Adolescent ; Adult ; Female ; Humans ; Male ; Maxillary Sinus ; pathology ; Middle Aged ; Paranasal Sinus Diseases ; etiology ; surgery ; Young Adult

Aim To observe the neuroprotective effect of different doses of propofol on ischemic fetal rat brain.Methods Eighteen healthy pregnant SD rats were randomly allocated into the following six groups with three rats in each.Group S: sham operation group, Group IR: ischemia/reperfusion group, Group P1~P3: different doses of propofol groups, Group B: bicuculline group.In group S and group IR, 1 ml saline solution was administered via caudal vein.In group P1~P3, 10, 30, 50 mg·kg-1 of propofol was administered via caudal vein respectively.In group B, when 50 mg·kg-1 propfol was administered via caudal vein, 5 mg·kg-1 bicuculline was injected intraperitoneally at the same time.Bilateral uterine ovarian arteries were clamped for 11 mins to make intrauterine distress model of the fetal rats.The brains of fetal rats were removed after 3 days of reperfusion.Brain sections(5 μm thick) were mounted and stained with Hematoxylin and eosin(HE).The profile of the hippocampus CA1 was evaluated under a light microscope and neuronal Lesion-index(LI) was calculated.MDA content of fetal rat brain was detected by thiobarbituric acid reaction method to determine the lipid peroxidation degree of brain.Results LI was (7.2±0.9) and MDA was (3.86±0.20) μmol·g-1 in group S.LI was 71.9±2.8 and the content of MDA was (9.10±0.45) μmol·g-1 in group IR, which increased significantly compared with those in group S(P<0.01).LI was (40.8±2.6), (21.4±1.4), (20.1±1.3) and the content of MDA was (7.32±0.41), (5.65±0.27), (5.44±0.28) μmol·g-1 in propofol groups, which decreased significantly compared with those in group IR(P<0.05).LI and the content of MDA was (51.2±2.3), (7.54±0.31) μmol·g-1 in group B,respectively, reversing partly the neuroprotevtive effect of propofl.Conclusion Propofol could protect the neurons in hippocampus CA1 region of fetal rat against intrauterine distress by reducing the concentration of MDA in the brain.

Objective To modify the methods of operation and establishment of cerebral ischemia rat models made by thread occlusion. Method We randomly divided 120 male SD rats into a common group (n = 50), an improvement group (n = 60) and a sham-operated group (n - 10). Rats in the common and improvement groups were made into models using the common and improvement methods separately. All models were evaluated on the basis of physical sign indices and 2,3,5-triphenyltetrazolium chloride (TTC) staining. The TTC staining results were taken as gold standards. Then, we compared the achievement ratios of the two groups, and computed the sensitivity and specificity of every physical sign index based on these standards. The χ~2 or correction χ~2 test was used to compare the ratios. Results (1) The achievement ratio in the improvement group was significantly higher than that in the common group (71.67% vs. 52.00%, P = 0.034). (2) The sensitivity of evaluation for both common and improvement methods was 98.55%. However, the specificity of evaluation for the improvement method was significantly higher than that for the common method (100.00% vs. 40.00%, P =0.000). Conclusions The establishment achievement ratio and evaluation correctness of models are obviously elevated by modification of the operation and establishment methods.

OBJECTIVE To investigate the distribution of integron in Gram-negative isolates which are causing nosocomial infection the association with drug resistance,and it′s contribution in horizontal transfer of drug resistance.METHODS Drug resistance test was performed by K-B method.ESBL-positive strains were detected by double-disk synergy test.Integron was determined by PCR assay with integron-specific-primer.Conjugative transfer test,plasmid profile analysis,nested-PCR,and DNA sequence analysis were used to investigate the transferable mechanism of integron mediated.RESULTS 66.4% of Strains were shown to be positive for classes Ⅰ integron,no class Ⅱ and Ⅲ integrons were detected.Profiles of class Ⅰ integron were 11 types,which sized from 700bp to 2300bp,gene cassettes included genes encoding resistance to aminoglycosides(aadA1,aadA2,aadA5 and aacA4),sulfamethoxazole/trimethoprim(dfrA12,dfrA5 and dfrA17) and chloramphenicol(catB8).Strains positive for class Ⅰ integron were highly related to multidrug resistance and ESBLs.Class Ⅰ integron could horizontal transfer along with plasmid among bacteria.CONCLUSIONS Class 1 integron is widespread in Gram-negative isolates which are causing nosocomial infection.Drug resistance is more liable to horizontal transfer via class Ⅰ integron along with plasmid.It implies the necessary for surveillance of horizontal transfer of antibiotic resistance gene among bacteria genus.

Objective To explore the pregnancy outcome and obstetric management of pregnancy and delivery after vaginal radical trachelectomy (VRT).Methods Forty-two cases of VRT from December 2003 to May 2012 in Peking Union Medical College Hospital were analyzed retrospectively.Among them ten cases got pregnant successfully.Results The average age of patient at VRT surgery was (30.6 ± 3.7) years old and average follow-up time was 29.5 months.There were 31 patients attempted conception.Ten of them got fourteen conceptions successfully.Overall conception rate was 45％ (14/31).There were four cases of first trimester abortion.Among them,two were miscarriage,two were elective abortion.There was one case of ectopic pregnancy operation and non of second trimester loss.Nine cases reached the third trimester.The total preterm delivery rate was 4/9.There were two cases delivered before 32 gestational weeks (2/9).Cesarean section was performed through a transverse incision in all of nine cases.No uterine rupture and postpartum hemorrhage occurred.All newborns had good outcomes.The average follow-up time after postpartum was 22.9 months.All cases were disease-free.Conclusions The conception rate of patients after VRT in our series is 45％.The preterm birth rate of pregnancy after VRT is higher.Routine cerclage of cervix during VRT procedure and pregnancy is not necessary.Cesarean section shortly after full term pregnancy through a transverse incision should be considered as a suitable and safe procedure.

In this study, different functional layer formulations and process parameters were used to prepare the levomilnacipran hydrochloride sustained-release capsules, the influence of functional layer formulation and process factors on dose dumping was studied by comparing their release curves in 40% ethanol; and the risk of dose dumping of the self-developed drug was evaluated by the similar factors of the release curve of the self-developed drug and the reference drug.The results showed that as the coating weight increased, the degree of dose dumping decreased; when the concentration of ethanol in the coating liquid solvent was less than 80%, the dose dumping increased; as the atomization pressure and maturation time increase, the dose dumping became more serious. In 0% ethanol (purified water), 5% ethanol, 20% ethanol and 40% ethanol media, the self-developed and reference preparations had the same degree of dose dumping within the specified time, and rotation speed had no significant effect on the release of metformin in vitro. In summary, formulation factors such as coating weight gain, ethanol concentration in the coating solution solvent, and process factors such as atomization pressure and curing time have a serious impact on the dose dumping of sustained-release capsules.Under the optimal functional layer formulation and process, special attention should be paid to the control of risk of self-developed dose dumping.

Objective To compare the clinical significance of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting prognosis of patients with hepatocellular carcinoma (HCC).Methods The clinical data of 661 patients with HCC were retrospectively analyzed.Routine peripheral blood test results were used to calculate the NLR and PLR,and the receiver operating characteristic (ROC) curves were drawn.Using the thresholds of NLR and PLR,the patients were divided into the low NLR group and the high NLR group,and the low PLR group and the high PLR group.Overall survival (OS) and disease free survival (DFS) were evaluated by the Kaplan-Meier method.Independent prognostic predictors were determined by the Cox proportional hazard model.Results The NLR and PLR thresholds were 2.790 and 99,respectively.Analysis of the ROC curves showed higher NLR and PLR were significantly associated with poorer OS and DFS (all P ＜ 0.05).Multivariate analysis showed that NLR was an independent risk factor of OS and DFS (both P ＜ 0.05).The results remained unchanged when the NLR was further analyzed by applying different cut-off values of 2.810 and 3.In subgroup analysis,NLR remained an independent factor of Barcelona Clinical Liver Cancer staging system (BCLC) 0/A/B (P ＜ 0.05 for all measurements).Conclusion An elevated preoperative NLR could be a better prognostic predictor for HCC patients in comparison with PLR,especially for BCLC 0/A/B patients.

Objective To compare the clinical efficacy of Philos plate and Multiloc intramedullary nail for 3-or 4-part proximal humeral fractures in the middle-aged and elderly patients.Methods A retrospective case control study was conducted to analyze the clinical data of 52 middle-aged and elderly patients with 3-or 4-part proximal humeral fractures admitted to Sichuan Orthopedic Hospital from January 2014 to January 2016.The patients were divided into Philos plate group (27 patients) and Multilloc intramedullary nail group (25 patients) according to different treatment methods.In the Philos plate group,there were 11 males and 16 females,aged (59.3 ± 4.5) years.Based on the Neer classification,there were 16 patients with 3-part fracture,11 patients with 4-part fracture including two patients with 4-part fracture dislocation.There were eight patients with varus fracture and 19 patients with valgus fracture.In the Multiloc intramedullary nail group,there were 10 males and 15 females,aged (62.2 ± 7.4) years.Based on the Neer classification,there were 18 patients with 3-part fracture,seven patients with 4-part fracture including one with 3-part fracture dislocation and one with 4-part fracture dislocation.There were 12 patients with varus fracture and 13 with valgus fracture.The operation time,intraoperative bleeding volume,fracture healing time,neck-shaft angle changes and complications of humeral head ischemic necrosis were compared between the two groups.At the last follow-up,the motion range of affected shoulder joint,American Shoulder and Elbow Surgeons (ASES) scale,Constant-Murley score and visual analogue score (VAS) were compared between the two groups.Results There was no significant difference in the operation time between the two groups (P ＞ 0.05).The intraoperative bleeding volumes were 170-350 ml [(260.1 ± 110.3) ml] in the Philos plate group and 70-250 ml [(172.2 ± 100.3)ml] in the Multiloc intramedullary nail group,with statistically significant difference (P ＜ 0.05).All incisions were healed by first intention,and no infection was found.The patients in the Philos plate group were followed up for 12-36 months [(17.2 ±6.5)months],and patients in the Multiloc intramedullary nail group for 12-36 months [(14.5 ± 4.7) months] (P ＞ 0.05).All fractures were healed,with the healing time for 2.5-4 months [(3.5 ± 0.5)months] in the Philos plate group and for 2-3.3 months [(3.0 ± 0.5) months] in the Multiloc intramedullary nail group.The neck-shaft angle was lost to some degree in both groups at the last follow-up compared with the first day after operation,but the differences were not statistically significant (P ＞ 0.05).The Philos plate group had a higher incidence rate of complication [22％ (6/27)] than the Multiloc intramedullary nail group [12％ (3/25)] (P ＜ 0.05).Three patients in the Philos plate group had partial ischemic necrosis of the humeral head,while none was found in the Multiloc intramedullary nail group.There were no significant differences in active shoulder joint ante-flexion and uplift,lateral intorsion and extorsion,ASES score,Constant-Murley score and VAS between the two groups (P ＞ 0.05).Conclusions For 3-or 4-part proximal humeral fractures in middle-aged and elderly patients,both Philos plate and Multiloc nail can obtain stable and reliable fixation and achieve satisfactory results of shoulder joint function.However,the Philos plate fixation has more intraoperative bleeding,longer fracture healing time,and higher incidence rate of humeral head ischemic necrosis than the intramedullary nail.

Objective To investigate the significance of albumin-bilirubin (ALBI) score in predicting prognosis of hepatocellular carcinoma (HCC).Methods The clinical data of 644 HCC patients were retrospectively analyzed from May 2010 to May 2013 in the First People's Hospital of Changde City and the Affiliated Tumor Hospital of Guangxi Medical University.Peripheral blood test results were used to calculate ALBI score,and ALBI score was categorized into the following 3 groups:grade 1,grade 2,grade 3.Overall survival(OS) and disease free survival(DFS) were evaluated by the Kaplan-Meier method.And independent prognostic predictors were determined by the Cox proportional hazard model.Results Multivariate analysis showed that ALBI grade 2 was an independent risk factor for OS(P＜0.05).The ALBI grade stratified patients into at least two distinct overall survival cohorts (P＜0.05),whereas the CP grade did not.The ALBI grade also classified patients with CP grade A patients into two distinct overall survival cohorts (P＜0.05).In the subgroup analysis,the ALBI grade seemed to be an independent factor in terms of Barcelona Clinical Liver Cancer staging system(BCLC) 0-C.Conclusion For patients with HCC who underwent R0 resection,the ALBI grade is a good predictor of OS in HCC patients,and the above conclusions is true in patients with BCLC stage 0-C.

Objective: To investigate the clinical results of arthroscopic double-pulley double row suture technique for the treatment of bigger Ideberg Ia glenoid fracture. Methods: From January 2014 to July 2017, data of patients with Ideberg Ia glenoid fracture who were treated by arthroscopic double-pulley double row suture technique were retrospectively analyzed. Totally 24 patients were enrolled of whom 13 were males and 11 were females. The mean age was 50.14±10.60 years (range, 34-67). In those patients, there were 8 cases of glenoid fracture alone, 4 cases of glenoid fracture associated with greater tuberosity fracture, 5 cases of glenoid fracture with rotator cuff tear, 4 cases of glenoid fracture with shoulder anterior dislocation and greater tuberosity fracture, 2 cases of glenoid fracture with shoulder anterior dislocation and rotator cuff tear, and 1 case of shoulder anterior dislocation with ipsilateral distal radius fracture. The fragment accounts for 28.91±5.35% (range, 25.1%-38.5%) of the glenoid articular surface. According to the size of the fragment, one medial row anchor was used to implant at the medial edge of the fracture bed of the anterior edge of the glenoid; two to four lateral row suture anchors were used to implant at the margin of the glenoid joint surface sequentially from low level to higher level, and simplified double-pulley technique was finally used to fix the fragment. The situation of fracture reduction and healing and the post-operative complications were evaluated. The Constant-Murley, DASH and VAS were also recorded. Results: Satisfactory fracture reduction and fixation were achieved in all 24 patients. The mean follow-up time was 19.5 months (range, 12-36). Mean VAS was 0.8±0.8 (range, 0-2). The range of motion at the latest follow-up was: anterior flexion 145°-180° (mean, 161.00°±5.77°), external rotation at the side 35°-60° (mean, 46.43°±6.63°), internal rotation L₃-T₁₀ level. The mean Constant-Murley score was 88.1±3.7 (range, 81-93), and mean DASH score was 8.4±4.7 (range, 0-40.4). All cases except one showed no dislocation or disability of the shoulder. The CT scans showed: 19 cases of which the step-off of articular surface was less than 2 mm; 4 cases of which the step-off was between 2 mm to 4 mm and 1 case of which the step-off was more than 4 mm. No severe osteoarthritis was identified at the latest follow-up, and only 1 patient at the age of 67 showed slight osteoarthritis. Two patients with shoulder anterior dislocation and rotator cuff tear committed significant restricted shoulder range of motion. Conclusion The arthroscopic simplified double-pulley double row suture technique was identified safe, effective and reliable for treating the bigger Ideberg Ia glenoid fracture. The technique is able to provide clear visulization of the fracture and achieve excellent clinical results.