0. 05) , mid-upper arm circumference and serum prealbumin (PA) were clearly improved (P

OBJECTIVE:To investigate the effects of aerosol inhalation of budesonide combined with Compound ipratropium bromide on therapeutic efficacy and safety of patients with pneumoconiosis during perioperative period of massive whole-lung la-vage (WLL). METHODS:One hundred and fifty male patients with pneumoconiosis receiving WLL under general anesthesia se-lected from our hospital during Dec. 2014-May 2016 were divided into treatment group and control group in accordance with ran-dom number table,with 75 cases in each group. Both groups received WLL under general anesthesia as well as pure-oxygen manu-al positive pressure ventilation alternating with negative pressure drainage keeping interval and respiratory rate of ventilator synchro-nization. Treatment group was given Budesonide suspension 2 mL,bid+ Compound ipratropium bromide solution 2.5 mL,tid,by aerosol inhalation from 3 d before surgery to 3 d after surgery. The levels of arterial blood gas indexes(pH,PaO2,PaCO2,BE)at different lavage stages,lung function indexes (FVC,MVV,FEV1/FVC),blood gas indexes and clinical symptom score 3 d be-fore surgery and 7 d after surgery were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:After two-lung ventilation for 20 min following unilateral/bilateral lung lavage,PaO2 of 2 groups were all increased significantly compared to be-fore surgery,with statistical significance (P<0.05);but there was no statistical significance between 2 groups (P>0.05). three days after surgery,FVC,MVV,FEV1/FVC and PaO2 of 2 groups were all increased significantly,PaCO2 and clinical symptom score were all decreased significantly. FVC,FEV1/FVC,PaO2 and clinical symptom score of treatment group were significantly bet-ter than those of control group,with statistical significance(P<0.05). The incidence of airway spasm,hypoxemia and airway pres-sure increasing in treatment group were significantly lower than in control group,with statistical significance(P<0.05). CONCLU-SIONS:During perioperative period of WLL,the aerosol inhalation of budesonide combined with Compound ipratropium bromide for patients with pneumoconiosis can improve clinical efficacy of WLL and reduce the occurrence of ADR during surgery.

Objective To observe the expression changes of matrix metalloproteinase 9(MMP-9),vascular endothelial growth factor(VEGF)in the esophageal squamous cell carcinomas,and to study the chinical significance. Methods The expression of MMP-9 and VEGF in 60 patients with esophageal carcinoma and 20 cases with adjacent normal mucosa were tested with immunohistochemical SP method. Results The positive rate of MMP-9,VEGF in the esophageal squamous cell carcinomas were 70%(42/60)and 80%(48/60),the positive rate of adjacent normal mucosa were 10%(2/20)and 20%(4/20).The positive rates of the two groups were compared,all the differences had statistical significance(P＜0.05); expressions of MMP-9,VEGF in the esophageal squamous cell carcinomas related to invasive depth of carcinoma and lymph node metastasis(P＜0.05).There were positive correlation(r=2.330,P＜0.05). Conclusion The higher expression of MMP-9 and VEGF in the esophageal squamous cell carcinomas played an important role in invasion and metastasis of esophagus squamous cancer.

BACKGROUND:Clinical studies have shown that early use of methylprednisolone can promote neurological functional recovery, reasonable initial dose, interval time and treatment duration are the key to the methylprednisolone treatment of acute spinal cord injury. OBJECTIVE:To observe the differential protein expression profile in spinal cord tissue after intrathecal injection of high-dose methylprednisolone was given in rat model of acute spinal cord injury. METHODS:Eight Sprague-Dawley rats were included in this study to establish acute spinal cord injury model and the models were randomly divided into two groups, receiving intrathecal injection of methylprednisolone 7.5 mg/kg at 0 and 8 hours after modeling. The injured spinal cord tissue was harvested after 24 hours of injection. The differentialy expressed proteins and nerve regeneration-related differential proteins in two groups were analyzed using isotope labeling and quantitative technical analysis. RESULTS AND CONCLUSION: Totaly 87 differentialy expressed proteins were identified in this study. Compared with 0 hour group, there were 43 up-regulated differential proteins and 44 down-regulated differential proteins in the 8-hour group. Eighteen differential proteins were related to neural regeneration, including 8 up-regulation proteins and 10 down-regulation proteins. OMgp as a potential neural axon growth inhibitory factor specificaly bound with NgR/P75/TROY/Lingo-1 to form receptor complexes and activated RhoA through the second messenger cAMP, thus inhibiting the colapse of axon growth cone. Folowing intrathecal injection of methylprednisolone for treatment of acute spinal cord injury in rats, differential proteins and nerve regeneration-related factors in spinal cord are identified and analyzed for protein database retrieval and protein function analysis, their expression may serve as the indicator of monitoring nerve regeneration after acute spinal cord injury.

Central pancreatectomy is an ideal surgical procedure for the treatment of benign or low-grade malignant tumors in the pancreatic neck or the proximal body of the pancreas,and it can preserve more normal pancreatic tissue in order to reduce the incidence of endocrine and exocrine insufficiency after surgery.Although some clinical studies have demonstrated the feasibility and safety of this procedure,laparoscopic central pancreatectomy was technically challenging with a few number of cases.This article reviews the current status of laparoscopic central pancreatectomy and introduces our clinical experience of laparoscopic central pancreatectomy and pancreaticojejunostomy.

Objective To investigate the clinical manifestation and outcome of severe acute respiratory syndrome (SARS).Methods The clinical data of 233 patients with SARS admitted to China-Japan Friendship Hospital from April 2003 to June 2003 were analyzed,including clinical manifestations,laboratory findings,chest radiograph,outcome and mortality of SARS.Results There were 115 male and 118 female patients in this cohort,aged 13-86 (mean 42 8?18 5yr);43 3%of the patients had one or two kinds of underlying diseases;73 0% of the patients had a history of SARS close contact. Incubation period was 1-21 days (mean 4 9?4 1d).The initial symptoms were fever in 86 3% of the patients.The respiratory symptoms were found after the onset of 1-2 weeks.The laboratory abnormalities were decreased in WBC (56 7%) and lymphocytes (78 5%).Corticosteriod was used in 69 5% of the patients.There were 10 deaths (4 3%).The elder age,underlying diseases,continued high fever, thrombocytopenia,leucocytosis and bilateral lung involvement were the risk factors.Conclusion SARS is a new and strongly contagious disease,which mainly affects youth and people in their prime life.It has its own characteristic clinical manifestations.There is high mortality in severe cases.The prognosis is poor in patients complicated with diabetes,leucocytosis,lymphocytopenia,thrombocytopenia and elevated serum LDH and CPK.

Object To study the chemical constituents of Schizonepeta tenuifolia (Benth.) Briq.. Methods The monoterpenoid constituents of S. tenuifolia were separated on silica gel column and their structures were elucidated by spectral. Results Two new compounds and three known compounds were obtained. Conclusion The new compounds were identified as 3-hydroxy-4(8)-ene-p-menthane-3(9)-lactone and 1, 2-dihydroxy-8(9)-ene-p-menthane.

Objective To summarize some problems about the management of acute pancreatic pseuclocyst(PPC) by CT guided percutaneous drainage(PCD).Methods The recent domestic and foreign literatures were reviewed in order to explore the research advancement,such as indication,applied time,technique skill,complication and curative effect by CT guided PCD.Results This operation could be early performed in patients with acute PPC,preventing and decreasing the incidence of possible complications resulted from the traditional long-term observation and waiting.The technique skill of operation was easy with low incidence of complications and the effect was good.Combined use of somatostatin might shorten the treatment time.Some patients could be postoperatively managed in out-patient,thus the expense could be cut down.Conclusions CT guided PCD is a minimally invasive operation and is easy to perform with high effective rate and low incidence of complications and low cost.Reasonable selection of the indications and improvement of equipments and operation techniques may be helpful to improve the curative effect.The extended application of this operation is advised.

Objective To explore the value of dynamic monitoring of the neutrophils/lymphocyte ratio ( NLR ) in peripheral blood for the prognosis of patients with bloodstream infection ( BSI ). Methods A retrospective study was conducted. 205 patients who were≥18 years old, their length of hospital stay>24 hours, and they were treated in the China-Japanese Friendship Hospital from January 2013 to October 2014 were enrolled. According to the 28-day survival, the patients were divided into survival group ( n=160 ) and death group ( n=45 ). The white blood cell ( WBC ), neutrophils count ( NEU ), neutrophils ratio ( Neut%), lymphocyte count ( LYM ), lymphocyte ratio ( Lym%), and NLR in peripheral blood were recorded at 1, 3, 7 days after admission. Receiver-operating characteristic curve ( ROC ) was plotted for evaluating the value of these factors on the 28-day prognosis, and logistic regression analysis was used to evaluate the risk factors for predicting the outcome. Results ①On the 1st day, WBC, NEU, Neut%, NLR, and procalcitonin ( PCT ) in the death group were significantly higher than those in the survival group [ WBC (×109/L ):15.28±8.23 vs. 11.58±6.55, NEU (×109/L ):13.34±7.53 vs. 10.03±5.31, Neut%:0.886±0.076 vs. 0.845±0.102, NLR:21.20 ( 13.10, 28.80 ) vs. 12.08 ( 6.81, 20.47 ), PCT (μg/L ):3.13 ( 0.85, 10.12 ) vs. 1.34 ( 0.36, 5.81 ), P<0.05 or P<0.01 ], while hemoglobin ( Hb ), platelet count ( PLT ), albumin ( ALB ) content were significantly lower than those of the survival group [ Hb ( g/L ):86.09±19.83 vs. 107.89±22.82, PLT (×109/L ):157.51±117.81 vs. 195.44±97.28, ALB ( g/L ):24.11±6.94 vs. 31.99±6.89, P<0.05 or P<0.01 ]. On the 3rd day and 7th day, WBC, NEU and NLR in the death group were significantly higher than those of the survival group [ WBC (×109/L ):16.61±10.25 vs. 8.91±4.93, 16.05±9.46 vs. 8.79±4.45; NEU (×109/L ): 14.15±9.98 vs. 6.97±4.64, 14.36±9.03 vs. 6.59±4.07; NLR: 24.13 ( 8.49, 38.26 ) vs. 5.52 ( 3.58, 8.87 ), 17.74 ( 10.74, 32.85 ) vs. 4.35 ( 2.78, 7.27 ), all P<0.01 ], and the LYM and Lym%were significantly lower than those in the survival group [ LYM (×109/L ):0.61 ( 0.38, 1.04 ) vs. 1.05 ( 0.78, 1.43 ), 0.69 ( 0.35, 0.92 ) vs. 1.37 ( 0.93, 1.76 );Lym%:0.039 ( 0.024, 0.101 ) vs. 0.135 ( 0.094, 0.186 ), 0.056 ( 0.033, 0.082 ) vs. 0.170 ( 0.108, 0.237 ), all P<0.01 ].②It was shown by ROC curve that the maximum area under the ROC curve ( AUC ) of WBC, NEU, Neut%, LYM, Lym%, and NLR about prognosis of BSI were observed on 7 days ( 0.777, 0.819, 0.905, 0.755, 0.880, 0.887 ). Based on Neut%>0.855 on the 7th day as a predictor of cut-off value of death in 28 days, the sensitivity was 78.8%, specificity 89.1%, respectively. When Lym%<0.088 on the 7th day as a predictor of cut-off value of death on 28 days, the sensitivity was 89.5%, and specificity was 83.9%. When NLR>10.34 on the 7th day as a predictor of cut-off value of death in 28 days, the sensitivity was 81.8%, and specificity was 91.0%.③Survival analysis showed that the 28-day survival rate in the patients with 7-day NLR<10.34 was significantly higher than that in those with 7-day NLR>10.34 ( 95.0%vs. 34.1%,χ2=82.650, P=0.000 ).④It was shown by multi-factor logistic regression analysis that the levels of 1-day Hb and 7-day NLR were the independent prognostic predictors of 28-day mortality [ Hb: odds ratio ( OR ) = 0.946, 95% confidence interval ( 95%CI ) = 0.913-0.981, P = 0.003; 7-day NLR:OR=34.941, 95%CI=8.728-139.884, P=0.000 ]. Conclusions The trend of changes in NEU, LYM and NLR as shown by repeated routine blood examinations contributes to prediction of the outcome of patients with BSI. The levels of 1-day Hb and 7-day NLR are the independent prognostic predictors for 28-day mortality.

n clinic.