Objective To observe the curative effect of nourishing the lung and strengthening the spleen and nourishing the lung to the acute exacerbation of chronic obstructive pulmonary disease with malnutrition.MethodsProspective selection 120 cases were diagnosed as AECOPD patients with malnutrition of the Department of respiratory medicine from June 2015 to August 2016,Were randomly divided into EN group and combination group, 60 cases in each group, EN group with high fat and low sugar EN liquid Omega and ω3 Yu You Zhi Fang Ru Zhu She Ye and N(2)-L-alanyl-L-glutamine for Injection, Combined group in the EN group based on the added benefits of lung spleen, compared the Nutritional status and immune function between the two groups.ResultsTwo groups of patients were successfully completed 14d treatment, After treatment, BMI, TSF, MAMC, TP, ALB, PA, HGB, TFN, NB levels were significantly higher than those before treatment (P<0.05);Combined group after treatment, the level of each index was significantly higher than the EN group (P<0.05).WBC, hs-CRP, IL-6, TNF-α levels in the two groups were significantly lower than before treatment, TLC, IgA, and IgG levels were significantly higher than before treatment (P<0.05);the combination group WBC, hs-CRP, IL-6, TNF-αlevel lower than the EN group, TLC, IgA, IgG level higher than the EN group (P<0.05).ConclusionBenefit lung and spleen strengthening traditional Chinese medicine combined with enteral nutrition can improve the nutritional status, respiratory function and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease, and has high application value.

Objective To investigate the clinical treatment efficacy of mutabilis coated nasal ointment to postoperative nasal septal reconstruction.Methods After surgical reconstruction,116 cases were divided into the treatment group and control group ac-cording to random method,58 cases in each group.The treatment group was given mutabilis coated nasal ointment combine with physiological seawater nasal care device;the control group was only given physiological seawater nasal care device in the same time. The effects were observed for 6 months.Results The total effective rate of treatment group was higher than the control group (98.28%),the two groups had significant difference(P <0.05).Postoperative follow-up,the bleeding rate in the treatment group have no significant difference compared with the control group(P >0.05);the incidence of infection and cavity stricture in the treat-ment group were significantly lower than the control group(P <0.05).Conclusion The application of mutabilis coated nasal oint-ment can promote the wound healing of nasal cavity,but also can prevent the operation adhesion,and shorten repair time,so as to improve the clinical effect of operation.

OBJECTIVE: To investigate the clinical features of chronic tracheoesophageal fistula (TEF), provided disease-related treatment experience and lessons for clinicians. METHOD: To successfully repair one case of chronic tracheoesophageal fistula with surgery, and to analyze the clinical treatment process, combined with relevant literature, the author reported the experiene of diagnosis and treatment in TEF. RESULT: After the gastrointestinal ostomy and Stent implantation, the fistula persisted, nine months later ,we took the surgery to repair the fistule, ten days postoperation, the fistule healed and esophageal iodine water examination didn't prompt obvious abnormalities, the patient was discharged without any postoperative complications 12 days postoperation. CONCLUSION If conservative treatment failed with TEF, the surgical repair should be carried timely, By double sutured with fistula in surgery, and reinforced with the approaching muscle tissue, It can achieve good results.
Humans ; Postoperative Complications ; Postoperative Period ; Tracheoesophageal Fistula ; pathology ; surgery ; Wound Healing

ObjectiveThe expression and significance of interleukin(IL)-17 in a murine model of experimental systemic sclerosis(SSc) was studied and its correlation with transforming growth factor-beta 1 (TGF-β1) was explored.Methods Thirty female BALB/c mice were randomly divided into 3 groups,including a control group, bleomycin(BLM) injection for 4 weeks group(model 1 group) and a termination injection of BLM 4 weeks group(model 2 group).The pathological changes of skin and lung were detected.The mRNA expressions of IL-17A,RORγt,TGF-β1 mRNA were evaluated by real-time PCR.Enzyme linked immunosorbent assay was used to measure the levels of IL-17 and TGF-β1 in the serum and bronchoalveolar lavage fluid(BALF).Comparisons among groups were performed by variance analysis.ResultsSkin and lung of the model groups showed evident inflammatory cell infiltration and increased deposition of collagen fibers.The score of dermal inflammation and lung fibrosis was significantly higher in the model 1 and model 2 groups (2.5±0.8,3.0±1.8), (2.4±0.8,3.1±1.2) as compared to that of the control group (0.9±0.7,0.9±1.0),(F=12.19,8.367,25.11,4.641; all P＜0.05).The amount of hydroxyproline was markedly increased in the model groups than in the control group.Compared with those of the control group,the mRNA levels of IL-17A,RORγt,TGF- 31 in the skin and lung of the model 1 group were higher.The levels of IL-17 in serum and BALF of the model 1 group was significantly increased and the levels of TGF- β1 were increased in BALF and decreased in the serum (all P＜0.05).The mRNA levels of IL-17A in skin and lung had a positive correlation with the mRNA levels of TGF- β1,score of dermal inflammation and lung fibrosis.The levels of IL-17 in serum had a positive correlation with hydroxyproline of the skin and lung.ConclusionIL-17 may participate in systemic immune-mediated inflammation and changes of skin and lung in SSc and when combined with TGF-β1 togetter will cause damage to skin and lung in SSc.

4"-O-isovaleryltransferase gene (ist) was regulated by positive regulatory genes of midecamycin 4"-O-propionyltransferase gene (mpt) in Streptomyces lividans TK24. A BamH I ~8.0 kb fragment from Streptomyces mycarofaciens 1748 was proved that it contained mpt gene and linked with two positive regulatory genes, orf27 and orf28. Orf of mpt was replaced by orf of ist and linked with two regulatory genes or orf27 single, and individually cloned into the vectors pKC1139 or pWHM3 (high copy number), and then transformed into S. lividans TK24. The levels of mpt and ist expression were evaluated by the bio-tramsformation efficacy of spiramycin into 4"-O-acylspiramycins in these transformants. The results showed that 4"-O-isovalerylspiramycins could be detected only in the transformants containing the plasmids constructed with pWHM3. The efficacy of bio-transformation of the transformants containing two regulatory genes was higher than that of orf27 single. So, the positive regulatory genes system of mpt gene could enhance ist gene expression.
Acyltransferases ; genetics ; metabolism ; Bacterial Proteins ; genetics ; metabolism ; Gene Expression ; Genetic Vectors ; Plasmids ; Spiramycin ; analogs & derivatives ; biosynthesis ; Streptomyces ; enzymology ; genetics ; Streptomyces lividans ; metabolism ; Transformation, Genetic

Objective To investigate the value of magnetic resonance imaging(MRI)in the evaluation of microwave ablation(MA)for liver cancer.Methods The clinical data of 51 patients with liver cancer who received MA at the General Hospital of PLA from November 2005 to June 2009 were retrospectively analyzed.The MRI findings of 65 nodules before and after the treatment of MA were evaluated by serological examination and needle biopsy of liver.Results All patients received MRI within 1 month after MA.Of all nodules.63 were presented with high signal intensity on T_1-weighted images(T_1 WI)and low signal intensity on T_2-weighted images (T_2 WI)and with peripheral ring-like enhancement.They were diagnosed as complete coagulation necrosis,and the alpha-fetoprotein(AFP)level of the patients decreased from 333.83μg/L before MA to 37.68 μg/L after MA.Two nodules were presented with low signal intensity on T_1 WI and high signal intensity on T_2 WI,and they were diagnosed as local residual.All patients were followed up l month after MA,and 5 nodules showed enhancement with the same image characteristics as local residual.They were diagnosed as local recurrence of liver cancer by needle biopsy of liver and AFP level detection.New intrahepatic nodules in 23 patients and an abdominal nodule in 1 patient were detected with an increase of AFP level(mean,120.16 μg/L).Conclusion MRI Can exactly evaluate the efficacy of MA in the treatment of liver cancer.

Objective To investigate the effect of trabeculectomy combined with segmental iridectomy, mitomycin C (MMC) and viscoelastic agents usage on the treatment of glaucoma secondary in uveitis. Methods According to the age, degree of inflammation and the condition of Tenon capsule of patients, differ-ent concentration of MMC (0.25-0.33 mg/ml) was used during the operation, with separation of the anterior and posterior synechia, resection of pupillary organization membrane using viscoelastic agents. Segmental iridec-tomy and releasable sutures were also performed on the patients. The visual acuity of preoperation and postoper-ation, intraocular pressure, inflammation and the complication were record. Results Forty-two eyes of 38 cases with glaucoma secondary in uveitis were studied, the mean follow-up time was (12.01±3.56) months. The postoperative visual acuity improved in 14 eyes, didn't change in 28 eyes. The postoperative inflammation of anterior chamber disappeared in 35 eyes, relieved in 7 eyes. And the average postoperative intraocular pres-sure (15.20± 4.64) mmHg was significantly lower than the preoperative intraocular pressure (38.37±12.93) mmHg (t = 8.255, P = 0.000). The total success rate was 92.9%. There were no severe complication. Conclusion Trabeculeetomy combined with MMC, viscoelastic agents usage, separation of anterior and poste-rior syneehia, segmental iridectomy and releasable suture could increase the success rate of operation on pa tients with glaucoma secondary in uveitis, decrease the complication and inflammation reaction of operation, and the recurrence of uveitis.

Objective To evaluate the effect of hypothermia on the expression of dynamin?related protein 1 ( Drp1) in brain tissues during global cerebral ischemia?reperfusion ( I∕R) in rats. Methods Thirty?six healthy male Sprague?Dawley rats, weighing 280-320 g, were divided into 3 groups ( n=12 each) using a random number table: sham operation group ( group Sham ) , global cerebral I∕R group ( group I∕R) and hypothermia group ( group H) . Cardiac arrest was induced by transoesophageal cardiac pacing followed by cardiopulmonary resuscitation to establish the global cerebral I∕R model in anesthetized rats in I∕R and H groups. In group H, the body temperature ( rectal temperature) was cooled down to 32-34 ℃ within 15 min starting from the beginning of reperfusion, and maintained at this level for 6 h. At 72 h of reperfusion, neurological deficit was scored, and the rats were sacrificed, and the whole brain was removed for examination of the pathological changes in hippocampal CA1 region and for determination of nor?mal pyramidal cell count and neuronal apoptosis in hippocampal CA1 region and expression of Drp1 and cy?tochrome c (Cyt c) in hippocampal tissues (by Western blot). The apoptosis rate was calculated. Re?sults Compared with group S, the neurological deficit score and apoptosis rate were significantly in?creased, and the number of normal pyramidal cells was decreased in I∕R and H groups, the expression of Drp1 and Cyt c in hippocampal tissues was significantly up?regulated in group I∕R ( P<0.05) , and no sig?nificant change was found in the expression of Drp1 and Cyt c in hippocampal tissues in group H ( P>0.05) . Compared with group I∕R, the neurological deficit score and apoptosis rate were significantly de?creased, the number of normal pyramidal cells was increased, and the expression of Drp1 and Cyt c in hip?pocampal tissues was down?regulated in group H ( P<0.05) . Conclusion The mechanism by which hypo?thermia inhibits cell apoptosis during global cerebral I∕R may be related to down?regulation of Drp1 expres?sion in rats.

Objective To explore the CT and MRI manifestations and clinical features of juxtaglomerular cell tumor (JGCT). Methods A retrospective analysis the data of eight JGCT patients who resected by surgery and comfirmed by histopathology. Seven cases were examined by CT before operation, five of whom underwent CT scan and dynamic enhanced scan, two of whom underwent CT scan, and all of the eight underwent MRI scan and dynamic enhanced scan. The clinical manifestations of patients were also observed, whether they have hypertension and reduced blood potassium, recorded the results of lying and standing test, and collected the segmental renal vein blood to detect the renin levels. Meanwhile, the CT and MRI manifestations were also recorded. Results (1) We found that all of the eight patients appeared hypertension, and hypokalemia were found among five cases. Seven patients proceeded the lying and standing test, six of whom the plasma renin activity (PRA) were elevate in erect position, and the levels of angiotensin Ⅱand aldosterone (ALD) were rised among all of the seven cases in erect position. Four patients were collected the segmental renal vein blood, and one of whom has positive result of the renin activity. (2) The tumors of all the eight cases were single, the border was clear, and the average size was 2.7 cm (range 1.9 to 3.8 cm). The CT scan results showed there's no calcification or pseudocapsule were detected, four cases showed homogeneous iso-density, one case with slightly high density, another one showed low density with dotty high density and one case with low density. The dynamic enhanced CT scan showed that four cases performed continuous enhancement from cortical to medullary phase, and no obvious enhancement was found in one case. The T2WI results of MRI scan showed six cases had pseudocapsule, 6 cases had heterogeneous signal (4 cases with patchy low signal and 2 cases with patchy high signal), and 2 cases had homogeneous signal (one case with iso-high signal and another with high signal). The T1WI results showed two cases performed low signal, anther two cases showed iso-signal, and four cases with heterogeneous signal. The DWI results showed all of the 8 lesions with homo-or peripheral high signal. The dynamic enhanced MRI scan results showed seven cases performed gradual enhancement, and the border of another case became clear on delay phase. Conclusions JGCT has specific clinical and imaging features, and the combination will help make a correct diagnosis.

AIM:To investigate the synergistic anti-proliferation effect of aspirin and 5-fluorouracil on the co-lon cancer cells and its mechanism .METHODS: Colon cancer cells were divided into 4 groups: control group , aspirin group, 5-fluorouracil group and aspirin +5-fluorouracil group .Synergistic anti-proliferation effect of aspirin and 5-fluoroura-cil on the colon cancer cells was observed by MTT assay .Apoptosis-inducing effect and mechanism were detected by Hoechst 33258 staining, caspase activity assay and flow cytometry analysis .The mRNA and protein levels of apoptosis-re-lated proteins were evaluated by real-time PCR and Western blotting .RESULTS:5-Fluorouracil inhibited proliferation of HCT116 and SW620 colon cancer cells effectively , and low concentration of aspirin exerted synergistic inhibitory effect .5-Fluorouracil induced apoptotic morphology and increased caspase activity and sub -G1 phase in HCT116 cells.The synergis-tic effect of aspirin obviously enhanced apoptotic ratio and caspase activity .Moreover , 5-fluorouracil inhibited the mRNA and protein expression of Bcl-2, which was amplified by low concentration of aspirin .CONCLUSION:Aspirin and 5-flu-orouracil had a synergistic anti-proliferation effect on the colon cancer cells through apoptosis pathway .