Objective To evaluate the value of the four kinds of diagnostic method in acquired immune deficiency syndrome (AIDS) infection complicating tuberculosis (TB) .Methods 52 cases of human immunodeficiency virus (HIV) infection complica‐ting TB were taken as the observation group and 100 cases of TB without complicating HIV infection were taken as the control group .The two groups were performed the PPD test ,sputum Mycobacterium tuberculosis culture ,tuberculosis antibody and inter‐feron gamma release assay(IGRA) for conducting the diagnosis .Results The positive rate of the PPD test ,sputum Mycobacterium tuberculosis culture and tuberculosis antibody in the control group were significantly higher than those in the observation group ,the differences were statistically significant (P<0 .01);the positive rate of the IGRA in the observation group was obviously higher than that of the PPD test ,sputum Mycobacterium tuberculosis culture and tuberculosis antibody ,the differences had statistical sig‐nificance (P<0 .01) .The negative occurrence rate of the IGRA in the observation group treated by the antiretroviral therapy was obviously higher than the positive rate ,the difference was statistically significant (P<0 .05) .Conclusion The IGRA may be a sen‐sitive method for diagnosing HIV infection complicating TB and the antiretroviral therapy may have a certain impact on the results .

Objective To explore clinical progress about the deep vein thrombosis after hip replacement at home and abroad,and discuss the preventive effect of nursing intervention.Methods The documents about the deep vein thrombosis after hip replacement were retrieved from PUBMED,China National Network Knowledge Infrastructure (CNKI),Chinese Scientific Journal Database (VIP),Chinese Bio Medical Literature Database (CBM) and Wan fang Database.And the retrieving duration was from 1st Jan.2001 to 1st Sept.2013.The research progress about prevention of deep vein thrombosis after hip replacement was analyzed through the analysis of the same and the difference of comparative literatures at home and abroad.Results There were totally 228 Chinese documents and 5 English documents of the deep vein thrombosis after hip replacement,and the number of document showed an increasing trend year by year.In the past five years,the clinical progress about the deep vein thrombosis after hip replacement was obvious,the research methods used was accurate,the involving intervention measures was continuously improved,literature quality was increased.Conclusions The quality of the documents published in domestic Chinese journals needs to be improved,and we should improve the quality of research design,research new methods of intervention,formulate the optimal nursing measures in order to achieve optimal care.

Objective To study the expressi on of thrombomodulin (TM) in endometrial carcinoma and explore its relation to the infiltration degree and histological grading of endometrial carcinoma. Methods The expression of TM was detected by immunohistochemistry in 50 cases of endometrial adenocarcinoma, 10 cases of endometrial complex hyper plasia and 10 cases of normal endometrium. Results The posi tive rate of TM in endometrial carcinoma was significantly higher than that in c omplex hyperplasia and normal endometrium (P 0.05). Conclusion TM can be used as a new index for judging progre ssion and prognosis of endometrial carcinoma.

Objective To investigate the effects of levels of serum C-reactive protein (CRP), B-natriuretic peptide (BNP) and cholinesterase (ChE) on prognosis of elderly patients with pulmonary infection.Methods Sixty cases aged ≥ 65 years old with lung infection admitted to Departments of Infectious Diseases and Respiration of Hebei Provincial People's Hospital from March 2012 to March 2014 were enrolled. According to the diagnostic criteria of pulmonary infection and the severity score (PSI) of pneumonia, the patients were classified into three groups with different grades of infectious severity (PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups), 20 cases in each group; in the same period, 20 elderly healthy people having accepted the physical examination in this hospital were designed as the healthy control group. Furthermore, according to the difference in prognosis, the patients were divided into a survival group (52 cases) and a death group (8 cases). The PSI scores, the levels of white blood cell count (WBC), D-Dimer, CRP, BNP and ChE, mortalities, times of stay in hospital were compared between the PSI Ⅰ-Ⅲ, PSI Ⅳ, PSI Ⅴ groups and the healthy control group as well as between the survival and death groups.Results The periods of stay in hospital of patients with PSI Ⅳ and Ⅴ were much longer than that patients with PSI Ⅰ-Ⅲ (days: 14.7±2.1, 18.3±2.6 vs. 9.2±1.7, both P < 0.05), the degree of increase in time in the PSI Ⅴ group being the most significant. Before treatment, compared with the healthy control group, the PSI score, the levels of WBC, D-dimer, CRP and BNP were significantly increased, the level of ChE was markedly decreased in patients with PSI Ⅱ-Ⅲ, Ⅳ and Ⅴ groups, and along with the rise of PSI score the changes were more remarkable [PSI score: 78.9±13.7, 117.4±20.2, 152.1±34.8 vs. 51.3±7.9; WBC (×109/L): 11.4±1.4, 13.6±1.9, 16.7±2.2 vs. 8.9±1.1; D-Dimer (μg/L): 779.6±46.1, 1 068.2±142.6, 1 846.2±215.0 vs.348.3±31.8; CRP (mg/L): 30.1±3.7, 58.2±6.7, 74.7±9.2 vs. 6.8±0.9; BNP (ng/L): 1 057.4±205.1, 1 976.7±333.7, 2 437.7±468.9 vs. 115.8±21.7; ChE (U/L): 6 260±826, 3 390±437, 1 861±268 vs. 7 804±904, allP < 0.05]. The mortalities of groups PSI Ⅳ and PSI Ⅴwere more than that in group PSI Ⅱ - Ⅲ [10.0% (2/20), 30.0% (6/20) vs. 0]; there was no statistically significant difference in age between the survival group and death group (P > 0.05). Compared with the survival group, the PSI score, the levels of WBC, D-dimer, CRP and BNP after treatment in death group were markedly higher [PSI score: 141.5±23.3 vs. 97.6±18.2; WBC (×109/L): 15.9±1.9 vs. 12.1±1.8; D-Dimer (μg/L): 1 373.9±179.4 vs. 627.4±69.6; CRP (mg/L): 69.8±9.8 vs. 42.6±7.3; BNP (ng/L): 2 745.6±374.9 vs. 1 022.2±171.3; allP < 0.05], the level of ChE was significantly lower (U/L: 2 569±309 vs. 5 692±777,P < 0.05).Conclusion The serum levels of CRP, BNP and ChE in aged patients with pulmonary infection are helpful to the early diagnosis of disease severity, so as they have guiding significance in predicting prognosis.

Objective To study the efficacy and complications of reconstruction of failed urethro-plasty for hypospadias with pedicle flap , bladder mucosa , buccal mucosa , and biological patch . Methods 23 patients were enrolled from Jul .2005 to Dec.2011.8 patients, with good local skin condition , were performed with pedicle flap urethroplasty .The other 15 patients, with bad local skin condition or with long segment urethral stricture , were performed with free grafts , including 6 bladder mucosa , 7 buccal muco-sal and 2 biological patch. Results Of the 23 cases, 7 cases were cured by one phase operation .There were 16 (16/25) cases had complications.3 (3/16) cases were failed because of serious infection (2 pedi-cle flap, 1 bladder mucosa ) .The failed cases were implemented with urethroplasty 6 months later by the buccal mucosa installments operation .4 (4/16) cases had solitary urethral fistula (1 pedicle flap, 2 bladder mucosa, and 1 buccal mucosal), who were successfully treated with simple fistula repair 3 to 6 months later. 9 ( 9/16) cases had urethral stricture ( 2 pedicle flap , 3 bladder mucosa , 3 buccal mucosal , and 1 biologi-cal patch graft ) , who were treated with urethral sound and got good result .We had reconstructed the urethra using mucosa graft onlay urethroplasty .All of the 23 patients were followed up with an average of 14.5 ( 6-24) months.23 cases were satisfied with the stretched penis , urination and no need to expand the urethra more than 6 months.3 cases were not satisfied with penile appearance .After communication, these patients did not require a further penis orthopedic surgery . Conclusions Pedicle flap, bladder mucosa , buccal mucosa and biological patch can be used in urethral repair and construction of failed urethroplasty for hypos -padias.Urethral sound dilation plays an important role in hypospadias repair .

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; epidemiology ; prevention & control ; Male ; Middle Aged ; Stroke ; epidemiology

Objective To investigate the expression of ki-67 and the development of the intimal hyperplasia(IH) of the irradiated human umbilical artery incorperated with nofloxacin and silver(IHUAINS) grafts into the carotid arteries of the rabbit. Methods Twenty IHUAINSs were sterilely produced. Thirty rabbit were performed bilateral carotid bypass grafting. The IHUAINS(experimental group)and the left carotid arteries (control group) were implanted in the left and right carotid arteries respectively. Graft patency was checked at the 2nd and 6th week after implantation, and the grafts were studied with standard histological techniques and immunohistochemieal method for meas-urement of intimal thickness and the expression of ki-67. Results The total patency rate of the grafts was 89.6%. Light microscopic exami-nation of the grafts revealed intimal and media proliferation, cellular in-filtration. The endothelial cells covered the vascular lumen. There was no significant difference of the intimal thickness between two groups at the 2nd week after grafting (P>0.05). The intimal thickness of the experimental group was larger than that in control group at the 6th week after implantation without statistical significance (P>0.05). At the same time, immunocytochemical analysis showed that the expression of ki-67 in the experimental group was stronger than that in control group without statistical significance(P>0.05). Conclusion The IH of the IHUAINS was larger than that of the autologous artery, but there is no difference between these two groups. Thus, IHUAINS may be an ideal graft in the field of coronary surgery.

ObjectiveTo improve the long term outcomes of the surgery for Stafford type A aorticdissection, we performed ascending aorta and total aortic arch replacement combined with transaorticstented graft implantation into the descending aorta for acute type A aortic dissection.MethodsFrom May 2005 to February 2011,36 consecutive patients with acute Stanford type A aorticdissection underwent this procedure.Right axillary artery cannulation was routinely used forcardiopulmonary bypass and selected cerebral perfusion.The stented elephant trunk was implanted through the aortic arch under hypothermic circulatory arrest.The stented elephant trunk was a 10 cm long selfexpandable graft.34 patients were followed up for 2 ～36 months.ResultsCardiopulmonary bypass time was (160 ± 31)min, average cross clamp time was (101 ±26)min, and average selective cerebral perfusion and lower body arrest time was (31 ± 16)min.The in-hospital mortality was 5.5％ (2/36).One patient died of multi-organ failure postoperatively and another died of cerebral infarction 9 day after surgery.No one suffered from spinal cord injury perioperatively.There was no late death during follow up.ConclusionsAscendingaorta and total aortic arch replacement combined with transaortic stented graft implantation into the descending aorta is an effective way in closing the residual false lumen of the descending aorta and might contribute to better long term outcomes of type A aortic dissection.

The aim of this study was to investigate the expression of circulating microRNAs (miRNAs) in apolipoprotein E (apoE) knockout mice (apoE-/-) and to validate the role of these miRNAs in human coronary artery disease (CAD). Pooled plasma from 10 apoE-/- mice and 10 healthy C57BL/6 (B6) mice was used to perform the microarray analysis. The results showed that miR-34a, miR-21, miR-23a, miR-30a and miR-106b were differentially expressed in apoE-/- mice, and these expression changes were confirmed by real-time quantitative reverse-transcription PCR. Then, miR-34a, miR-21, miR-23a, miR-30a and miR-106b were detected in the plasma of 32 patients with CAD and of 20 healthy controls. Only miR-34a, miR-21 and miR-23a were significantly differentially expressed in the plasma of CAD patients (all P<0.01). In conclusion, miR-34a, miR-21 and miR-23a were elevated in CAD patients, which means that these miRNAs might serve as biomarkers of CAD development and progression.
Aged ; Animals ; Apolipoproteins E/deficiency ; Biomarkers ; Case-Control Studies ; Coronary Artery Disease/*genetics ; Disease Models, Animal ; Gene Expression Profiling ; Gene Expression Regulation ; Humans ; Male ; Mice ; Mice, Knockout ; MicroRNAs/*genetics ; Middle Aged ; Pilot Projects ; Reproducibility of Results ; Risk Factors

Objective:To explore the feasibility and safety of robot-assisted retrohepatic inferior vena cava(IVC) tumor thrombectomy for renal tumor patients with a single position.Methods:The clinical data of 6 renal tumor patients with retrohepatic IVC thrombus (5 males and 1 female, mean age of 58 years) who underwent robot-assisted retrohepatic IVC tumor thrombectomy with a single position in First Affiliated Hospital of Zhengzhou University from December 2015 to August 2020 were retrospectively reviewed. Four cases had the renal tumor on the right side and two on the left side. The mean tumor size was 9.6 cm(range 7-13 cm). There were 4 cases of Mayo level Ⅱ and 2 cases of level Ⅲ IVC thrombus with the mean IVC thrombus length of 6.5 cm(range 5-8cm). The "IVC-first, kidney-last" robotic technique was developed to minimize chances of IVC thrombus embolization for retrohepatic IVC thrombus, and a "artery-first, vein-second" robotic operative strategy were developed to minimize chances of intraoperative hemorrhage. The whole procedure (the suprahepatic infradiaphramatic IVC, first porta hepatis and left renal vein control, caval exclusion, tumor thrombectomy, IVC repair, radical nephrectomy) was performed exclusively robotically with a single position.Results:All 6 robotic procedures were successful, without open conversion or mortality. The mean operative time was 210 min(130-320 min), estimated blood loss was 800 ml(300-2 100 ml) and three patients (5%) received intraoperative blood transfusion. The mean time of occlusion of IVC was 21 min (15-43min). Incomplete blocking occurred in two cases(one IVC, one first porta hepatis), and tumor thrombectomy were completed with intraoperative loss. IVC invasion was confirmed intraoperatively in one patient and we staple-transected the IVC without reconstruction. Six patients were all transferred to the intensive care unit for median of 2.1 days (1-4 days) after surgery. The mean time of postoperative drainage was 5 days (4-9 days). Renal dysfunction occurred in 3 patients and liver dysfunction occurred in 2 patients, and all recovered after medical therapy. Postoperative pathological diagnosis revealed 5 cases of clear cell carcinoma and 1 case of renal sarcoma, and the 5 cases received targeted therapy. With a median follow-up of 27 months (3-54 months), 3 patients were alive, 1 alive with tumor recurrence, and 2 died of cancer.Conclusions:Robot-assisted laparoscopic retrohepatic IVC thrombectomy with a single position have the advantage of simple procedure, shorter operative time, less trauma and quicker recovery, and it is a feasible and effective method for renal tumor patients with retrohepatic IVC thrombus.