Objective To evaluate the surgical treatment of pheochromocytoma. Methods A total of 151 cases of pheochromocytoma were studied in regard to the preoperative preparation,anesthetic management,operative technique and postoperative treatment. Results Of the 151 cases 132 underwent total tumor excision,12 cases intracapsular excavation and 7 cases partial cystectomy.Only 1 patient died during the course of operation.Pathological examination showed that 137 cases were of benign pheochromocytoma and 14 cases of malignant.After operation 136 cases had normal blood pressure and 15 cases were treated with hypotensor to maintain normal blood pressure.Of the 137 cases of benign pheochromocytoma 9 experienced relapse.Of the 14 cases of malignancy 10 died of metastasis within 5 years. Conclusions Surgical excision is the fundamental approach for cure,and correct preoperative diagnosis and proper perioperative management are extremely important.

Objective To compare the safety of dopamine ( DA) and norepinephrine ( NE) in hypovolemic shock , and the impact on the stability of blood pressure and haemodynamics .Methods Eighty two patients with hypovolemic shock were given fluid resuscitation . All the patients were divided into two groups including DA group (n=41) and NE group(n=41).Recovery of blood pressure, hemody-namic parameters were observed at different time point , and the complications and mortality of two groups were recorded .Results Blood pressure of all the patients returned to normal in 15min after the medication, and became stable after 30min.There was no significant difference in the blood pressure in both groups except that of 15min.Compared with T0, There were higher in the numerous of CVP , CI, ELWI, ITBI.The ELWL at T2 in DA group was higher than that of NE group , while there was no significant difference in the other time points between the two groups(P>0.05).After treatment for 24 h, blood oxygen saturation, urine volume in two groups were significantly increased, blood lactic acid markedly reduced , but lactic acid in NE group was obviously lower than that in DA group (P<0.05).Com-pared with DA group, the incidence of arrhythmia cordis , 2-week mortality in NE group were significantly reduced (P<0.05), while the acute kidney injury in two group was not statistically different (P>0.05).Conclusion The effect of NE and DA in maintaining the stability of blood pressure and hemodynamic are equivalent , and NE did not increase the risk of acute kidney injury , but can effectively improve tissue perfusion , reduce arrhythmia and case fatality rate , improve clinical outcomes .

Objective To screen and identify the predicted epitopes of synthesized HLA-A*0201restricted CTL derived from HPVll E7 antigen.Methods Five HPVll E7 CTL epitope peptides and terramers consisting of HLA-A*0201 were selected by way of computer and synthesized by Sanquin company,including HPVllE7 7-15(TLKDIVLDL),15-23(LQPPDPVGL),47-55(PLTQHYQIL),81-89(DLLLGTLNI)and 82-90(LLLGTLNIV).These peptides binding to human peripheral blood-derived DCs were tested for their ability to activate T cells isolated from peripheral blood lymphocytes of HLA-A*0201 healthy individuals.the number of specific tetramer+CD8+T cells by flow cytometry,the level of the section of IFN-γ by ELISA,and the ability of the CTL to kill the target cells were observed.Results The immature DCs could be fully activated by all the five HPV11 E7 peptides.Peptide-loaded mature DCs were able to stimulate the epitope-specific T cells responses in vitro.An increased frequency(P<0.05)of T ceils specific for the E7 7-15 epitope compared to other epitopes of HPV11E7.The epitope-specific CTL of E7 7-15 induced by the activated DCs specifically killed HPV11E7 expressing 293 cell line,and in a ratio of 50:1,the specific cytolytic activity was the strongest than the others(P<0.05).Conclusion DCs loaded with HPV11 E7 7-15(TLKDIVLDL)peptide can induce highly effective and specific ectogenic processed epitopespecific CTL responses in vitro.This peptide may be the candidate for development of CTL based vaccine in the treatment of HPV infeetions.

This study was aimed to summarize the adverse drug reaction (ADR) caused by the toxicity of Tripterygium Wilfordiiand its preparations, in order to explore possible relationship betweenTripterygium Wilfordiifactors and reported ADR. Relevant articles on toxicity ofTripterygium Wilfordiiand its preparations were systematically searched in 5 databases, including the Pubmed, CNKI,Wanfang Data, VIP Data and Sinomed from the database was established until Feb 25th, 2014. And then, the randomized controlled trials (RCTs) were systematically collected, analyzed and summarized. The results showed that there were 260 RCTs with 13301 patients included. The outcome of data analysis showed that ADR rates of digestive system and reproductive system of RCT1 and RCT2 were different. ADR rates (per hundred people) in RCT1 and RCT2 were as follows: digestive system were 14.73 and 12.26, reproductive system were 8.25 and 8.00, liver was 6.50 and 5.66, kidneys were 6.79 and 3.03, blood system were 6.73 and 6.50, cardiovascular system were 2.35 and 0.67, skin and mucous system were 11.42 and 4.78, respectively. Articles on rheumatoid arthritis (RA) of both RCT1 and RCT2 were the highest, which occupied 22.17% in RCT1 and 63.16% in RCT2. The corresponding ADR rates were 34.18 and 27.26. The standard deviation (SD) of 7 disease types, which were RA, IgA nephropathy, nephritis, nephrotic syndrome (NS), diabetic nephropathy, psoriasis, lichen and rashes, as well as uterine fibroids, was 8.69 in RCT1. The SD of RA, IgA nephropathy, psoriasis, lichen and rashes was 7.11 in RCT2. It was concluded that the possible ADR distribution ofTripterygium Wilfordiiand its preparations were the highest in the digestive system, reproductive system and liver. Besides, different diseases (i.e., RA, nephritis, NS, and etc.) had huge differences with their correspondent ADR rates. Therefore, it was suggested that specific measures should be taken to select the appropriateTripterygium Wilfordiipreparation, protect the stomach and liver during the application ofTripterygium Wilfordiiand its preparations. During medication, attentions should be paid to the reaction of patients. Stop the medication when necessary to minimize ADR rates to the lowest.

Objective To research the change rule of peripheral serum Th1/Th2/Th17 balance and relevant cytokines in atopic dermatitis(AD) and to further study its immunologic mechanism .Methods The levels of peripheral serum IFN‐γ,IL‐4 ,IL‐17 ,IL‐21 and IL‐23 in the patients with AD were detected by the flow immunofluorescence technology and the detection results were performed the statistical analysis ,thus the change rule of Th1/Th2/Th17 balance in AD was analyzed .Results The IL‐4 level in peripheral serum of the patients with AD was increased compared with the healthy control group (P<0 .05);the IFN‐γ/IL‐4 and IFN‐γ/IL‐17 in the AD group were significantly decreased compared with the control group (P<0 .01);IL‐17 was positively corre‐lation with SCORAD scores of AD severity (P<0 .05) .Conclusion Th1/Th2 and Th1/Th17 are decreased in the AD course .Th1/Th2/Th17 balance drift may be the important mechanism of AD pathogenesis .

This study was aimed to compare the antioxidant activity of puerarin and 3 other flavonoid compounds, and to investigate their structure-activity relationship. The intragastric administration of 4 kinds of typical flavonoids compounds (soybean element, puerarin, quercetin and rutin) were given to mice, respectively. The model mice of acute hepatic injury were established with intraperitoneal injection of 0.1% carbon tetrachloride (CCl4) after 7 days. After 18 h fasting, liver tissues were removed. The histomorphology was observed after paraffin sectioning and hematoxylin-eosin staining. The activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP) in serum were detected with automatic biochemical analyzer. The content of malondialdehyde (MDA), the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in liver tissues were detected with homogenization. The pathological results of liver tissues showed that hepatic damages were decreased in all 4 medicine treatment groups compared with the model group, but there were no significant differences among these treatment groups. The results of blood serum bio-chemical analysis showed that compared with the model group, puerarin and quercetin could decrease the activities of ALT, AST and GGT in serum significantly (P < 0.05, orP < 0.01). There were no content changes of ALP. In the soybean element group, only the activities of ALT and AST decreased obviously (P < 0.05, orP < 0.01). There was no obvious change in the serum of mice in the rutin treatment group. The homogenate detection results of liver tissues showed that compared with the model group, quercetin and rutin significantly lowered MDA (P < 0.05), increased SOD and GSH-Px (P < 0.05, orP < 0.01); while soybean element and puerarin only improved GSH-Px levels (P < 0.05, orP < 0.01). It was concluded that the antioxidant capacity of quercetin was better than that of soybean element, puerarin and rutin, which may be related to its structure. Compared with 3 other chemical compounds, quercetin had more polyhydroxies and its polyhydroxies were not glycosylated, which suggested that the structure of quercetin may be closely related to its antioxidation activity.

Objective To investigate the cellular immune response to the recombinant DNA vaccine CRT120/HPV6bE7 in mice. Methods The recombinant encoding HPV6bE7, linked with CRT120, was constructed in pcDNA3.1 eukaryotic vector with the report gene GFP. The pcDNA3.1-GFP -HPV6bE7 was transfected into B16 cells by a lipofectamine kit. The C57BL/6 mice were vaccinated with recombinant DNA plamids. The T-cell phenotype in the peripheral blood lymphocytes of the immunized mice was measured by flow cytometry. The CTL activity of the lymphocytes from the spleens and lymph nodes, and the levels of IL-2 and IFN-? were analyzed. Results The constructed recombinant plasmid CRT120/HPV6bE7 was analyzed. Positive transfected cell clones were established and could stably express the target gene HPV6bE7. Compared with HPV6bE7, CRT120/HPV6bE7 plasmid enhanced to a greater extent CD8+ T-lymphocyte differentiation, the number of TCR?? T-lymphocytes and the levels of IL-2 and IFN-? (all P

Objective To investigate the preliminary clinical efficacy of percutaneous plate internal fixation with fracture reduction oriented forcep in the treatment of lower humeral fractures. Methods A retrospective case control study was conducted to analyze the clinical data of 46 patients with lower humeral fractures admitted to Wuzhong People's Hospital of Suzhou from October 2013 to March 2015. There were 25 males and 21 females, aged 19-76 years, with an average age of 45. 7 years. A total of 22 patients ( percutaneous group) were treated with minimally invasive percutaneous internal fixation with self-developed fracture reduction oriented forcep according to the dimensionality reduction method (DRM). The other 24 patients (control group) were treated with open reduction internal fixation. The length of incision, operation time, intraoperative blood loss, fracture healing time, the American Foot and Ankle Surgery Association ( AOFAS ) ankle-hindfoot score at the last follow-up, and postoperative complications were compared between the two groups. Results All patients were followed up for 12-24 months, with an average of 14. 6 months. There were statistically significant differences between percutaneous group and control group in incision length [(7.1 ±0.8)cm vs. (8.8 ±0.7)cm, operation time [(32.5 ±4.9)min vs. (39.2 ±4.3)min], intraoperative blood loss [(8.0 ±2.7) ml vs. (31.0 ± 11.4)ml], and fracture healing time (16.4 ±2.3)weeks vs. (19.5 ±2.9)weeks], respectively (all P<0.05). In percutaneous group, the AOFAS ankle-hindfoot score was (92.3 ±5.9)points (range, 75-99 points ) , and the overall results were good and excellent in 21/22 ( 96％) including excellent results in 18 patients, good in three, fair in one and poor in 0. In control group, the AOFAS ankle-hindfoot score was (91.8 ±4.9)points (range, 76-99 points), and the overall results were good and excellent in 23/24 (96％) including excellent results in 20 patients, good in three, fair in one and poor in 0. There was no significant difference in the excellent and good rate between two groups (P>0. 05). Poor wound healing was observed in one patient in control group. No case of nonunion was found in either group. Conclusion For lower humeral fractures, the percutaneous plate internal fixation with fracture reduction oriented forcep has the characteristics of simple operation, shortened operation time, reduced soft tissue injury and blood loss, and quick healing of the fracture, which is worthy of clinical application.

Objective To investigate the effects of the third-generation mechanical chest compressor on outcomes of cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest.Methods The patients with out-of-hospital cardiac arrest from October 2015 to September 2017 in the Yuyao peoples' hospital were included and divided randomly into 2 groups:manual chest compression group and mechanical chest compression group.The duration of resuscitation,the rate of restoration of spontaneous circulation (ROSC),4-h survival rate and the rate of survival getting to hospital discharge with favorable neurological status of two groups were analyzed.Results A total of 95 patients with out-of-hospital cardiac arrest were included.The rate of ROSC and 4-h survival was significantly increased in the mechanical chest compression group compared with the manual chest compression group (P＜0.05).There was no remarkable difference in the duration of resuscitation and the rate of survival getting to hospital discharge with favorable neurological status between 2 groups.Conclusions The thirdgeneration mechanical chest compressor significantly improves the rate of ROSC and the shout-term survival in patients with out-of-hospital cardiac arrest.

Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.