Objective To investigate the clinical value of combining early urine paraquat early clearance rate (UPCR) with severity index of paraquat poisoning (SIPP) in predicting the prognosis for paraquat poisoning patients.Methods In this retrospective research,a total of 425 cases diagnosed with acute paraquat poisoning from March 2014 to March 2016 in Emergency Intensive Care Unit,First Affiliated Hospital of China Medical University were enrolled.The general data of patients,the results of rapid qualitative test of paraquat in blood and urine,the concentration of paraquat in blood / urine,the poisoning time,the concentration of blood lactic acid and the APACHE Ⅱ score were collected.The early UPCR and SIPP were measured at different time intervals,and the ratio of 6-SIPP and 12 h-UPCR were calculated.These patients were divided into death groups and survival groups according to the 28-day mortality.The relationship between these factors and the mortality were analyzed.Results Of all the 425 patients,268 cases (63.1％) died,157 cases (36.9％) survived;the blood concentration of paraquat,the lactate concentration,SIPP values and the APACHE Ⅱ scores were significant difference between the two groups (P ＜ 0.05).The mortality of 2-6 hour paraquat rapid qualitative test result positive patients was higher (96.4％) than that of the negative patients (3.6％) (P ＜ 0.05);the mortality of 12-24 hour paraquat rapid qualitative test result negative patients was lower (11.5％) than that of the positive patients (88.5％) (P＜0.05).The 2-6 hour SIPP value was 19.8 ±6.7 in death group,which was higher than that in survival group (4.9±3.1) (P＜0.05);the 2-6 hour UPCR value was (41.7±9.3) indeath group,which was lower than that in survival group (86.3 ± 15.8) (P ＜ 0.05).There was no significant difference in the 2-6 hour UPCR value and 12-24 hour UPCR value between two groups (P ＞0.05).The 6 h-SIPP/12 h-UPCR value was (41.94 ±5.9) in death group,which was higher than that in survival group (5.27 ± 3.6) (P ＜ 0.05).Conclusion The combined use of early UPCR and SIPP values is an effective indicator of the prognosis of patients with acute paraquat poisoning and is helpful for the early stratification.We should pay more attention to the patients whose rapid qualitative blood test is positive because of their high mortality risk;for the patients whose 12 h urinequalitative test was negative,the hemoperfusion therapy might be stopped because the toxin was completely excluded,and the medical resources can be saved reasonably.The UPCR might indicate the excretion of toxins,and SIPP might indicate the severity of poising.

Objective To investigate the joint value of early peak temperature and 48 h-△sequential organ failure assessment (SOFA) score in predicting the prognosis for patients with sepsis in emergency department.Methods Two hundred and thirty-one patients with sepsis admitted from January 2013 to January 2015 in Emergency Intensive Care Unit of the First Affiliated Hospital of China Medical University were enrolled.Clinical features,early peak temperature,SOFA scores,the length of stay in EICU and the mortality in 28 days were studied.The patients were divided into two groups according to the 48 h-△SOFA.Each group were divided into three subgroups according to the early peak temperature.For example,hypothermia subgroup had temperature below 36 ℃,normothermia subgroup had temperature between 36 ℃ and 38 ℃,and hyperthermia subgroup had temperature above 38 ℃.The relationship between peak temperature plus 48 h-△SOFA and the length of stay in EICU as well as mortality were analyzed.Results Of 231 patients,in 48 h-△SOFA＞0 group (n =142) 27 (19.0％) patients died,and in 48 h-△SOFA≤0 group (n =89) 33 (37.1％) patients died (P ＜ 0.05).Hypothermia subgroup had a higher odds ratio value in predicting nonsurvival in 48 h-△SOFA≤0 group (OR =4.51,95％CI:1.33-2.17,P =0.01).Hyperthermia subgroup had a longer stay in EICU than hypothermia subgroup and normothermia subgroup (P ＜ 0.05).Conclusion The combination of the early peak temperature and 48h-△SOFA score is an effective indicator to evaluate the prognosis and to stratify patients with sepsis in emergency department.More attention should be paid to the patients with an early peak temperature ＜ 36 ℃ and 48 h-△SOFA ≤0 because of higher mortality.The condition of patients should be reassessed and try to make a more rational treatment for the patients with an early peak temperature ＞38 ℃ and 48 h-△SOFA ＞0 because of its longer stay in EICU.

Objective To compare the efficacy of video-assisted thoracoscopy plus minithoracotomy(VAMT) and limited axillary thoracotomy(LAT) for the treatment of lung cancer.Methods 85 consecutive lung cancer patients were treated by either VAMT or LAT.The operative time,blood loss during operation,postoperative chest drainage time,and hospital stay time and postoperative complication were compared between the two groups.Results There was no death in two groups.The operative time and blood loss during operation were significant less in VAMT than inLAT(t =6.514,2.413,all P ＜0.05).But postoperative chest drainage time,and hospital stay time and postoperative complication were no significant difference between the two groups (t =0.490,0.338,all P ＞ 0.05).Conclusion VAMT is a safe and less traumatic procedure in the treatment of lung cancer,which is worthy of promotion and application.

Objective To explore the clinic effect of arthroscopic in the treatment of Haglund deformity.Methods Sixteen patients with Haglund deformity were treated with arthroscopy from June 2009 to December 2011,including 7 males and 9 females,with an average age of 28.8 years (range,17-39 years).All 16 patients were suffered ankle back pain,exacerbations of pain during active and passive plantar flexion.This group of patients was chosen arthroscopic surgery to treat Haglund deformity as conservative treatment was invalid.With the prone position for surgery,we selected two approaches next to the Achilles tendon.Use the C-arm X-ray fluoroscopy observed calcaneus orthopedic during the operation.From the posteromedial approach to the posterolateral approach to alternately use the shaver and ArthroCare to clean up the front of the inflammation of the Achilles tendon bursa,by which could form arthroscopic operations security zone.All operating equipment was on the back toward the Achilles tendon,which could maximize the protection Achilles tendon.Postoperative plaster or brace short brake was used for two weeks.16 cases of postoperative patients were followed up； the mean follow-up time was 13 months (9-18 months).According pain visual analogue scale (VAS) and the American Orthopaedic Foot and Ankle (AOFAS),the clinic effects were evaluated.Results At the last follow-up,the AOFAS hindfoot score of 91.5±2.8 was significantly higher than the preoperative 71.0±3.7 (t=17.38,P=0.014),postoperative VAS score 1.3±0.6 was significantly lower than the preoperative 5.10±0.44 (t=19.20,P=0.022).Conclusion The treatment of Haglund deformity by means of arthroscopic minimally invasive,with smaller trauma,faster recovery and lower complications,is effective and safe in clinical practice.However,dues to its steep learning curve,this method requires doctors to carry out who had relatively large arthroscopic surgery experience.

CD98 is a transmembrane heterodimer of cell surface.It regulates cell signaling pathway by activating some correlated proteins,and controls cell polarization,proliferation,adhesion and migration.CD98 plays an important role in the development of cancer and may be a novel tumor marker for diagnosis and prognosis in lung cancer.

The activity of eNOS was singificantly depressed by a high concentration of glucose in a concentration-and time-dependent manners after incubation of HUVECs with different concentrations of glucose and with high glucose plus insulin for different times.The physiological concentration of insulin can partially reverse the inhibitions of the activity and expression of eNOS induced by high concentration of glucose.

Medicine, Chinese Traditional ; methods ; trends

Coronary Disease ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods

BACKGROUND: Liuwei Dihuang Pills (LWPs), a famous Chinese prescription for replenishing the liver and kidney, have achieved good effect in the treatment of backache. However, the mechanism underlying LWPs treating backache with kidney deficiency is unclear. OBJECTIVE: To observe the effect of LWPs on extracellular matrix components of rabbit intervertebral disc degeneration models in vitro, and to explore the effect of LWPs in the prevention and treatment of intervertebral disc degeneration.METHODS: Totally 100 L1-6 intervertebral discs with endplate removed from 20 New Zealand rabbits were randomly divided into control, tumor necrosis factor α (TNF-α), p38-JNK/SAPK blocked, LWPs, and combination groups (n=20 per group). 2 μL of 10 mg/L TNF-α, 10 μL of 20 μmol/L SB203580 (specific inhibitor of p38MAPK) and SP600125 (inhibitor of JNK), 10% LWPs serum, 10% LWPs combined with 2 μL of 10 mg/L TNF-α were added into the medium of the corresponding group. Samples were collected at 2, 4, 6 and 14 days of culture. RESULTS AND CONCLUSION: The addition of TNF-α significantly upregulated the mRNA and protein expression levels of collagen type I, while significantly downregulated the levels of glycosaminoglycan and hyaluronic acid, chondroitin sulfate/keratan sulfate ratio, as well as the protein and mRNA expression levels of proteoglycan and collagen type Ⅱ (P < 0.05). LWPs could partly reverse the changes caused by TNF-α, indicating that LWPs can alleviate intervertebral disc degeneration to a certain extent.

BACKGROUND:JNKs and p38 MAPK, as important members of mitogen-activated protein kinase (MAPK), play critical roles in the cell proliferation, differentiation, transformation and apoptosis. OBJECTIVE:To observe the effects of Liuwei Dihuang Pill on the MAPK signaling cascade of nucleus pulposus cells in a rabbit model of intervertebral disc degeneration. METHODS:100 discs samples with endplate cartilages were equivalently randomized into five groups and cultured in the medium containing 10 mg/L tumor necrosis factor-α(TNF-α, 2μL), p38-JNK/SAPK blockers (10μL of 20μmol/L SB203580 and SP600125, 2μL of 10μmol/L TNF-α), 10%Liuwei Dihuang Pill serum, 10 mg/L TNF-α(2μL) plus 10%Liuwei Dihuang Pill serum, respectively. Those cells received no intervention as controls. Samples were collected and detected at 2, 4, 8 and 14 days of culture. RESULTS AND CONCLUSION:Real time-PCR and western blot assay showed that mRNA and protein expressions of JNK and P38 pathways by the nucleus pulposus cells were upregulated with time, while all above indicators were significantly decreased by the Liuwei Dihuang Pill serum. These findings reveal that Liuwei Dihuang Pill can delay the process of disc degeneration by blocking JNK and P38 signaling pathways, thus exerting protective effect on the intervertebral discs.