Benzene ; toxicity ; Epigenesis, Genetic ; Humans

Objective To investigate the correlation between atherosclerotic renal artery stenosis and hypertension.Methods One hundred and seventy-nine patients underwent renal artery angiography after coronary artery angiography. Results Among the 179 patients, 56.4% patients were detected as renal artery normal, 24% as renal artery disease, and 19.6% as renal artery stenosis. Compared with hypertensive patients with normal renal artery, ARAS patients had higher systolic blood pressure (148?23 mm?Hg vs 136?18 mm?Hg, P

Objective To investigate the correlation between atherosclerotic renal artery stenosis and the severity of coronary lesions in patients with confirmed coronary artery disease and the impact of renal artery stenosis on serum inflammation related factors.Methods 163 patients from Peking University First Hospital with confirmed coronary heart disease by coronary angiography underwent selective renal artery angiography from Dec 2002 to Sep 2003.Serum hypersensitive C reactive protein(hs-CRP)and Interleukin-6(IL-6)were measured.Results Patients combined with coronary disease and renal artery stenosis were presented with more acute coronary syndrome(ACS)and triple-vessel CAD.Serum hs-CRP and IL-6 levels were also higher in this group.Conclusion Renal artery stenosis is correlated with severe coronary disease.Inflammation state could be one of the reasons for this connection.

Objective To evaluate the accuracy of point-of-care testing (POCT) for blood glucose monitoring in critically ill patients.Methods Two hundred and forty critically ill patients,of both sexes,aged 20-88 yr,with Acute Physiology and Chronic Health Evaluation Ⅱ score of 1-45,were enrolled.The venous,arterial and capillary blood samples were collected to determine the real-time blood glucose level using glucose oxidase (GOD) and glucose dehydrogenase (GDH) methods.The blood glucose level measured by central laboratory hexokinase method simultaneously was served as standard level.Error Grid analysis (EGA) and Bland-Altman analysis were used to determine accuracy and consistency,respectively.The accuracy of real-time blood glucose levels within the consistent limits was evaluated.Results 1.The results of EGA showed that 98.7 ％,98.3 ％,98.3 ％(GDH method) and 96.2％,96.6％,96.7％ (GOD method) of the difference between venous,arterial and capillary blood glucose levels measured and the standard level were located in the A and B zones,respectively,and 1.2％,1.7％,1.7％ (GDH method) and 2.9％,3.3％,3.3％ (GOD method) in the D zone.0.8％ (GOD method) of the difference between venous blood glucose levels and the standard level were located in the C zone.2.Bland-Altman analysis showed that the difference between the standard level and glucose level measured in blood samples from the vein,artery and capillary.was-0.1,-0.3,-0.2 mmol/L (GDH method) and-0.9,-1.0,-0.9 mmol/L (GOD method),respectively,and the incidence beyond the upper and lower limits of consistency zone was 4.5 ％,6.7 ％,6.6 ％ (GDH method) and 4.6 ％,5.0 ％,7.1％ (GOD method),respectively.The accuracy of venous,arterial and capillary blood glucose levels within the consistent limits was 94.3 ％,92.1％,93.7％ (GOD method) and 96.6％,95.1％,95.5％ (GDH method),respetively.Conclusion The accuracy of POCT for blood glucose monitored by GOD and GDH methods is good in critically ill patients,but it is possible to overestimate the patient's real glucose level.

Objective To investigate the application and clinical significance of 24-hour multichannel intraaluminal impedance-pH (MII-pH) monitoring in gastroesophageal reflux disease (GERD).Methods Fiftythree patients with GERD were enrolled in this study according to the Montreal consensus (consulting for twice reflux a week or above) from July 2011 to June 2012.Patients were divided into erosive esophagitis (EE,n =25)group and non-erosive reflux disease (NERD,n =28) group after endoscopy and MII-pH monitoring.Fifteen healthy volunteers were recruited as the normal controls.The change of pH and MII-pH parameters were compared among the three groups and the significance of the change was investigated.Results Twenty-four-hour pH monitoring showed that all the acid reflux events in the EE and the NERD groups were significantly higher than those in the control group (P ＜ 0.05).MII-pH monitoring showed that the frequencies of total reflux,acid reflux,weakly acidic reflux and percentage of acid reflux in the GERD group were higher than in the control group (total reflux:83 (54,118) vs.62 (44,111) vs.42 (20,70),P =0.003 ; acid reflux:45 (25,79) vs.22 (11,45) vs.3(1,10),P =0.000 ;weakly acidic reflux:36(18,47) vs.43(21,82) vs.23(11,43),P =0.001 ;percentage of acid reflux:53％ (37％,81％) vs.32％ (13％,48％) vs.11％ (1％,23％),P =0.002).The frequency and percentage of acid reflux in the EE group were higher than those in the NERD group (P =0.000)The percentage of weakly acidic reflux in the NERD group was higher than in the EE group (66％ (43％,79％) vs.46％ (21％,57％),P ＜0.01).The frequencies of liquid reflux and mixed reflux in the GERD groups were higher than those in the control group (22 (12,40) vs.18 (12,26) vs.9 (4,18) ; 54 (39,79) vs.42 (25,77) vs.29(14,48) ;P ＜0.01).The frequency of gas reflux in the control group was higher than in the GERD group (86(56,207) vs.31 (14,62) vs.34 (15,119),P ＜ 0.01).The frequency and percentage of proximal reflux in the GERD group were significantly higher than in the control group (28(18,41) vs.16(12,34) vs.3 (2,9) ; 33％ (22％,49％) vs.29％ (22％,35％) vs.11％ (6％,22％),P ＜ 0.001).The percentage of symptom positive index in patients with acid reflux,non-acidic reflux and total reflux in the EE group were 36.0％ (9/25),20.0％ (5/25) and 56.0％ (14/25) respectively which were higher than in the NERD group (21.4％ (6/28),14.3％ (4/28) and 35.7％ (10/28)).Conclusion MII-pH monitoring can detect more reflux events.Acid reflux plays an important role in GERD.The detective rate of GERD will be elevated when combined with MII-pH monitoring in the diagnosis.MII-pH monitoring has a distinct advantage in diagnosing GERD.

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) with scissors knife in difficult cases.Methods A total of 36 sessions of ESD in 34 patients were performed from May 2010 to May 2012 with application of new scissors knife.The complications and followup outcomes were recorded.Results All lesions were removed successfully with an en bloc resection rate at 91.7％.Delayed bleeding occurred in 2 patients (5.6％),and both of them were cured sucessfully with endoscopy.No perforation happened and the average hospitalization time was 5 days.Follow-up endoscopy performed 6 or 12 months after ESD in 6 patients revealed no recurrence or residual lesions.Other patients are under follow-up now.Conclusion The scissors knife is easy to manipulate,which can ensure the safety and efficiency of ESD.

Objective To compare the effects of different resuscitation pressure on lung function of rats with uncontrolled hemorrhagic shock.Methods Uncontrolled hemorrhagic shock model of rats was built.Sixty Sprague-Dawley rats were randomly sent into six groups: NC group (the control group),NF group (shock but non-resuscitation),NS40,NS60 group (limited fluid resuscitation),NS80,NS100 group (large-volume fluid resuscitation).When the mean arterial pressure (MAP) reached between 35 mm Hg to 40 mm Hg (1 mm Hg=0.133kPa) resuscitation was begun,normal saline infusion was used to maintain the following desired endpoints.After the fluid resuscitation for one hour,rats of each fluid resuscitation group were given haemostasis and all-out fluid resuscitation,including blood infusion,to maintain the rats' MAP at 90 mm Hg.Results Findings showed that the blood loss in limited fluid resuscitation groups was significantly lower than that in large-volume fluid resuscitation groups at the situation of uncontrolled hemorrhagic shock,damage to lung tissue pathology and acidosis were significantly lower than those in large-volume fluid resuscitation groups.Nine rats in NS60 group survived 72 hours.Three rats in NS40 group survived 72 hours.No rat in NF group as well as in both NS80 and NS100 groups survived 72 hours.Conclusions Uncontrolled hem-orrhagic shock in trauma and different pressure of fluid resuscitation can cause lung injury to varying de-grees.Limited fluid resuscitation provide significant protective effects against such injuries.

Objective To investigate the effect of pelvic autonomic nerve preservation (PANP) for urinary function and sexual dysfunction after total mesorectal excision (TME) of rectal cancer in male patients. Methods A total of 147 patients, hospitalized from March 2009 to March 2010,were enrolled into this study and received TME plus PANP combination treatment. The clinical data of these cases were analyzed retrospectively. Results There were no operative deaths. The 0. 5 - 1.0 years follow-up data showed that 9 cases (6. 12% ) had voiding dysfunction, 11 cases (7.48%) had sexual dysfunction, 12 cases ( 8.16% ) had local recurrence. Conclusion TME plus PANP combination treatment can improve the urinary and sexual function,without increasing the postoperative local recurrence rate.

Objective To analyze the clinical features and risk factors of invasive fungal infections (IFI) in children with acute leukemia.Methods Ninety-six acute leukemia children complicated with IFI admitted in Guangzhou Women and Children's Medical Center during January 2005 and February 2017 were retrospectively reviewed, and 96 cases of acute leukemia without IFI admitted at the same period were randomly selected as control group.The clinical manifestations of IFI were analyzed, multivariate Logistic regression was used to study risk factors of the complication of IFI in pediatric acute leukemia.Results Among 96 children complicated with IFI, fungus were detected in samples from sputum, bronchoalveolar lavage fluid, or blood in 78 cases, in which 42 cases (43.75％) were oral infection, 36 cases (37.50％) were pulmonary infection.Candida albicans (33.33％, 26/78) was the most commonly isolated pathogen, followed by Candida parapsilosis (20.51％, 16/78) and Candida tropicalis (20.51％, 16/78).Univariate analysis revealed hormone-containing chemotherapy, neutropenia (＜ 0.5 × 109/L), time duration of neutropenia ≥ 10 days, usage of carbapenem antibiotics and combined drug administration ≥2 types were associated with fungal infection (P ＜ 0.05 or ＜0.01).Multivariate Logistic regression showed that the time duration of neutropenia ≥ 10 days (OR =11.390, 95％ CI 4.145-55.263, P ＜ 0.01),usage of carbapenem antibiotics (OR =4.825, 95％ CI 1.681-13.842, P ＜ 0.01) and hormone-containing chemotherapy (OR =2.220, 95％ CI 1.542-8.246, P ＜ 0.05) were the independent risk factors of IFI.Conclusion Rational usage of antibiotics and effective measures taken to restore the granulocytes can help to reduce the incidence of IFI in children with acute leukemia.

Objective: To investigate the diagnosis and treatment of rapidly growing mycobacteria bloodstream infections.Methods: Based on the two pharmaceutical consultation practice for one case of rapidly growing mycobacteria bloodstream infections after fracture operation, the paper summarized and analyzed the problems in different stages of treatment.Results: The first consultation optimized the dosage of vancomycin according to the patient''s serum concentration and creatinine clearance rate.The second consultation suggested doctors actively perform anti-infection treatment for rapidly growing mycobacteria after the patient''s clinical symptoms and examination results were improved significantly.It is recommended to withdraw anti TB drugs, and the use of clarithromycin combined with amikacin was suitable.The patient was discharged with improved health conditions.Conclusion: Positive intervention and correct diagnosis are the keys for the successful treatment of suspected or definite mycobacteria infection in surgical sites.