Objective To study the methods and efficacy of selective or superselective renal artery embolization for renal neoplasms,abcesses and bleeding. Methods Sixty cases of renal carcinomas and 4 cases of abcesses were all treated with selective renal artery embolization before surgery,and 3 cases of advanced renal carcinomas were treated with selective renal artery embolization alone.Embolization materials for carcinoma and abcesses were mainly gelfoam.Nine cases of renal angiomyolipomas,23 of traumatic renal hemorrhages,1 undergoing extracorporeal shock-wave lithotripsy (ESWL) and 2 nephrolithotomy,all of whom had severe hematuria,were treated with selective or superselective renal segment artery embolization.Embolization materials for hemorrhages were mainly self-blood clots and(or) gelfoam,and the materials for angiomyolipoma were pure alcohol and(or) gelfoam. Results The sizes of carcinomas and abcesses were decreased in all of the 60 cases of renal carcinomas and 4 cases of renal abcesses.The edema around the carcinomas and abcesses became obvious,and bleeding was reduced,which were convenient for operation and prolonged survivals.All the renal bleeding were cured with selective or superselective renal artery embolization except for one traumatic case treated by operation for continuous bleeding.All these cases were followed up for 1 month to 18 years.One case had mild atrophy of kidney and in one case IVU didn't develop.All the others were in good condition. Conclusions Selective or superselective renal artery embolization is a safe,effective approach with less complications and most probability to preserve the diseased kidney. Renal artery embolization as a valuable treatment should be studied and widely applied.

AIM: By studying the ultrastructure of organs (hearts, brains, lungs, livers, kidneys) and vascular endothelial cells, and changes of physiological and biochemical indexes with multiple organ dysfunction syndrome in the elderly rats, their signification and their developing rules were analyzed. METHODS: Wistar rats(Half of Wister rats were three-month-old and another half of twenty-month-old) were anaesthetized and dealt with cecal ligation puncture (CLP) operation. They were defined as MODSE group and MODSY group, respectively. They were perfused through all vascular circulation by 1% glutaric dialdehyde. These slices were observed under transmission electron microscopy. RESULTS: Physiological and biochemical indexes at 24 huor in elder rats were shown significant difference compared with the younger rats ( P

OBJECTIVE To investigate the ?lactamase genes in Escherichia coli and their resistance.METHODS Twenty strains of E.coli producing extended spectrum ?-lactamases(ESBLs) were isolated from hospitalized patients.?-Lactamase drug-resistant genes were detected by PCR.RESULTS There were higher positive rates of ?-lactamase genes of TEM,SHV,LEN,CTX-M-1,CTX-M-9,VEB,GES,PER(75.0%,20.0%,95.0%,15.0%,70.0%,5.0%,85.0% and 70.0%,respectively). This study showed that there were high positive rate of drug resistance.CONCLUSIONS There are very high positive percentages of TEM,LEN,CTX-M-9,GES,and PER genes in ESBLs producing E.coli isolated clinically,and showing highly drug-resistant E.coli of producing ESBLs can be transmitted in hospital and induce fulminant prevalence.

In this paper,such information of argon-fluoride excimer laser is introduced as its principle,capacity,features and application to corneal refractive surgery.Its treatment effects and developing trend are also mentioned.

In this paper, the constitution and operation principle of an automatic ventilation system for excimer laser therapeutic instrument are introduced. With high accuracy, stability and reliability, the system benefits the performance and service life of the instrument.

This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward. When vital signs became stable at 30 hours post injury, bedside rehabilitation was begun. On post injury day (PID) 4, escharectomy was performed for both lower limbs, followed by microskin grafting and allogeneic skin covering. On PID 10, invasive infection of multi-drug resistant bacteria was found with accompanied high fever, and at the same time allograft began to disintegrate, with dissolution of large area of eschar, leading to a raw surface reaching 86% TBSA. Following debridement, dressing, application of compound polymyxin B ointment, temporary covering of wounds with porcine acellular dermal matrix, adjustment of antibiotics, patient's condition was finally stabilized. From PID 28 on, split-thickness skin grafting was conducted 7 times, and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered. At the same time, our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise, occupational therapy, prevention of scar formation, organ function training and psychological intervention. Finally, the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury. Oriented forwards functional rehabilitation, strong cooperation between team members, and synchronous effective implementation of burn treatment and rehabilitation in the whole process are the keys to achieve successful integration of burn treatment and rehabilitation of this child.
Acellular Dermis ; Animals ; Anti-Bacterial Agents ; therapeutic use ; Burns ; rehabilitation ; therapy ; Cicatrix ; Debridement ; Humans ; Shock ; complications ; Skin ; Skin Transplantation ; Swine ; Trauma Severity Indices ; Treatment Outcome ; Wound Healing

Objective To evaluate the short-term and mid-to-long-term clinical effectiveness of endovascular isolation technique with covered-stent in treating Stanford type B aortic dissection. Methods A total of 183 patients with Stanford type B aortic dissection, who were admitted to authors’ hospital during the period from January 2005 to December 2013 to receive endovascular isolation treatment with covered-stent under general anaethesia, were enrolled in this study. The clinical data, including post-operative symptoms, complications, retention time in ICU, hospitalization days, 30-day mortality, etc. were retrospectively analyzed. After discharged from hospital, the patients were followed up to check the situation, position and shape of the stent, the diameter of dissection false lumen, the internal leakage, etc. The survival rate and the quality of life were determined. Results Endovascular isolation procedure with covered-stent was successfully accomplished in all the 183 cases. The retention time in ICU was (3.08 ± 1.93) days, the mean hospitalization time was (3.08 ± 1.93) days, and the 30-day mortality was 1.09%. After discharged from hospital, the patients were followed up regularly, and no collapse or displacement of stent was observed, and the stent remained in its normal shape. No recurrence of dissection, rupture or reversal tear was observed. No long existing internal leakage could be detected. During the follow-up period 4 patients died, among them three died from cerebral infarction and one died of natural death. The 5-year survival rate was 97.82% and the patient’s quality of life did not become apparently worse. Conclusion For the treatment of Stanford type B aortic dissection, endovascular isolation therapy with covered-stent has excellent short-term effect and stable mid-to-long-term result.

Objective To investigate the association of tumor necrosis factor (TNF)-α, heat shock protein (HSP)70-2 gene polymorphisms and susceptibility of acute pancreatitis(AP). Methods Using case-control method,The gene polymor?phism of TNF-α and HSP70-2 was detected by PCR-RLFP in 72 patients with AP and 71 healthy controls. Results There were no significant differences in proportion of TNF-αgenotype and alleles between AP and control groups (P>0.05). There were no significant differences in TNF-αgenotype and alleles between severe acute pancreatitis (SAP) and light acute pancreatitis (MAP) of AP group (P>0.05). There were no significant differences in white blood cell count, C-reactive pro?tein (CRP), amylase, three acyl glycerin and glucose between TNF-a and HSP70-2 gene of AA type and GA+GG type pa?tients (P>0.05). The HSP70-2 genotype GA+GG proportion was significantly higher in AP group than that of control group (69.4%vs 49.3%). The ratio of patients with G allele was significantly higher in AP group than that of control group(46.5%vs 31.7%). The ratio of patients with GA+GG type AP was significantly higher in SAP patients than that of MAP patients of AP group(81.0% vs 53.3%). There was no significant difference in G allele between SAP and MAP patients (P>0.05). Conclusion TNF-α polymorphisms is not associated with acute pancreatitis. There is an association between HSP70-2 polymorphisms and acute pancreatitis. Carrying the G allele increases the possibility of a severe acute pancreatitis ,which is one of the genetic susceptibility factors of severe acute pancreatitis.

Objective To investigate the molecular background of the New Delhi-metallo-1 (NDM-1)-producing Morganella morganii.Methods Two carbapenem-resistant M.morganii named 1 and 2 were isolated in the Second Hospital of Jiaxing,Zhejiang on October 4th and 29th,respectively.Antimicrobial susceptibility was determined by agar dilution method.Pulsed-field gel electrophoresis (PFGE) was performed to analyse the homololgy of isolates.Amplification with specific primers,DNA sequencing,conjugation experiments and genetic environment analysis were conducted to investigate the molecular mechanisms of resistance.Results The two M.morganii isolates were resistant to carbapenem and fluoroquinolones,while susceptible to aztreonam.PFGE analysis indicated that the two isolates were distinguishable.Amplification and DNA sequencing confirmed the coexistence of blaNDM-1,blasHv-12,qnrS1 and aac(6')-Ib-cr in both isolates.Transconjugants were detected with blaNDM.1 and qnrS1 simultaneously.Genetic environment analysis demonstrated that the blaNDM-1-bleMBL-trpF-dsbC-cutA1 structure was in consistence with those from known blaNDM-1-carrying Klebsiella pneumoniae.Conclusion The blaNDM-1 in M.morganii isolates possiblely obtained from K.pneumoniae through translatable plasmids.

Objective To knock out Asxl2 gene in murine embryonic fibroblast cell line NIH3T3 using CRISPR/Cas9n system. Methods A pair of sgRNAs which targeted exon 5 of Asxl2 gene were designed and subcloned into the pX462 vec?tor. The recombined plasmids were verified by sequencing and transfected into NIH3T3 cell line. Single cells were isolated through serial dilutions, followed by an expansion period to obtain new monoclonal cell lines. The genomic DNA of the new monoclonal cell lines was extracted and a DNA fragment flanked the target site was amplified by genotyping PCR then se?quenced. Lastly, western blotting were applied to confirm whether Asxl2 was successfully knocked out. Results The CRIS?PR/Cas9n plasmids that targeted Asxl2 were successfully constructed. NIH3T3 cells were co-transfected with the two recom?binant constructs. After puromycin selection, subclonal cell lines were obtained and one of them was validated by genotyping PCR-sequencing. Western blotting also confirmed that Asxl2 was completely depleted in the NIH3T3 cell line. Conclu?sion CRISPR/Cas9n plasmids that targeted Asxl2 were successfully constructed therefore a Asxl2 knockout NIH3T3 stable cell line was established via this system.