Objective To research the preventing and controlhng measure of esophageal cancer and the high-risk factors of influencing surgical effect. Method Retrospective collecting 3358 patients of the esophageal cancer by surgical treatment, and summaring and analysing the clinical material of the recent death of 94 cases after surgery. Results The recent surgical mortality was 2.8% (94/3358) in all of the esophageal cancer patients after surgery. The advanced age and the partner disease before surgery had significant influence to the recent surgical mortality (P <0.05). The tallies fistula in chest and the cardiopulmonary complication after surgery had unusual significant influence to the recent surgical mortality (P< 0.05). Surgery way and spleen excision had no influence to the recent surgical mortality (P > 0.05). Conclusions The tallies fistula in chest, the cardiopulmonary complication after surgery, the advanced age and the partner disease before surgery are the high-risk factors of the recent death to esophageal cancer after surgery.Purposeful controlling these factors will be possible to reduce the surgical complication and the recent surgical mortality.

0.05 respectively .The side effects including gastrointestinal response and bone marrow depression in union group was markedly higher than those in pure group,P

OBJECTIVE To study the correlated factors in acquired infection of liver cirrhosis and offer more reliable theory of treatment for clinic. METHODS The liver cirrhosis history of 302 cases was retrospectively analyzed and reviewed. RESULTS From them 43 cases acquired infection during hospitalization, with 61 case-times of infection, the rate of hospital acquired infection was 14.2%, the rate of case-times of infection was 20.20%. Nineteen cases were died and the mortality rate was 44.19%, Among the 259 non-infected patients only 5 cases were died, the mortality rate was 1.93%, the difference was significant (P

Assembling an adapted smoothing method and a classifier of wavelet transform combined support vector machine ( SVM) , a Raman spectrum recognition approach was built for low signal noise ratio situation. Firstly, spectra data were denoised by the adapted smoothing method. The smoothing window was adapted to the signal noise ratio, which would effectively remove noise with the intensity of the signal well remained. Secondly, the wavelet transform was used for dimension reduction of the data. The decomposition level of wavelet transform was optimized according to the best classification result of the training set. Lastly, SVM was used for classification. Cross Validation ( CV ) was applied to obtain the optimized parameters of SVM. Conditions for the effective parameters were searched considering the relation between the cross_validation result and the classification accuracy. Combined with the surface enhanced Raman scattering ( SERS ) technology , the developed spectrum recognition approach was used for qualitative analysis of methamphetamine ( MAMP ) and 3, 4_methylenedioxymethamphetamine ( MDMA ) in peopleˊs urine, where the detecting accuracy is above 95. 0%. The uniform Au nanorods (NRs) SERS substrate synthetized by the Hefei Institute of Intelligent Machines of Chinese Academy of Sciences was used for the experiment. Raman spectra were acquired using an Inspector Raman ( DeltaNu) spectrometer, with the excitation wavelength of 785 nm and the integrate time of 5 seconds.

Objective To investigate the current status of healthcare-associated infection(HAI)and antimicrobial usage,so as to provide a scientific basis for improving the management of HAI. Methods A cross-sectional survey was conducted by combination of bedside visiting and medical records reviewing,HAI were investigated among all hospitalized patients between 0:00 and 24:00 on August 21 ,2014.Results A total of 2 216 patients were investiga-ted,the prevalence rate of HAI was 4.83% ,the case infection rate was 5.14% ;the main infection site was lower respiratory tract(63.16% ),antimicrobial usage rate was 39.71% ,the proportion of prophylactic and therapeutic use of antimicrobial agents was 32.27% and 61 .71% respectively.596 patients received therapeutic antimicrobial use,specimen detection rate was 56.21% (n= 335),the detection rate of pathogens was 15.52% (n= 52). The ma-jor detected bacteria were Pseudomonasaeruginosa,Klebsiellapneumoniae,Acinetobacterbaumannii,Escherichia coli,and Stenotrophomonasmaltophilia.Conclusion HAI prevalence survey is helpful for realizing the occurrence of HAI,respiratory tract is the main infection site,gram-negative bacteria is the major pathogen,management of prophylactic use of antimicrobial agents is the focus of HAI management.

[ ABSTRACT] AIM: To explore whether autophagy is involved in the excessive death of renal tubular epithelial cells in subtotal nephrectomy ( SNx) rats and the relationship between autophagy and necroptosis in the kidney of SNx rats. METHODS:Male Sprague-Dawley rats were randomly assigned to control group ( n=6 ) and SNx group ( n=42 ) .The rats in SNx group were subjected to SNx.Sham surgery was performed in the rats in control group.The rats in SNx group were divided into subgroups at 0, 4, 8 and 12 weeks ( n=6) and the other rats in SNx group were divided into SNx+vehi-cle group, SNx+necrostatin-1 (Nec-1) group and SNx+3-methyladenine (3-MA) group.The expression of RIP1, RIP3, LC3 and beclin-1 at mRNA and protein levels was measured at 0, 4, 8 and 12 weeks by qPCR and immunohistochemistry. The effects of Nec-1 or 3-MA on the protein expression of LC3-I, LC3-II and beclin-1, and production of reactive oxygen species ( ROS) in the rat kidney were determined by Western blot and DCFH-DA staining.The death of renal tubular epi-thelial cells in the SNx rats was observed by TUNEL staining and electron microscopy.Finally, the effects of Nec-1 and 3-MA on blood urea nitrogen ( BUN) , serum creatinine ( SCr) and the pathological changes of the renal tissues were ana-lyzed.RESULTS:The highest mRNA and protein levels of RIP1, RIP3, LC3 and beclin-1 appeared at the 8th week after SNx (P<0.01).Compared with the rats in SNx+vehicle group, the protein over-expression of LC3-II/I and beclin-1, re-nal tubular epithelial cells with typical morphological features of necroptotic cell death and TUNEL-positive renal tubular
cells were decreased in the SNx rats treated with Nec-1 and 3-MA (P<0.01), but 3-MA did not reduce the increased con-centration of ROS.In addition, treatment with Nec-1 and 3-MA obviously reduced BUN, SCr (P<0.05), glomeruloscle-rosis index and tubulointerstitial injury score (P<0.01).CONCLUSION:Autophagy participates in the excessive death of renal tubular epithelial cells in SNx rats.Inhibition of autograph prevents necroptotic cell death of renal tubular cells, and alleviates chronic renal injury in SNx rats.

Objective To explore a method of preparing the acellular tendons of human with chemical approaches.Methods From April 2011 to June 2012,several treatments were performed on human tendons using 1.00％ tri(n-butyl) Phosphate (TnBP) combinded with Triton X-100 at the concentration of 0,0.25％,0.50％,1.00％ respectively.Specimens were examined using histological observation,scanning electron microscopy,biomechanical testing and hydroxyproline quantitation.The results were then compared with fresh tendons of control group,so as to value the characteristics of decellularized human tendon scaffold.Results Acellular human tendons had glossy surface,intact aponeurotic membrane and satisfactory flexibility.A small number of disrupted cells remained in the 1.00％ TnBP + 0％ Triton X-100 treated tissue,while other three experimental groups successfully eliminate all cells.Intact and regular collagen architecture was retained in 1.00％ TnBP +0.25％ Triton X-100 treated tissue.1.00％ TnBP + 0.50％ Triton X-100 and 1.00％ TnBP + 1.00％ Triton X-100 treated tissue were nearly identical to 1.00％ TnBP +0.25％ Triton X-100 treated tissue,but the interval of collagen was slightly wider than the control group,the maximum load (385.22 ± 80.32N,398.22 ± 127.20N),ultimate tensile strength(46.69 ± 16.30Mpa,46.20 ±5.52Mpa) and hydroxyproline content(0.282663 ± 0.0110109 μg/mg,0.279355 ± 0.0102129 μg/mg) were statistically lower (P ＜ 0.05) compared with those of the control group,maximum load(533.28 ± 135.77N),ultimate tensile strength (65.56 ± 14.40Mpa) and hydroxyproline content (0.292882 ± 0.0100988 μg/mg) respectively.Conclusion The decellularization treatment with 1.00％ TnBP + 0.25％ Triton X-100 could be optimized for preparing acellular human tendons.

Objective:To investigate the number of necroptotic renal tubular epithelial cells in renal tissues of patients with chronic kidney disease (CKD) and the correlation with clinicopathologic parameters, and explore its role in the progression of the excessive loss of renal tubular cells and chronic kidney injury.Methods:Renal tissue samples from 60 patients (18-65 years old) with CKD proven by kidney biopsy in the First Affiliated Hospital of Hainan Medical University from June 2017 to June 2019 were collected. According to internationally accepted K/DOQI guidelines, the patients were divided into 1-4 stages of CKD, with 15 cases in each stage. The number of necroptotic renal tubular epithelial cells in patients with different stages of CKD was detected using receptor-interacting protein 3 (RIP3) and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) fluorescent staining, and the expression of RIP3 and MLKL, marker protein of necroptosis, was detected by immunohistochemistry. Pearson correlation analysis was used to analyze the correlation between the percentage of necroptotic renal tubular epithelial cells and clinicopathologic parameters. In addition, the expression of angiotensinogen Ⅱ receptor (AT2R) in renal tissue and its correlation with the percentage of necroptotic renal tubular epithelial cells were analyzed.Results:With the development of CKD, the structural destruction of renal tubules in patients with CKD was gradually aggravated, and the renal tubules in the corresponding areas were atrophied, accompanied by worsening interstitial fibrosis. The adjacent renal tubules were focally dilated and numerous protein tubules were seen in the tubules. Importantly, renal tubular injury score in second and third stage of CKD was significantly higher than that in control group (both P<0.01). TUNEL+RIP3 immunofluorescence staining results showed that the percentage of TUNEL/RIP3 double positive renal tubular epithelial cells (necroptotic renal tubular epithelial cells) in renal tubules of the second and third stage of CKD was higher (all P<0.01). Immunohistochemical results showed that RIP3, MLKL and AT2R proteins were mainly expressed in cytoplasm of renal tubular epithelial cells, and the expression of RIP3, MLKL and AT2R in renal tubular epithelial cells was higher in the second and third stage of CKD patients (all P<0.05). Pearson correlation analysis showed that the percentage of necroptotic renal tubular epithelial cells was positively correlated with blood urea nitrogen ( r=0.514, P=0.003), serum creatinine ( r=0.507, P=0.019), serum cystatin C ( r=0.571, P=0.026), serum uric acid ( r=0.592, P=0.008), renal tubules injury score ( r=0.901, P<0.001), renal interstitial fibrosis index ( r=0.700, P=0.001) and the expression of AT2R protein in renal tissue ( r=0.715, P=0.001). Conclusions:As CKD progresses, necroptosis of renal tubular epithelial cells in CKD patients occurs. The necroptotic cell death may be an important factor leading to renal tubular epithelial cell excessive death and the progression of chronic kidney injury. Furthermore, necroptosis of renal tubular epithelial cells may be related to the high expression of AT2R in kidney tissue.

Background The deposition of advanced glycation end products (AGEs) in lens is the risk factor of diabetic complications.Researches revealed that AGEs has autofluorescence.Crystallin is a longevity protein.AGEs accumulation is probably associated with diabetic retinopathy (DR).Objective This study was to evaluate the association of AGEs autofluorescence intensity with diabetes and with DR.Methods A cross-sectional study was carried out under the approval of Ethic Committee of Shenyang He Eye Hospital and informed consent of each patient.One hundred eyes of 100 patients with age-related cataract aged 50-70 years were included in He Eye Hospital from September to December 2015.The patients were divided into non-diabetes group (40 patients) and diabetes group (60 patients),and then the patients in diabetes group were subdivided into non-DR (NDR) group,non-proliferating DR (NPDR) group and proliferating DR (PDR) group according to the DR grading criteria,20 patients for each.Glycosylated henoglobin A1c (HbA1c) and fasting plasma glucose (FPG) were detected for each subject,and the lens autofluorescence was assayed with lens fluorescence biomicroscope (Clearpath DS120).The association of lens autofluorescence intensity with serum HbA1c level or DR severity was analyzed.Results The age and diabetes course were matched among the non-diabetes group,NDR group,NPDR group and PDR group (F=2.587,2.899,both at P＞0.05),and the FBS and HbA1c level were evidently higher in the NDR group,NPDR group and PDR group than those in the non-diabetes group (all at P＜0.01).The autofluorescence intensity of lens was (0.159±0.032),(0.256±0.024),(0.319 ±0.013) and (0.394±0.035) cd in the non-diabetes group,NDR group,NPDR group and PDR group,respectively,showing a significant difference among the groups (F =90.265,P =0.000).The autofluorescence intensity of lens in the NDR group,NPDR group and PDR group was significantly increased in comparison with the non-diabetes group and the autofluorescence intensity of lens was gradually increased with the severity of DR (all at P＜0.01).A positive linear correlation was found between autofluorescence intensity of lens and serum HbA1 c level in diabetes patients (r =0.654,P ＜ 0.05).Conclusions The autofluorescence intensity of AGEs in lens appears to be associated with the severity of DR and HbA1 c.The autofluorescence intensity of AGEs in the lens of diabetes patient is probably one of the evaluation indexes of early stage of DR.

Objective To evaluate the prevalence of chronic kidney disease (CKD) in Chinese adult health check-up population,and to compare with the prevalence of CKD in the study of the general population as well as the large CKD cross-sectional study in China.Methods Epidemiological studies about CKD in Chinese adults health check-up population from January 2007 to December 2017 were searched in PubMed,SinoMed,CNKI,VIP and Wanfang Data.Meta-analysis of the prevalence of CKD was performed with software of Stata 12.0.Subgroup analyses of CKD staging,urban and rural,as well as geographical areas of the general population were executed.Results Twenty-two studies from adult health check-up population were included (238 349 persons).Egger's regression showed no publication bias (P ＞ 0.05).The unstandardized prevalence rate of CKD was 12.49％ (male 12.8％,female 12.5％).The respective unstandardized prevalences of proteinuria,hematuria and eGFR decline were 5.90％,5.83％ and 2.75％.The unstandardized prevalences of CKD in urban and rural population were 13.21％ and 11.90％.The stages of CKD were mainly concentrated in the early stages.There was no significant difference in the non-standard detection rate of total eGFR decline among the adult medical examination population,the general population and the population studied cross-sectionally (P ＞ 0.05).Furthermore,no significant difference in the non-standard detection rate of total hematuria and male hematuria was found between the adult health check-up population and the general population.In addition,the total proteinuric non-standard detection rate of the adult general population was similar with that of population studied cross-sectionally (P ＞ 0.05).Conclusions The prevalence of CKD in Chinese adults is higher,the overall prevalence is however underestimated.The results of epidemiological investigation in adult health check-up population are similar to those of the general population,especially in men.