Objective To investigate the expression and variation of MIP 1β,MIP-2,and IL-12p70 in mice with bloodstream infection caused by 4 kinds of bacteria.Methods CD-1 (ICR) mouse models of bloodstream infection with Staphylococcus aureus (S.aureus),Enterococcus f aecalis (E.f aecalis),Escherichia coli (E.coli),and K lebsiella pneumoniae (K.pneumoniae) were established.After mice in each trial group and PBS control group were infected by bacteria for 0.5h,1h,3h,6h,12h,24h,and 48h,concentrations of MIP-1β,MIP-2,and IL-12p70 were detected by Luminex liquid suspension chip system.Results Concentrations of MIP-1β increased significantly 1h after bacteria was in blood,S.aureus,E.faecalis,E.coli,K.pneumoniae,and control groups were (134.5 ± 18.3),(61.5 ± 15.4),(3 354.0 ±809.0),(6 888.4 ± 1 100.2),and (28.9 ± 4.6) pg/mL respectively;the peak values of IL-12p70 were (389.3 ± 118.1),(127.6 ± 10.0),(42.2 ± 3.5),(62.8 ± 8.4),and (4.8 ± 0.3) pg/mL respectively.Concentrations of MIP-1β and MIP-2 in E.coli and K.pneumoniae groups were significantly higher than other trial groups and control group (all P＜0.01),while concentrations of IL-12p70 in S.aureus and E.faecalis groups were both significantly higher than E.coli,K.pneumoniae,and control groups (all P＜0.01).Conclusion Concentrations of MIP-1β and MIP-2 in E.coli and K.pneumoniae groups were both significantly higher than those in S.aureus and E.faecalis groups,while concentrations of IL-12p70 in S.aureus and E.faecalis groups were both significantly higher than those in E.coli and K.pneumoniae groups.The combination detection of multiple cytokines or chemokines are valuable in predicting gram-positive or gram-negative bacterial infection,and can provide basis for treatment of early infection.

BACKGROUNDNon-valvular atrial fibrillation is associated with an increased risk of ischemic stroke; however, the appropriate intensity of anticoagulation therapy for Chinese patients has not been determined. The purpose of this study was to compare the safety and the efficacy of standard-intensity warfarin therapy, low-intensity warfarin therapy, and aspirin therapy for the prevention of ischemic events in Chinese patients with non-valvular atrial fibrillation (NVAF).

METHODSA total of 786 patients from 75 Chinese hospitals were enrolled in this study and randomized into three therapy groups: standard-intensity warfarin (international normalized ratio (INR) 2.1 to 2.5) group, low-intensity warfarin (INR 1.6 to 2.0) group and aspirin (200 mg per day) group. All patients were evaluated by physicians at 1, 3, 6, 9, 12, 15, 18, 21 and 24 months after randomization to obtain a patient questionnaire, physical examination and related laboratory tests.

RESULTSThe annual event rates of ischemic stroke, transient ischemic attack (TIA) or systemic thromboembolism were 2.6%, 3.1% and 6.9% in the standard-intensity warfarin, low-intensity warfarin and aspirin groups, respectively (P = 0.027). Thromboembolic event rates in both warfarin groups were significantly lower than that in the aspirin group (P = 0.018, P = 0.044), and there was no significant difference between the two warfarin groups. Severe hemorrhagic events occurred in 15 patients, 7 (2.6%) in the standard-intensity warfarin group, 7 (2.4%) in the low-intensity warfarin group and 1 (0.4%) in the aspirin group. The severe hemorrhagic event rates in the warfarin groups were higher than that in the aspirin group, but the difference did not reach statistical significance (P = 0.101). The mild hemorrhagic and total hemorrhagic event rates in the warfarin groups (whether in the standard-intensity warfarin group or low-intensity warfarin group) were much higher than that in the aspirin group with the annual event rates of total hemorrhages of 10.2%, 7.6% and 2.2%, respectively, in the 3 groups (P = 0.001). Furthermore, there was no significant difference in all cause mortality among the three study groups.

CONCLUSIONIn Chinese patients with NVAF, the warfarin therapy (INR 1.6 - 2.5) for the prevention of thromboembolic events was superior to aspirin.

Aged ; Aged, 80 and over ; Anticoagulants ; administration & dosage ; therapeutic use ; Aspirin ; administration & dosage ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Warfarin ; administration & dosage ; therapeutic use

Adenocarcinoma ; genetics ; Adult ; Age Factors ; Aged ; Base Sequence ; Carcinoma, Squamous Cell ; genetics ; DNA, Mitochondrial ; genetics ; Female ; Humans ; Lung Neoplasms ; genetics ; Male ; Middle Aged ; Sequence Deletion ; Smoking ; genetics

OBJECTIVE: To describe our experience in the clinical manifestation and treatment of malignant tumors of the external and middle ear. METHOD: The study reviewed 39 patients between 1994-2011 in our hospital, including 15 pinna tumors, 18 external canal tumors and 6 middle ear tumors. 23 males and 16 females were enrolled in this study. The mean age of patients at the time of surgery was 59. Radiotherapy or radiotherapy and chemotherapy were the only possible treatment in 6 cases. Thirty-three patients were treated surgically, and 9 patients also received radiotherapy after surgery. RESULT: All of the patients had been followed up over 3 years, except for 1 case of external canal and 1 case of middle ear tumor. The 3-year survival of pinna, external canal and middle ear tumors were 86.7%, 82.4% and 60.0% respectively. At the last follow up, the pinna tumors showed that the survival rate was 100% in T1, T2 and Tx stage, and 0% in T4 stage; the external canal tumors showed that the survival rate was 90% in T1 stage, and 66.7% in T2, T3 stage; the middle ear tumors showed that the survival rate was 100% in T1 and T2 stage, 0% in T3 stage. CONCLUSION The T staging system is for an important prognostic factor, and it is important for an early diagnosis and radical surgery to achieve a better therapeutical result.
Ear Auricle ; pathology ; Ear Canal ; pathology ; Ear Neoplasms ; pathology ; Ear, Middle ; pathology ; Female ; Humans ; Male ; Neoplasm Staging ; Retrospective Studies ; Survival Rate

Objective To explore the effects and mechanisms of losartan on atheroscleorsis and T cell (Treg/Th17) immune balance of CKD apolipoprotein E knockout (ApoE-/-) mice.Methods The model of CKD was induced by a 5/6 nephrectomy (SNx) in male ApoE-/-mice.ApoE-/-mice were randomly allocated into 3 subgroups:the control group,SNx group and losartan group.The fifth week after building model the mice in losartan group were taken losartan at a dose of 30 mg/(kg · d) by intragastric administration for 12 weeks.While the other mice were treated with the same volume of 0.5％ sodium carboxymethylcellulose.Sixteen weeks after nephrectomy,the serum levels of urea and creatinine were determined.Haematoxylin Eosin (HE) staining were used to observe the general morphology changes of atherosclerotic plaque.Flow cytometry was performed to detect the proportion of T cells (Treg/Th17) in spleen.Enzyme linked immunosorbent assay (ELISA) was performed to detect the level of cytokines in serum such as interleukin (IL)-17,IL-6,transforming growth factor-β1 (TGF-β1) and IL-10.Results Sixteen weeks after nephrectomy,the result of serum creatinine and urea nitrogen showed the CKD animal model established successfully.Losartan could improved the renal function of CKD mice.The size of aortic root plaques in control group,SNx group,and losartan group are (16.35 ± 3.72) × 104 μm2,(28.64 ± 5.86) × 104 μm2 and (22.76 ± 3.97) × 104 μ m2 respectively,indicating that losartan treatment significantly decreased the size of aortic root plaques of the CKD mice (P ＜ 0.05).The proportion of Treg cells in the spleen of control group,SNx group,and losartan group are (4.34 ± 0.93) ％,(1.78 ± 0.56) ％,and (2.68 ± 0.58)％ respectively,indicating that losartan treatment significantly increased the proportion of Treg cells of CKD mice (P ＜ 0.01).The proportion of Th17 cells in the spleen of control group,SNx group,and losartan group are (0.11 ± 0.06) ％,(0.67 ± 0.12) ％,(0.37 ± 0.08) ％ respectively,indicating that losartan treatment significantly decreased the proportion of Th17 cells of CKD mice (P ＜ 0.01).Compared with control mice,the level of cytokines TGF-β1 and IL-10 in the serum of the SNx group mice significantly decreased (P ＜0.01),and the level of cytokines IL-17 and IL-6 in the serum of the SNx group mice significantly increased (P ＜0.01),indicating that such effects could be significantly regulated by losartan (P ＜ 0.05).Conclusions Losartan inhibited the differentiation of Th17 cell subsets,promoted the differentiation of Treg,and alleviated atherosclerosis in CKD ApoE-/-mice by modulating the immune imbalance of the Treg/Th17 cell.

OBJECTIVETo investigate the risk factors of lung cancer in Tianjin and to provide evidence for further monitor there of.

METHODSA case-control study involving interviews with 193 new cases and 259 controls aged 30 - 76 years was carried out. Structured questionnaires were used to collect information on general condition, living environment, living style, disease and family history, etc. Logistic regression model univariate and multivariate analysis were used to pick out the significant lung cancer risk factors.

RESULTSBy monovariate analysis, risk factors such as smoking, passive smoking, drinking, history of malignancy in family and occupation were found. By multivariate analysis, smoking, passive smoking, higher body mass index (BMI) and average income and living space per capita ten years earlier were ascertained, their operations research (OR) values were 3.302, 1.193, 1.003, 1.067 and 0.913.

CONCLUSIONSmoking and passive smoking are independent risk factors of lung cancer. Monthly income per person and living space per person 10 years earlier are associated with elevated risk of lung cancer. Higher body mass index has protective effects on lung cancer risk.

Adult ; Aged ; Humans ; Logistic Models ; Lung Neoplasms ; etiology ; genetics ; Middle Aged ; Occupations ; Risk Factors ; Smoking ; adverse effects

OBJECTIVETo prevent chronic severe hepatitis, even more fulminant hepatic failure (FHF) occurrence in patients with chronic hepatitis B of severe degree using steroid.

METHODS120 patients were randomized into conventional supporting treatment and steroid treatment groups. The latter, 62 patients were given intravenously hydrocortisone sodium succinate at the dose of 150 mg to approximately 200 mg everyday plus support care.

RESULTSThe rate of deteriorating to chronic severe hepatitis in steroid treatment group was significantly lower than that of conventional group (22% vs 48%, x(2) =7.60, P<0.01). 53.6% (15/28) patients with chronic severe hepatitis in conventional group died, while only 28.6% (4/14) in steroid treatment group succumbed to terminal liver disease (x(2)=0.02, P>0.05). There was no difference between the two groups regarding to complications incidence: gastrointestinal bleeding and infections except for some controllable serious reverse events, such as candidiasis, diabetes, herpes zoster and pulmonary tuberculosis found in some patients in steroid-treated group.

CONCLUSIONThese results suggest that steroid administration with improved support care not only is likely to prevent chronic severe hepatitis occurrence in patients with chronic viral hepatitis of severe degree, but also shows some efficacy for FHF, which warrant further investigation.

Adult ; Female ; Glucocorticoids ; therapeutic use ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Liver Failure ; prevention & control ; Male

OBJECTIVETo estimate the clinical and pathological features of pancreatic solid cystic papillary tumor (SCPT) in children.

METHODSFrom 2000 to 2005, 8 cases with SCPT of the pancreas were analyzed retrospectively. All cases but one were females. Average age was 12.8 years. By case review, we discussed the clinical and pathological features of SCPT in children.

RESULTSThe chief complains were abdominal pain and palpable mass. There were 3 cases in the head, 1 case in the body, and 4 cases in the tail of pancreas. The procedures employed included local resection (1 case), distal pancreatectomy (5 cases), pancreaticoduodenectomy (1 case), and biopsy (1 case). Histological examination showed solid with cystic areas and papillary protrusions in the 8 cases; as for immunohistochemical examinations, the positive rate was 100% for alpha-antitrypsin (AACT), 87.5% for vinmentin, and 62.5% for neuron-specific enolase (NSE). The patients were followed up for 2 months to 4 years but one was lost by follow-up and all were alive postoperatively. SCPT in 2 cases relapsed.

CONCLUSIONOccurring predominantly in young females, SCPT is usually curable by surgical resection with a favorable prognosis.

Adolescent ; Child ; Cystadenoma, Papillary ; diagnostic imaging ; pathology ; surgery ; Duodenum ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Pancreatectomy ; Pancreatic Neoplasms ; diagnostic imaging ; pathology ; surgery ; Prognosis ; Retrospective Studies ; Splenectomy ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To investigate the effect and safety of patient controlled intravenous analgesia and patient controlled brachial plexus block in the prevention of postoperative pain in children with upper limb operation.Methods Totally 80 children with upper limb surgery were randomly divided into two groups:patient controlled intravenous analgesia group (PI group) and patient controlled brachial plexus block group(PN group),with 40 patients in each group.The dynamic pain score,static pain score,sedation score,sleep quality score,parent satisfaction score,and adverse reaction of the two groups were recorded.Results There was no significant difference between the two groups in the static pain score(P ＞ 0.05).The dynamic pain score of PN group was better than that of PI group within 24 hours,and the difference was statistically significant(P ＜ 0.05).The difference was statistically significant in the comparison of sedation score between the two groups within 6 hours (P ＜ 0.05),but the difference was not statistically significant after 6 hours (P ＞ 0.05).PN group was better than PI group in terms of sleep quality,parent satisfaction and adverse reaction incidence,and the difference was statistically significant (P ＜ 0.05).Conclusion Patient controlled brachial plexus block can provide a more satisfactory analgesic effect for children after surgery with low incidence of adverse reactions and higher safety,which is conducive to early functional exercise in children.

Objective To investigate the role of overexpression of Smad7,the inhibitory factor of TGF-?/Smads signaling,in epithelial-mesenchymal transition (EMT) of peritoneal mesothelial cells.Methods Peritoneal fibrosis rat model was built by daily intraperitoneal injection with 4.25% Dineal (100 ml/kg) and lipopolysaccharide(LPS) (0.6 mg/kg) at day 8,10,12,22,24,26. Smad7 or control empty vectors was transferred at day 0,14 and was induced by doxycline in the daily drinking water (200 mg/L).Rats were sacrificed on day 28 and the expression of TGF-beta/ Smads,?-SMA and E-cadherin was examined.Results Compared with normal rats,empty vector rats showed higher expression of phosphorylated Smad2/3.?-SMA expression was elevated but E-cadherin was reduced.Under electron microscope,the mesothelial cells removed to submesothelial zone and showed large bundles of actin microfilaments and dense bodies within the cytoplasm. Basement membrane was broken.After induction of Smad7 in peritoneal fibrosis rats,the morphology of mesothelial ceils normalized partly,phosphorylated Smad2/3 was reduced.Moreover,expression of E-cadherin was increased,expression of?-SMA was dramatically reduced.Conclusion Inhibition of TGF-?/Smad signaling by Smad7 overexpression may inhibit the epithelial-mesenchymal transition of mesothelial cell,which may provide a new therapeutic method for peritoneal fibrosis by overexpression of Smad7.