IL-10 in coronary blood of ACS patients were higher than those in peripheral blood (all P<0.05). The number of coronary artery disease branches (≥3), the onset time of myocardial infarction (>4 h), diabetes mellitus, ischemic post-treatment, preoperative blood flow level ( 2.5 mm, coronary artery disease number ≥ 3, severe right coronary artery disease, preoperative blood flow 22 frames, and cardiovascular events, the IL-10 levels are higher (all P<0.05). Conclusions:The levels of inflammatory factors IL-1, IL-6, and IL-10 in coronary blood of ACS patients are higher than those in peripheral blood, suggesting that acute coronary artery originates from local coronary inflammatory reaction, and the increase of inflammatory factors in peripheral blood belongs to "Erosion" effect. The level of inflammatory factors is significantly related to the diameter of the diseased blood vessel, preoperative blood flow, the number of coronary artery disease, the location of myocardial infarction, diabetes and smoking history.

Objective:To study the prognostic risk factors of Enterobacteriaceae bloodstream infection in patients with sepsis.Methods:The medical records of patients with sepsis caused by Enterobacteriaceae bloodstream infection in our hospital from June 2017 to May 2019 were screened. The gender, age, admission department, basic disease, infection site, etiology examination and treatment plan were recorded in detail. The survival and death groups were divided according to the patient's survival status. The ratio of C-reactive protein (CRP) to serum prealbumin (PA) was recorded within 24 h after admission. The acute physiological and chronic health scores (APACHEⅡ score) and Pitt bacteremia score (PBS score) were calculated within 24 h, and based on the results of blood culture drug sensitivity test to analyze whether the initial experience treatment was appropriate. Logistic regression analysis was used to analyze the risk factors affecting the prognosis of patients, and the receiver operating characteristic curve (ROC curve) was drawn to predict the occurrence of poor prognosis in patients with sepsis.Results:Logistic regression analysis showed that CRP ( OR=1.021, P<0.01), CRP/PA ( OR=34.638, P<0.01), extended-spectrum β-lactamase production ( OR=0.244, P<0.01), inappropriate empirical antibacterial treatment ( OR=0.156, P<0.01), APACHE Ⅱ score ( OR=1.436, P<0.01), and PBS score ( OR=8.622, P<0.01) were risk factors affecting patient's prognosis. Multivariate regression analysis showed that CRP/PA ( OR=25.420, P<0.05), inappropriate empirical treatment ( OR=0.077, P<0.05), APACHEⅡ score ( OR=1.476, P<0.01), PBS score ( OR=12.042, P<0.01) were independent risk factors for death in patients with sepsis ( P<0.05). The higher the CRP/PA level, PBS score and APACHEⅡ score, the worse the prognosis. When CRP/PA ≥0.89, PBS score ≥3.5, APACHEⅡ score ≥17.5, the patient's risk of death increased significantly. In addition, inappropriate empirical treatment was also a key factor in patients with poor prognosis. Conclusions:CRP/PA, PBS score, APACHE Ⅱ score, and inappropriate empiricaltreatment are independent risk factors affecting the prognosis of patients with enterobacter hemorrhagic infection with sepsis. The PBS score and APACHEⅡ score can better predict the poor prognosis and risk of death. Compared with APACHEⅡscore, the former is simpler and practical and can be widely used.

Background:The prognostic values of staging parameters require continual re?assessment amid changes in diag?nostic and therapeutic methods. This study aimed to identify the prognostic factors and failure patterns of non?meta?static nasopharyngeal carcinoma (NPC) in the intensity?modulated radiotherapy (IMRT) era. Methods:We reviewed the data from 749 patients with newly diagnosed, biopsy?proven, non?metastatic NPC in our cancer center (South China, an NPC endemic area) between January 2003 and December 2007. All patients under?went magnetic resonance imaging (MRI) before receiving IMRT. The actuarial survival rates were estimated using the Kaplan–Meier method, and survival curves were compared using the log?rank test. Multivariate analyses with the Cox proportional hazards model were used to test for the independent prognostic factors by backward eliminating insigniifcant explanatory variables. Results:The 5?year occurrence rates of local failure, regional failure, locoregional failure, and distant failure were 5.4, 3.0, 7.4, and 17.4%, respectively. The 5?year survival rates were as follows: local relapse?free survival, 94.6%; nodal relapse?free survival, 97.0%; distant metastasis?free survival, 82.6%; disease?free survival, 75.1%; and overall survival, 82.0%. Multivariate Cox regression analysis revealed that orbit involvement was the only signiifcant prognostic fac?tor for local failure (P=0.011). Parapharyngeal tumor extension, retropharyngeal lymph node involvement, and the laterality, longest diameter, and Ho’s location of the cervical lymph nodes were signiifcant prognostic factors for both distant failure and disease failure (allP<0.05). Intracranial extension had signiifcant prognostic value for distant failure (P=0.040). Conclusions:The key failure pattern for NPC was distant metastasis in the IMRT era. With changes in diagnostic and therapeutic technologies as well as treatment modalities, the signiifcant prognostic parameters for local control have also been altered substantially.

Objective:To explore the clinical effect of dual triangular skin flaps for male nipple reconstruction.Methods:From October 2011 to March 2019, we admitted 4 male patients with flat or missing nipples, aged 29 to 45 years old, with an average of 37 years old in Jiangxi Provincial People’s Hospital. Among them, there was 1 case of congenital bilateral flat nipples, 1 case of bilateral nipple loss caused by drug corrosion, and 2 cases of exogenous injury with failure history of bilateral nipple reconstruction. According to the blood supply and elasticity of the skin of the nipple and areola, dual triangular flaps were designed for bilateral nipple reconstruction. The survival of the skin flap was observed and the sensation and shape of the nipple were followed up.Results:Among the 4 patients with 8 nipples, 7 nipples were fully survived symmetrically with no skin flap infection and necrosis. One nipple had local flap necrosis, resulted in wide and flat nipple appearance. During the 12-month follow-up, the reconstructed nipples were soft and felt good. The height of the nipple was 3-4 mm, the diameter was about 5 mm, 7 nipples were in good shape, 1 nipple was slightly small.Conclusions:Dual triangular skin flaps is a good choice for male nipple reconstruction with satisfactory symmetrical appearance and less complication.