Bone Neoplasms ; Female ; Humans ; Middle Aged ; Waldenstrom Macroglobulinemia

Objective To adopt the cone beam computed tomography(CBCT) to analyze the bone thickness of infrazygomatic crest with different vertical skeletal facial types in teenagers.Methods Sixty teenagers of skeletal class were collected,including each 20 cases of high angle,average angle and low angle.The CBCT scanning data of oral maxillofacial region were collected.The bone thickness at different coronary slices in buccal side of infrazygomatic crest region at 13,15,17 mm above the maxillary occlusal plane was measured.The measured data were analyzed statistically.Results The bone thickness of infrazygomatic crest was gradually thinned from down to up,and the difference was statistically significant(P＜0.05);the bone thickness(except 3 points at 13 mm from maxillary plane) at each measured point in the high,average and low angle groups showed the change trend of low angle ＞average angle＞high angle,the difference was not statistically significant(P＞0.05).Conclusion In teenagers,the bone thickness of infrazygomatic crest in skeletal class Ⅱ is gradually thinned from cranial direction and rearward,the high angle is thinnest and the low angle is thickest.

Objective To observe the clinical effects of the homemade medicated and dietary compound granules in treating sub-health insomnia with deficient cultivation of heart-spirit. Methods Sixty qualified patients were randomly divided into treatment group and control group, 30 cases in each group. The treatment group was given homemade medicated and dietary compound granules(mainly composed of Semen Ziziphi Spinosae, Radix Codonopsis, Sclerotiium Poriae Circum Radicem Pini, Radix Polygalae, Flos Rosae Rugosae, Plumula Nelumbinis, Fructus Ziziphi Jugubae, and Arillus Longan). The control group was given Oryzanol powder. The course of treatment lasted for half a month. Before and after treatment, the scores of Pittsburgh Sleep Quality Index(PSQI) and the traditional Chinese medicine(TCM)symptom rating scale were observed, and the clinical efficacy of the two groups were also evaluated. Results After treatment for half a month and after suspension of medicine for half a month , (1) the total effective rate of the treatment group was higher than that of the control group (P<0.05);(2) the total PSQI scores , sleep quality scores , falling asleep time scores , and daytime function disorder scores were decreased in the treatment group (P < 0.01 compared with those before treatment) , but the scores of each PSQI item in the control group stayed unchanged (P > 0.05). The total PSQI scores , sleep quality scores , falling asleep time scores, and daytime function disorder scores of the treatment group were lower than those of the control group (P<0.01);(3) the total scores of TCM symptoms as well as the scores of dreaminess and susceptibility to awakening, palpitation and amnesia, lassitude and weakness, poor appetite, pale complexion, vertigo and dizziness, abdominal distension and loose stools were declined in the treatment group (P < 0.05 or P < 0.01 compared with those before treatment). Conclusion Medicated and dietary compound granules are effective on improving sleep quality, shortening time to fall asleep, improving sleep disorder, increasing the efficiency of daytime function, improving patients’ mental state entirely, and maintaining the short-term curative effect.

ObjectiveTo assess the efficacy of subglottic secretion drainage for preventing ventilatorassociated pneumonia.MethodsData of relevant randomized controlled trials (RCT) from January 1991 to June 2010 were collected,and data were split into two groups,namely draining group and non-draining group.Meta analysis of ventilator-associated pneumonia was carried out for finding the incidence and mortality in patients with mechanical ventilation using the methods recommended by the Cochrane Collaboration.ResultsSeven RCTs met the inclusion criteria and 1647 patients were enrolled.Subglottic secretion drainage reduced the incidence of ventilator-associated pneumonia ( OR =0.45,95％ confidence interval [CI]:0.32 - 0.63 ),primarily by reducing early-onset pneumonia.But the mortalities of ventilator associated pneumonia were not significantly different between the two groups ( OR =1.03,95％ confi dence interval [CI]:0.75 - 1.41 ).ConclusionsSubglottic secretion drainage appeared effective in preventing ventilator associated pneumonia among patients expected to require ＞48 hours of mechanical ventilation,but the mortality was unchanged.

ObjectiveTo investigate the age distribution of serum prostate specific antigen (PSA) and explore its correlation with fasting blood glucose(FBG)and lipid in the male elderly.MethodsThe levels of FBG,triglyceride (TG),low-density lipoprotein (LDL-C),high density lipoprotein (HDL-C) and PSA were reviewed in 2903 elderly men (aged ≥ 60 years) in our hospital.The subjects were classified into 6 groups by age,and PSA levels were compared among groups.The correlations of FBG,TG,LDL-C,HDL-C with PSA were analyzed using multiple linear regression analysis.Results The level of PSA had the trend to increase with age.Positive association of TG,LDL with serum PSA level,but negative correlation between HDL and serum PSA level were noted in the group aged 60-64 years (r=0.10,0.15,0.12,P＜0.05).In the group aged 66-69 years,there was negative relationship between FBG and serum PSA(r= 0.10,P＜0.05).No relationship could be found in other groups (P＞0.05).ConclusionsPSA level may increase with age,but without relation with FBG,TG,LDL-C and HDL-C.

Objective To investigate the effect of antimicrobial-impregnated incise drape on preventing surgical site in-fection(SSI)following neurosurgical operation.Methods Patients undergoing neurosurgical operation from January to De-cember 2012 were divided into two groups:antimicrobial-impregnated incise drape group(group A)and general incise drape group(group B).The occurrence of SSI and risk factors for SSI were analyzed.Results Percentage of drape lifting at the wound edge in group A was lower than group B(38.3%[98/256]vs 96.88% [248/256],χ2 =200.57,P <0.01).Among 512 patients,SSI rate was 3.32%(n=17),SSI rate in group A was lower than group B(1.56%[4/256]vs 5.08%[13/256],χ2 = 7.93,P <0.05 ).Multivariate analysis revealed that body mass index ≥24,perioperative hypothermia,smok-ing,perioperative length of hospital stay ≥5 days,and lack of drape use were independent risk factors for SSI following neurosurgical operation.Conclusion Whether antimicrobial-impregnated incise drape is used in neurosurgical operation is one of the independent risk factors for SSI following neurosurgical operation,it can effectively reduce the drape lifting rate and incidence of SSI,and is recommended to be used in neurosurgical operation.

Objective To investigate the role of p38 MAPK in the trypsin-induced injury in human esophageal epithelial cells.Methods Primary cultured human esophageal epithelial cells were stimulated with trypsin (20,40,and 80 μg/ml) for4 hours,phosphorylation of p38 MAPK was evaluated by Western blotting.Primary cultured human esophageal epithelial cells were stimulated with trypsin (40 μg/ml) and treated with p38 MAPK inhibitor (SB203580,1 and 10 μmol/L) simultaneously.Four hours later,the cells were collected for analysis.Results Western blotting results revealed that stimulation with trypsin enhanced phosphorylation of p38 MAPK,indicating that trypsin activated p38 MAPK in esophageal epithelial cells.SB203580 treatment suppressed trypsin-induced expression of pro-inflammatory cytokines including interleukin-8 (IL-8),cyclooxygenase 2 (COX2),and tumor necrosis factor alpha (TNFcα).Finally,SB203580 treatment suppressed trypsin-induced upregulation of protein expression of inducible nitric oxide synthase (iNOS),and subsequently reduced nitric oxide (NO) levels.Conclusions The regulation of p38 MAPK was involved in the trypsin-induced injury in esophageal epithelial cells.

Objective To detect the hypermucoviscosity phenotype , capsular serotype and virulence gene of Klebsiella pneumonia (K.pneumonia) from various kinds of clinical specimens and understand the characteristics of different K.pneumonia causing infections.Methods A retrospective study was conducted through collection of 178 K.pneumonia isolates from blood, sputum, bronchoalveolar lavage fluid , urine, normally sterilized fluid , puncture fluid from liver abscess and other abscesses between January 2010 and December 2012 in General Hospital of Chinese PLA.String test was carried out for detection of hypermucoviscosity phenotype.Capsular serotype and virulence gene ( rmpA) were checked by polymerase chain reaction.Analysis was made according to the hypermucoviscosity , capsular serotype , rmpA gene , as well as the sources of K.pneumoniae.Statistic data was analyzed by contingency table analysis and χ2 test.Results Eighty-three out of 178 ( 46.6%) strains of K.pneumonia were hypermucoviscous with positive string test, the positive rate of virulence gene rmpA was 92.8%(77/83).K1/K2/K57 capsular serotypes were the predominant serotypes in the group of puncture fluid from liver abscess and other abscesses (75.0%,27/36)than the group of blood (32.4%,12/37), urine(21.7%,5/23) and normally sterilized fluid(25.0%,5/20), and also more than in the group of sputum , bronchoalveolar lavage fluid (50.0%,22/44),χ2 =21.19,P<0.01.The positive rate of string test in the group of puncture fluid from liver abscess and other abscesses (77.8%, 28/36)was significantly higher than the group of blood (29.7%, 11/37), urine (30.4%, 7/23), or normally sterilized fluid (25.0%, 5/20),χ2 =27.90,P<0.01.The positive rate of rmpA gene in the isolates from puncture fluid of liver abscess and other abscesses was higher than other groups.Conclusions As the pathogens of various kinds of infections , mainly abscess and respiratory infection, hypermucoviscous strains of K.pneumonia were of great clinical significance.Capsular serotype K57, as well as K1 and K2, possessed hypermucoviscosity and hypervirulence in China.

Objective To observe the effect of nutritional status change on hemodialysis patients of chronic renal failure and deficiency of spleen and kidney treated bytraditional Chinese medicine(TCM) of warming kidney and invigorating spleen. Methods In our center, 146 patients who were diagnosed chronic renal failure belonging to deficiency of spleen and kidney in TCM were received hemodialysis between Jun2012 and May2013. All patients were randomly divided into a treatment group (n=72) and a control group (n=74). 74 patients in the control groupreceived conventional hemodialysis and medicine treatment, and 72 patients in treatment group received conventional hemodialysis、medicine treatment and TCM treatment of warming kidney and invigorating spleen. The comprehensive nutritional assessment of all patients were treated by modified SGAN method (MQSGAN), anthropometric, biochemical and laboratory examination before and 6 monthsafter the treatment. Results The treatment group patients of modified SGAN(9.58±3.15), BMI (body mass index 19.34±0.52) Kg/m2, MAC(upper arm circumference 27.51±1.95)cm, TSF(tricepsskinfold thickness 12.92± 2.42) mm and MAMC(upper arm muscle circumference 23.64±1.96)cm were significantly improved compared with the control g roup(respectively data 13.23±3.14, 17.29±0.76) Kg/m2, (24.01±2.55, 10.58±2.71) mm, (20.71±2.04)cm, P<0.05,and treatment group patients with ALB(serum albumin 38.19±1.95)g/L, PA(prealbumin 2.23±0.16)g/L, TF(transferrin 0.21±0.04)g/L, CH(cholesterol 4.02±0.26)mmol/L, BUN(blood urea nitrogen 19.58±2.17)mmol/L and SCr (creatinine 869.54±79.15)mmol/L were significant improved also compared with the control group(respectively data 33.73±1.31)g/L, (1.67±0.25)g/L, (0.17±0.02)g/L, (3.22± 0.46)mmol/L, (16.27±1.12)mmol/L, (792.73±71.65)mmol/L, P<0.05. Conclusion Traditional Chinese medicine of warming kidney and invigorating spleen can improve the nutritional status and quality of life on patients with chronic renal failure belonging to deficiency of spleen and kidney type during hemodialysis.

It is confirmed that chronic atrophic gastritis (CAG) caused by Helicobacter pylori is the main cause of gastric precancerous lesions.CAG is also the key determinant in gastric cancer risk assessment,which affects pepsinogen and gastrin-17 secretion.Most of the gastric cancer patients have poor prognosis,and non-invasive tools for gastric cancer screening and diagnosis are lacking.Therefore,the early detection of gastric cancer in order to reduce the disease mortality is necessary.Pepsinogen and gastrin-17 are biomarkers of gastric mucosa and gastric antra.The serological testing for the stomach-specific biomarkers offers the possibility to know preneoplastic gastric mucosal conditions.