Allostasis ; physiology ; Chronic Disease ; General Adaptation Syndrome ; physiopathology ; Humans ; Stress, Psychological ; physiopathology

Lung cancer is one of the commonest of malignant tumor in the world.It is a major threat to human health in China with highest morbidity and mortality.Steady increase in incidence rates have been observed worldwide in the last few decades in young patients,but previous studies have provided conflicting data about the clinical characteristics and prognoses of young patients with lung cancer.Consequently,we have difficulty in comparing their results with each other,as the cutoff ages defining"young"were different in each study.Therefore,this article focuses on the clinical characteristics and the different results of researches for the young patients with primary lung cancer.

Objective To explore the relationship between administration of different doses of colloid before general anesthesia induction and general anesthesia-induced hypotension. Methods Fifty patients for selective gastrointestinal operations were randomly divided into 5 groups according to the volume of colloid administered 30 min before general anesthesia induction: 0 mL/kg group (control group), 4 mL/kg group, 8 mL/kg group, 12 mL/kg group and 15 mL/kg group. To replace the deficit of hypovolemia before operation, crystalloid was given to each patient. Anesthesia was induced with propofol 25 min after infusion. Hemodynamic parameters were compared before and after anesthesia induction among groups. Results The changes in diastolic blood pressure and mean arterial blood pressure were related to colloid supplementation volume (r=-0.657, P<0.01). There were significant differences between control group and 8 mL/kg group, 12 mL/kg group and 15 mL/kg group (P<0.05), while there was no significant difference among 8 mL/kg group, 12 mL/kg group and 15 mL/kg group. Conclusion Administration of colloid before general anesthesia induction attenuates the severity of general anesthesia-induced hypotension, especially when the dose of colloid is over 8 mL/kg.

OBJECTIVE To investigate the clinical distribution and drug resistance status of Stenotrophomonas maltophilia and provide clinical guidance for treatment.METHODS Sixty clinical isolates of S.maltophilia were identified with GNI+ cards of VITEK-32.Drug sensitivitiy were detected by Kirby-Bauer disc diffusion method.The data were analyzed by WHONET5.3 software.RESULTS Thirty-eight strains were isolated from sputum(63.3%).Infection caused by S.maltophilia mainly occurred at the departments of respiratory diseases,ICU,old cadre,et al.Sixty isolates of S.maltophilia were highly resistant to imipenem,aminoglycosides and most of ?-lactam antibiotic,but showed the lowest resistance rate(16.7%) to SMZ/TMP.Then resistance rate of S.maltophilia to minocycline,levofloxacin,cefoperazone/sulbactam,piperacillin/tazobactam,and ticarcillin/clavulanic acid was 18.3%,20.0%,21.7%,25.0% and 30.0%,respectively.CONCLUSIONS The drug resistance of S.maltophilia is extremely severe.Among different areas of china the drug resistance is obviously different.Treatment based on drug susceptibility test should be adapted as soon as possible.

OBJECTIVE:To investigate and analyze the causative factors and characteristics of drug-induced rhabdomyolysis in China,in order to reduce the incidence of rhabdomyolysis. METHODS:Search all cases of rhabdomyolysis in China Knowledge Re-source Integrated Database from Jan 1975 to Jun 2014. Sex,age,disease history,drugs administered,drug combination,clinical presentation and outcome of rhabdomyolysis were censused and analyzed. RESULTS:There were altogether 185 rhabdomyolysis cas-es reported,of which 57.8% were over 60 years old ,78.9% were induced by lipid regulators,and 55.7% were by statins;74.1%occurred within 1 month after drug administration,and 86.6% became normal within 1 month when causative drugs discontinued or with treatment;and 4.9% died. CONCLUSIONS:Eldly,complicated with multi-factors,such as multiple organ dysfunction syn-drome,irrational drug combination and over-doses,especially with lipid regulators,are important causative factors of rhabdomyoly-sis. Individualized administration of drugs and prescription as less as possible should be recommended to reduce the incidence of rhabdomyolysis.

Objective To study and compare the protective effects of pmtease inhibitor and corticosteroid on endotoxin-indueed acute lung injury in order to guide the choice of appropriate drugs. Method Thirty-two New Zealand rabbits were randomly divided(random number) into four groups with 8 rabbits in each, namely normal controls(C) ; lipopolysaecharide(LPS) group(L) ; ulinastatin(UTI) group(U) and dexamcthasone(DEX) group (D) .Except group C, all rabbits were injected with a dose of LPS 600 μg/kg iv. Meanwhile the rabbits in group U,group D received UTI(100 000 μ/kg), DEX(5 mg/kg), respectively. The specimens were collected 4 hours later for detecting the levels of TNF-α and NO in serum, and blood gas analysis, histological manifestations, the lung wet/dry weight ratio, lung tissue MPO and SOD activity, lung tissue MDA. Data were analyzed by ANOVA (SNK- q test), and P < 0.05 was considered as significantly different. Results Compared with group C, the lungs of the rabbits in group L had inflammatory granulocyte infdtration, diffused alveolar septum thickening and hemorrhagic spots were observed in pathological examinations. The histological changes of group U and group D were much lessened than those in group L. As groups U and D were compared with group L, there were significant differences inmany biomarkers including lung wet/dry weight ratio[(5.02±0.11),(4.93±0.13) vs.(5.37 ±0.29)],lung tissue MPO activity[(0.51 ± 0.05),(0.54±0.07) vs.(0.82 ± 0.09)] and MDA[(0.82 ±0.05),(0.81 ±0.04) vs.(0.96±0.05)], NO[(296.2± 11.7),(291.7 ± 15.8) vs.(351.8±19.6)] and TNF-α[group D(2.021 ± 0.122) vs. group L(4.999 ± 0.139)],lung tissue SOD activity[(120.3 ± 6.1),(122.6±3.5) vs.(105.1 ± 8.5)] and blood gas analysis[pH(7.30±0.23),(7.30±0.17) vs.(7.22±0.45) and PaO_2( 101.9 ± 6.8).( 102.5 ± 4.7) vs.(80.3 ± 3.3)] ; but there were no differences of above mentioned biomarkers between group U and D( P > 0.05). And there were no significant differences in PaCO_2 betweeu group U and D and group L[(37.0 ± 3.3),(37.6 ± 3.0) vs.(34.8 ± 2.3)]( P > 0.05). Conclusions The protective effects of ulinastatin on endotoxin-induced acute lung injury is comparable to those of dexamethasone, thus the former may be a clinical substitute for the latter with less side effects.

Objective To discuss the surgical treatment for huge hepatoblastoma in children,and the technique of hepatectomy without blockade of the blood supply to the remained liver lobes.Methods We reviewed 12 cases of huge hepatoblastorna who had been operated from July 2001 to January 2009 in our hospital.The mean age of the children was 3.2 years(range,11 months to 12 years).The diameter of the tumor was from 10 to 23 cm.3～7 cycles of chemotherapy was routinely administrated before operation.When the tumor reduced to a certain size that radical resection could be performed safely,regular hepatectomy was conducted.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes was performed in every patient.Results The operations were successfully accomplished in all the 12 children.5 cases received right trihepatectomy (segment Ⅳ,Ⅴ～Ⅷ),4 cases received right hemihepatectomy(segment Ⅴ～Ⅷ),and the other 3 cases received Ⅳ,Ⅶ,Ⅷ segmentectomy,right Ⅴ,Ⅵ segmentectomy,and left hemihepatectomy respectively.The intraoperative hemodynamic parameters were stable,and there was no perioperative mortality.Postoperative chemotherapy wag routinely administrated.The follow-up period varied from 2 to 92 months.11 children survived and were disease free,among those 6 children have survived for more than 5 years.One child had brain and lung metastasis 5 months post operation,and died 7 months post operation. Conclusion Preoperative chemotherapy administrated to children with huge hepatoblastoma can reduce the tumor size and render tumor reseetable.Hepatoblastoma resection without blocking the blood supply to the remained liver lobes is a safe and feasible surgical technique.

Objective To introduce the technique and treatment outcome of the fingertip soft tissue defect with improved transverse palmar island flap.Methods From January 2011 to February 2013,15 cases(17 fingers) fingertip defect were repaired by improved transverse palmar island flap,the vascular pedicled of flap was a side of the neurovascular bundle,the flap revolved 90° to coversoft tissue defect.Defect area:1.2 cm × 0.8 cm to 1.7 cm × 1.6 cm.The time between the injury and admission was 40 minutes to 27 hours.Five cases were repaired defection with flap immediately,10 cases were repaired defection in stage Ⅱ.Results The wounds of injury in 15 cases get primary healing,and all the flaps were successfully survived.The 13 cases were followed up for 6 months to 14 months.The blood circulation of flap was fine,and the fingertip shape as well.The two point discrimination of the skin pulp was 6 mm to 11 mm.Conclusion The improved transverse palmar island flap for repairing transverse finger pulp defect and a small area of skin defect in patients.The procedure has a simple surgery,donor area don't skin graft,postoperative appearance and hand finger satisfactory functional recovery,etc.

Objective To set up the molecular cytobiological model of endogenous coagulation factor Ⅷ (FⅧ) re-expressing in human liver cells L02,and to study the regulation pathway and molecular basis of the re-expression of FⅧ in L02 cells activated by NO signal.Methods The L02 cells at logarithm growth phase were selected and randomly divided into blank control group and experimental group, inhibitor group and inhibitor control group;they were cultured for 0,12,24,36,48,and 60 h.Flow cytometry was used to detect the expression of human FⅧ protein in L02 cells after treated for 48 h.Griess experiment was performed to detect the levels of NO in L02 cells at different time points;the transcription levels of human FⅧ gene,iNOS gene,NF-κB1 gene and I-κB alpha gene were detected by RT-PCR method.Western blotting method was used to detect the expression levels of human phosphorylated I-kappaB (phosphorylated I-κB)in L02 cells.Results The results of flow cytometry showed that the expression of human L02 FⅧ protein was found after treated with L-arginine for 48 h. The Griess results showed that the levels of NO in L02 cells in experimental group were significantly increased at 3,6,12,and 24 h (P<0.05)and the levels of NO in blank control group,inhibitor group and inhibitor control group had no changes. The RT-PCR results showed that the transcription of human FⅧ mRNA in L02 cells was found in experimental group,but there was no transcription of human FⅧ mRNA in blank control group,inhibitor group and inhibitor control group;the transcription levels of iNOS,NF-κB1 and I-κB alphain experiment group were increased(P<0.05)and the transcription levels of these genes in blank control group,inhibitor group and inhibitor control group had no changes. The Western blotting results showed that after adding L-arginine the expression level of phosphorylated I-κB was significantly increased (P < 0.05 ), other groups had no such change. Conclusion L-arginine can activate the phosphorylation of I-κB by NO signal pathway to lead to the changes in the expression of human FⅧ gene promoter upstream regulatory-related transcription factors NF-κB to activate the expression of human FⅧ in human liver cells L02.

Adult ; Device Removal ; Equipment Failure ; Female ; Foreign-Body Migration ; surgery ; Heart Septal Defects, Atrial ; surgery ; Humans ; Myocardial Revascularization ; adverse effects ; instrumentation ; Postoperative Complications ; etiology