Objective To select a kind of stent with better property and spread its clinical application. Methods Three kinds of stents including “Z” type stainless steel stent(SSS), mesh Ni Ti alloy stent(AS), and gild stent(GS) were placed into dogs′ vena cava. Angiography was performed 2 weeks, 4 weeks, 8 weeks, 6 months, and 9 months after stent placements (according to the grouping time), then the animals were sacrificed to get the veins with stents for histopathology examinations (including macro pathology, microscope and scanning electron microscope). Data of displacement rate, expand rate, patency rate of stents, patency rate of tributary veins, endothelial thickness, and course of endothelialization were acquired to indicate stent application property. Measurement data were analyzed by analysis of variance and q test. Enumeration data were analyzed by ? 2 test. Ranked data were analyzed by Ridit analysis. Results The displacement rates of SSS, AS, and GS were 13 3%, 13 3%, and 7 7%, respectively(? 2=0 281, P =0 869); The incomplete expanding rates of SSS, AS, and GS were 6 7%, 46 7%, and 0.0% respectively. There was statistical difference(? 2=12 194, P 0 05); The patency rates of SSS, AS, and GS were 93 3%, 66 7%, and 84 6%, respectively. There was no statistical difference among the rates(? 2 =3 649, P =0 161). Endothelialization reached about 100% 4 weeks after the stents placements. Desquamating of GS plating layer was found 4 weeks after stent placement, surface erosion of SSS wire and AS wire was not found in 9 months. Conclusion Z type stainless steel stent has better anticoagulative capability, anticorrosive capability, and biocompatibility, and it is now an ideal intravenous stent.

Carcinoembryonic Antigen ; analysis ; Humans ; Luminescence

According to operative modalities,128 patients with unilateral benign thyroid disease were divided into hemithyroidectomy group (n =68) and subtotal thyroidectomy group (n =60).The operative duration of hemithyroidectomy group was (63 ± 14) min,intraoperative blood loss (54 ± 15) ml,postoperative drainage volume (64 ± 10) ml and hospitalization stay (5.9 ±0.8) days.The hospital charge of (8 335 ± 278) yuan was less than that of subtotal thyroidectomy group (P ＜ 0.05).The incidence rate of postoperative hoarseness,water bucking,low calcium and hypothyroidism had no significant inter-group difference (P ＞ 0.05).But the postoperative recurrence rate of hemithyroidectomy was significantly lower than that of subtotal thyroidectomy group (P ＜ 0.05).Treating patients of unilateral benign thyroid disease with hemithyroidectomy yield excellent efficacies.It is worthy of wider clinical application.

Objective To analyze the results of syphilis serology test among inpatients and to provide information for the control of syphilis.Methods Syphilis serology test results of inpatients from Jan.2010 to Nov.2012 in a tertiary general hospital were collected and retrospectively analyzed.The serum samples were screened by Treponema pallidum (TP) antibody enzyme linked immunosorbent assay (ELISA) and syphilis toluidine red unheated serum reagin test (TRUST) simultaneously.The TP-ELISA positive samples were confirmed by Treponema pallidum particle agglutination test (TPPA).Difference of measurement data was compared with analysis of variance.Results A total of 81 946 cases were collected,among which 1618 cases were positive of anti-TP.The positive rate of anti-TP was 2.27％ in the year 2010,1.58％ in 2011,and 2.11％ in 2012.For male and female patients,the positive rates of anti-TP were 2.38％ and 1.69％,respectively (x2 =48.97,P=0.00).The positive rates of anti-TP in the age groups of ≤19 years,20-39 years,40-59 years,60-79 years,and ≥80 years were 2.83％,0.94％,2.14％,2.37％,and 3.63％,respectively.The titer of TRUST was relatively lower in anti-TP positive inpatients.The anti-TP positive patients with TRUST titer ＜ 1∶8 accounted for 84.65％ in the age group of ≤19 years,79.69％ in the 20-39 years group,81.69％ in the 40-59 years group,86.12％ in the 60-79 years group,and 87.45％ in the age group of ≥80 years.The highest anti-TP positive rate (3.63％) was observed in the age group of ≥80 years with the lowest percentage (12.55 ％) of TRUST titer ≥1∶8.The lowest anti-TP positive rate (0.94％) was observed in the 20-39 years group with the highest percentage (20.31％) of TRUST titer ≥1∶8.Conclusions The characteristics of syphilis serological positivity vary depending on genders and ages.The prevention and control measures for syphilis should be strengthened,especially in the senior population.

Diabetic rats were induced by intraperitoneal injection of streptozotocin.TUNEL and immunohistochemistry results showed that the renal tubular cell apoptosis index(AI)and Bax protein expression were significantly reduced,and the Bcl-2 protein expression in glomeruli was significantly increased in diabetic rats with stable hyperglycemia treated by benazepril compared with diabetic rats with stable hyperglycemia treated by vehicle(all P

Objective To investigate clinical characteristics of relapsing polychondritis(RP)and to improve early recognition for it.Methods Clinical and laboratory data of 56 patients with RP were analyzed retrospectively.Results Ratio of number of male patients to female ones was 1.2.Age at onset was(46?11)years(ranging from 27 to 71)and average interval between onset and diagnosis was(21? 35)months,(8?6),(16?31)and(29?37)months for patients initial onset with auricle,respiratory tract and joints involved,respectively.Site involved included airway in 40 patients(71.4%),auricle in 32 (57.1%),joints in 32(57.1%),eyes in 27(48.2%),nasal chondritis in 25(44.6%)and inner ear in 13(23.2%).At initial stage of the course,17 patients were misdiagnosed as respiratory infection (30.4%),nine as perichondritis(16.1%),six as pulmonary tuberculosis(10.7%),five as rheumatoid arthritis(8.9%).Seven of 40 patients with airway involvement received metallic stents for their tracheobronchial stenosis.Four patients whose condition never improved after regular therapy all had respiratory involvement.Conclusions Patients of RP with initial onset at non-auricle,non-nasal sites tended to be misdiagnosed.Prevalence of airway involvement was not so low with a poor prognosis in patients of RP.

Objective To emphasize the importance of embolization of nonbronchial systemic arteries in treatment of acute and life-threatening massive hemoptysis.Methods In a series of 146 patients with hemoptysis who underwent bronchial artery embolization,we found 12 cases whose blood supply were from 17 nonbronchial systemic arteries and hemoptysis was more than 300 ml blood within 24 hours.Embolic materials included absorbable gelatin sponge(GS),kelp micro gelatin(KMG),polyvinyl alcohol(PVA) particles and metal coils. Results In the 12 cases with 17 nonbronchial systemic arteries (4 were intercostal,3 internal mammary,3 thyrocervical trunk,3 inferior phrenic,1 left gastric,2 originated from the inferior aortic arch,and 1 originated from anterior abdominal aortic wall).Five cases were embolized by GS alone,2 cases by KMG,3 cases by GS+PVA,and 2 cases by GS+PVA+metal coils.Eight cases were performed embolization once,3 cases were performed twice and 1 case was performed three times.No significant complications developed related to embolization,except that 1 patient had transient eyesight decrease after embolization of thyrocervical trunk and 2 patients had chest pain after embolization of intercostal artery which resovled without any treatment.Conclusions During bronchial artery embolization for hemoptysis patients,all supplying artery should be searched and found.Even after successful embolization of bronchial arterys for hemoptysis patients,nonbronchial systemic arterial supply should still be taken into account.

Objective To analyze the survival rate of HIV /AIDS patients receiving highly active antiretroviral therapy(HAART)since the implementation of the national Four Free and One Carepolicy against HIV in Hangzhou.Methods Clinical data of 2370 AIDS patients were collected from National AIDS Comprehensive Treatment Information System Treatment Library from 2004 to 2014.The data, including basic information,viral load,CD4 +T lymphocyte counts,starting time of treatment,WHO clinical stage,infection pathways and follow-up were respectively analyzed.Kaplan-Meier and Cox proportional hazards models were used to analyze the survival rate and the factors affecting survival.Results The total follow-up time was 3968.14 person years and 57 patients died in 2370 patients with a mortality rate of 1 .44 /100 person years (57 /3968.14).Kaplan-Meier method showed that the cumulative survival rates of the first,third and fifth year were 98.08%,96.20% and 95.24%,respectively.The overall mortality rate fell from 6.06 /100 person years in 2006 to 1 .44 /100 person years in 2014.The mortality rate of AIDS-related disease declined from 1 .10 /100 person years in 2009 to 0.90 /100 person years in 2014.Multivariate Cox regression analysis showed that the risk of death for patients with CD4 +T 200-349 cells/μL was 0.466 times(95%CI 0.246-0.882)as that for patients with CD4 +T cells <200 /μL.The risk of death was 3.408 times(95%CI 1 .365-8.506)in patients aged≥ 50 years,3.788 times(95%CI 1 .645-8.718)in patients aged 40 to <50 years,and 2.593 times(95%CI 1 .139-5.905)in patients aged 30 to 40 years as that in patients aged <30 years.The mortality risk for patients with baseline WHO stage Ⅲ and Ⅳ was 1 .960 times as patients with WHO stage Ⅰ and Ⅱ (95% CI 1 .117-3.439 ).Conclusions Patients with increased age,low CD4 +T counts and baseline WHO stage Ⅲ or Ⅳ are main risk factors affecting survival rate of HIV /AIDS patients,early antiviral therapy is the key for improving the survival rate of patients.

Objective To study the clinical and immunologic features of 67 cases of patients with scrub typhus.Methods Epidemiological data,clinical manifestations,laboratory and image examination results and treatment of 67 cases of patients with scrub typhus hospitalized from January 2010 to December 2013 at the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed.Results Autumn-winter type scrub typhus was predominant in the 67 patents.The main clinical manifestations included hyperpyrexia (100％,67/ 67),eschar or ulcer (91.0％,61/67),rash (52.2％,35/67),lymphadenopathy (46.3％,31/67) and other non-specific symptoms.Laboratory test results:①80.6％ (54/67) of the patients had normal or decreased white blood cell count,62.7％ (42/67) of them with elevated lymphocytes (＞ 40％),thrombocytopenia was detected in 34.3％ (23/67) of the patients,the lowest platelets count was 14 × 109/L.②14 of 17 cases (82.4％) had normal percentage of CD3+ T lymphocytes,CD8+ T lymphocytes increased in 16 of 17 cases (94.1％),while the percentage of CD4+ T lymphocytes (14 of 17,82.4％) and B lymphocytes (15 of 17,88.2％) decreased in most of the patients.③C reactive protein (CRP),ferritin and erythrocyte sedimentation rate (ESR) were elevated in 95.2％ (59/62),93.8％ (45/48) and 89.1％ (49/55) of the patients,respectively.④Elevated alanine aminotransferase (77.6％,52/67) and aspartate aminotransferase (80.6％,54/67) were frequent findings.⑤94.6％ (35/37) of the patients had increased adenosine deaminase.⑥ Antinuclear antibody was positive in 31.0％ (13/42) patients.⑦Epstein-barr virus DNA was detected in 15.6％ (7/ 45) cases,77.6％ (38/49) was accompanied with chest radiographic abnormalities.Two cases had tuberculosis.All the patients recovered after therapy with doxycycline,levofloxacin or moxifloxacin.Conclusion Autumn-winter scrub typhus has typical clinical manifestations in the 67 patients,and it can cause patients' immune disorders.

Objective Subarachnoid hemorrhage ( SAH) is a devastating disease with a high mortality.This study was to in-vestigate the effect of Nrf2 on secondary brain injury following SAH and its action mechanism in mice. Methods SAH models were established in wild-type ( WT) and Nrf2 knockout ( KO) ICR male mice by injecting fresh blood drawn from the femoral artery into the pre-chiasmatic cistern.The animals were divided into four groups, WT sham, WT SAH, KO sham, and KO SAH.At 24 hours after modeling, the expression levels of malondialdehyde ( MDA) , GSH/GSSG, TNF-αand IL-1β, the volume of brain water, and content of Evans blue were measured, the activity scores obtained, and cerebral vasospasm of the anterior and middle cerebral arteries ( ACA and MCA) detected. Results At 24 hours, the expressions of MDA, TNF-α, and IL-1βwere (3.299 ±0.335), (1.187 ± 0.436), and (59.330 ±21.787) mg/g in the WT sham group, (4.339 ±0.328), (2.432 ±0.434), and (121.584 ±21.675) mg/g in the WT SAH group, (3.488 ±0.634), (1.170 ±0.312), and (58.497 ±15.608) mg/g in the KO sham group, and (5.335 ±0.499), (3.132 ±0.548), and (171.117 ±50.479) mg/g in the KO SAH group, markedly increased in the SAH groups as compared with the sham controls (P<0.05), while the GSH/GSSG levels were significantly higher in the former two groups than in the latter (0.553 ±0.100 and 0.375 ±0.068 vs 0.714 ±0.091, 0.761 ±0.114, P<0.01).The contents of brain water and Evans blue were (0.784 ±0.005) and (7.055 ±1.046) μg/g in the WT sham group, (0.808 ±0.004) and (7.230 ±1.192) μg/g in the WT SAH group, (0.784 ±0.004) and (9.620 ±1.290) μg/g in the KO sham group, and (0.819 ±0.004) and (11.628 ±1.040)μg/g in the KO SAH group, remarkably increased in the SAH groups in comparison with the sham groups (P<0.05).The apoptosis rate 8.916 and 82.100 ±6.870 vs 70.833 ±8.750 and 51.767 ±13.006), ACA radius/wall thickness value (13.885 ±3.360 and 14.212 ±3.2545 vs 8.024 ±2.780 and 6.861 ±2.702), MCA radius/wall thickness value (18.648 ±2.893 and 19.435 ±2.775 vs 6.337 ±3.993 and 5.107 ±3.805), and activity score (2.733 ±0.450 and 2.767 ±0.430 vs 1.967 ±0.928 and 1.433 ±0.679) (all P<0.01). Conclusion Nrf2 knockout increases oxidative stress and inflammatory reaction following SAH and consequently aggravates secondary brain injury.Nrf2 has a protective effect against SAH-induced brain injury.