Objective To evaluate the application of fibrobronchoscopy in the management of severe brain injury with concurrent pulmonary infection. Methods Forty-three procedures of fibrobronchoscopic sputum clearance or bronchoalvelar lavage were performed in 26 patients with severe brain injury and concurrent pulmonary infection. The effect of fibrobronchoscopic treatment was assessed by observing the changes in the respiratory symptoms, arterial oxygen saturation (SaO2) and partial pressure of oxygen (PaO2) in these patients. Results The symptoms of the respiratory system, SaO2, and PaO2 of the 26 patients were significantly improved after fibrobronchoscopic treatment, which caused no serious complications. Conclusion Fibrobronchoscopy can be safely and effectively used in patients with severe brain injury complicated by pulmonary infection.

Objective To investigate the new way that can improve the emergency treatment rate on patients with traumatic brain injuries in Guangdong mountain area. Methods New emergency treatment way was adopted from June 2006 to June 2008 in patients traumatic brain injuries and these patients were chosen as experimental group. Control group is composed of patients treated with old emergency treatment way from June 2004 to June 2006. The pre-hospital mortality rate, in-hospital mortality rate and CPR success rate in the 2 groups were compared; the interphase between injury and receiving treatment, and the rescuing radius in these 2 groups were analyzed. Results Control grouphad the in-hospital mortality rate and pre-hospital mortality rate reaching 29.06% (68/234) and 32.76%(114/348), respectively, which was significantly higher than the experimental group (in-hospital mortality rate: 10.49% [28/267], pre-hospital mortality rate:18.10% [59/326]) (P<0.05). The maxima rescuing radius and mean interphase between injury and receiving treatment in the experimental group (10 km, 50min) were statistically different as compared with those in the control group (70 km, 85 min) (P<0.05).CPR success rate in the experimental group (80.32%) was obviously higher man that in the control group (23.24%) (P<0.05). The death rate in the experimental group was increased following the prolonged interphase between injury and receiving treatment. Conclusion The new way, by increasing 120urgent care centre, shortening the rescuing radius and reaction time, strengthening the care technique ofthe doctors and nurses and reinforcing the equipment in the urgent care centre, can obviously increase the emergency treatment rate.

OBJECTIVETo study the serum level of interleukin-17A (IL-17A) and its expressions in the lung, spleen and thymus in asthmatic mice.

METHODSIn 14 normal BALB/c female mice and 14 asthmatic mice, the changes in the airway pathology and the cell proportion in the bronchoalveolar lavage fluid (BALF) were observed. The serum level of IL-17A and IL-17A expressions in the tissue homogenates of the lung, spleen and thymus of the mice were detected by sandwich enzyme-linked immunosorbent assay (ELISA).

RESULTSThe airway inflammation in the asthmatic mice was characterized mainly by eosinophil and neutrophil infiltration, which was not observed in the normal control group. Serum IL-17A levels and IL-17A expressions in the lung, spleen and thymus of the asthmatic mice were significantly higher than those in the normal control group (P<0.01). In the asthmatic mice, IL-17A expression in the lung tissues was positively correlated with the percentages of neutrophils (r=0.693, P=0.040) and eosinophils (r=0.733, P=0.030) in the BALF.

CONCLUSIONIL-17A is highly expressed in the serum, lung, spleen and thymus of asthmatic mice. IL-17A may be one of the major cytokines involved in exacerbation of bronchial asthma, and is probably associated with the recruitment of neutrophils and eosinophils into the airways.

Animals ; Asthma ; blood ; etiology ; metabolism ; Bronchoalveolar Lavage Fluid ; chemistry ; Female ; Interleukin-17 ; blood ; metabolism ; Mice ; Mice, Inbred BALB C ; Random Allocation

Aim To determine the effect of exosomes from lipopolysaccharide-treated human bone marrow mesenchymal stem cells on proportion of Ly6Chigh and Ly6Clow monocytes/macrophages in inflammatory micro- environment. Methods BMSCs were obtained by gra-dient centrifugation, identified and then treated with li-popolysaccharide for 48 h. The exosomes were purified from conditional medium with or without LPS treatment and identified by CD63 protein using Western blot and transmission electron microscope. The diameters and concentration were detected by Nanoparticle Trafficking Analysis ( NTA ) . The monocytes/macrophages were sorted from bone marrow of the mice by magnetic beads. Cells were co-cultured with exosomes for 24 hours, and then treated with LPS for 48 hours. The proportion of Ly6C monocytes/macrophages was detec-ted by flow cytometry. Inflammatory cytokines in cell supernatant were investigated using ELISA. Results BMSCs surface markers CD44, CD90 were positively detected, but CD34, CD45 were not expressed. BM-SCs presented adipogenic differentiation ability. Exo-somes were positively expressing CD63 protein, and NTA showed that the diameters of exosomes were up to (82.4 ± 3.7 ) nm. BMSCs stimulated by LPS pro- duced more exosomes ( P < 0.01 ) . Exosomes from BMSCs with or without LPS treatment could increase the ratio of Ly6Chigh monocytes (P<0.01) and down-regulate the ratio of Ly6Chigh macrophages (P<0.05), and the effect of LPS treated-exosomes was more signif-icant than untreated-exosomes (P<0.05). Moreover, the concentration of IL-6 was also elevated under exo-somes treatment ( P <0.05 ) . Conclusions Human bone marrow mesenchymal stem cells-derived exosomes contribute to the regulation of Ly6Chigh monocytes/mac-rophages, indicating that they could be involved in the therapeutic treatment of inflammatory diseases.

OBJECTIVETo summarize the reasons for bile duct injury (BDI) after laparoscopic cholecystectomy (LC), and to determine the effect of multiple treatment after BDI.

METHODSA retrospective cohort study was performed. The medical records of 110 patients diagnosed with BDI after LC from October 1993 to November 2007, in ten large hospitals in Guangdong of China, were reviewed.

RESULTSAmong 110 patients with BDI, 58 cases (52.7%) were local patients, whereas 52 cases (47.3%) were transferred from outside hospitals. Reasons for BDI following LC were: (1) Lack of experience of the LC operator (48.2%); (2) LC performed during acute cholecystitis (20.0%); (3) The structure of Calot triangle was unclear (15.5%); (4) Variable anatomical position (11.8%); (5) Intra-operation bleeding (4.5%). The commonest sites of injury were the choledochus and common hepatic duct (76.4%). Following BDI, endoscopic stenting or operative repair was performed in 106 patients. The overall success rate was 95.3% (101/106), with a mortality rate was 0.9% (1/106). Cholangitis occurred in 3.8% (4/106) cases. Choledocho-enterostomy operation was performed in almost 60.0% (63/106) cases, and the success rate was 93.7% (59/63). Endoscopic stenting or operative repair was performed immediately following BDI in 23.6% (25/106) patients, the success rate was 100%; and within 30 days in 63.2% (67/106) patients. Eighty-eight out of 106 patients who underwent repair were successful following the first operative procedure.

CONCLUSIONSFactors such as an un-experienced operator and unclear anatomical position were causes of BDI following LC. Early operative repair should be regarded as the treatment of choice, in patients diagnosed with BDI. Early refer to an experienced hepatobiliary operator ensures a high success rate.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bile Ducts ; injuries ; surgery ; Cholecystectomy, Laparoscopic ; adverse effects ; Female ; Humans ; Iatrogenic Disease ; Intraoperative Complications ; diagnosis ; etiology ; surgery ; Male ; Middle Aged ; Retrospective Studies

The articles regarding needle-embedding treatment for hemifacial spasm published before September 30, 2019 were searched from SinoMed, Wanfang, CNKI, VIP and PubMed database, and were analyzed and summarized from treatment methods, acupoint selection, stage differentiation and action mechanism. As a result, 45 Chinese articles were obtained. The needle-embedding treatment was divided into intradermal needling and acupoint thread-embedding; the top five acupoints were Sibai (ST 2), Taiyang (EX-HN 5), Dicang (ST 4), Jiache (ST 6) and spasm trigger points. The basic research of needle-embedding treatment for hemifacial spasm is weak, and the literature regarding stage differentiation is insufficient, which are in need of further study.
Acupuncture Points ; Acupuncture Therapy ; Hemifacial Spasm/therapy* ; Humans ; Meridians ; Needles

Biopsy, Needle ; Female ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Lung Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Middle Aged ; Situs Inversus ; diagnostic imaging ; metabolism ; pathology

BackgroundSerum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus (HIV) adult patients with pulmonary cryptococcosis and its clinical features.

MethodsOne hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive (CrAg+ group) and 29 were negative (CrAg- group). It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio (OR) was used to measure correlation. Student's t- test was obtained to analyze continuous variable.

ResultsNo difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups (P > 0.05 in all). Nevertheless, diffuse extent lesion was 82.1% in CrAg+ group and 10.3% in CrAg- group (χ = 40.34, P < 0.001; OR = 39.87).

ConclusionsAmong patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.

Adolescent ; Adult ; Cross-Sectional Studies ; Cryptococcosis ; immunology ; pathology ; Humans ; Lung Diseases ; immunology ; pathology ; Male ; Retrospective Studies