Objective To discuss the surgical outcomes of atrial septal defects(ASD) by closing the ostium secundum via small chest incision.MethodsTotally 41 cases with ASD were treated by occlusion via a small incision(3-4 cm) at the right anterior chest.After cutting the pericardium,the right atrial was sutured with double ring and a special occluding device was inserted to close the ostium.Afterwards,under the guidance of transthoracical or transesophageal echocardiography,the satisfiable position for the occluder was confirmed by repeated testing with the protect string.After that,the right atrial and the occluder were sutured by a needle thread for fixation.ResultsOf the patients,the procedure was successfully completed in 39 cases.The mean operation time was 45 to 95 minutes(mean,60 minutes).The patients were discharged from our hospital in 3 to 6 days.No dislocation of the device or atrial shut was found in 2 to 24 months after the operation.Two patients were converted to open surgery because of failure in the occlusion.ConclusionOcclusion via small chest incision is safe,minimally invasive,and convenient procedure for ASD.

24 cases of renal failure induced by chemotherapy were treated with Wuling powder plus additives.Theresult of clinical amelioration was 87.5%.with a to-tal effective yielded marked actions of promoting ap-petite in animals,lowering serum urea nitrogen,cre-atinine,2 microglobulin.It also decreased the inhibi-tion of PDD on the enzyme activity of renal Na~+—K~+ATP.Microscopic exam revealed the pathological le-sion of kidney to be milder in the tested group.

Objective To understand the distribution and drug resistance of pathogens from patients with anastomotic fistula infection after esophageal cancer surgery, and provide basis for clinical diagnosis and treatment.Methods Patients were admitted to a hospital due to anastomotic fistula after esophageal cancer surgery between January 2012 and December 2015, microbial culture and antimicrobial susceptibility testing results of patients were retrospectively analyzed.Results 1 986 patients underwent radical resection of esophageal cancer within 4 years, 148 of whom developed anastomotic fistula, 104 (70.27％) were with positive microbial culture.A total of 197 pathogenic strains were isolated, 52(26.40％)and 145 (73.60％)strains were isolated from intrathoracic anastomotic fistula and cervical anastomotic fistula respectively;127 (64.47％)strains were gram-negative bacteria, the major were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii, 62(31.47％) strains were gram-positive bacteria, the major were Staphylococcus aureus, Enterococcus spp., and Streptococcus viridans, 8 strains (4.06％) were fungi.49(47.12％) cases were with mixed pathogenic infection.The resistance rates of gram-negative bacteria to imipenem were 17.86％-47.62％, to polymyxin B was 0, resistance rates of Pseudomonas aeruginosa to other antimicrobial agents were all<50％, Klebsiella pneumoniae to piperacillin and aztreonam were both>70％, Acinetobacter baumannii to most antimicrobial agents were all>50.00％;resistance rates of gram-positive bacteria to clindamycin and tetracycline were both>50.00％, to linezolid, vancomycin, and teicoplanin were all 0, resistance rates of Staphylococcus aureus to penicillin, oxacillin, and ciprofloxacin were all>60％,resistance rate of Enterococcus spp.to quinupristin/dalfopristin was 100.00％.Conclusion Postoperative anastomotic fistula combined with infection can affect the prognosis of patients after esophageal cancer surgery, regular monitoring on distribution and drug resistance of pathogens can provide the basis for initial empirical treatment, and is conducive to the early treatment and rational use of antimicrobial agents.

BackgroundThe effects of extremely low frequency electromagnetic fields (ELF-EMFs) on public health have attracted wide attentions.The association of the thermal effect of ELF-EMFs with cancer and ocular tissue damage has been of concern.However,the pathological changes of scleral tissue after exposure to ELF-EMFs as well as the relationship between these changes and myopia are still poorly understood.ObjectiveThe present study was to investigate the molecular pathological changes of human fetal scleral fibroblasts (HFSFs) after exposure to ELF-EMFs in vitro and to explore the possible mechanism in the occurrence and development of myopia.MethodsHFSFs were cultured and passaged and then exposed to 50 Hz electromagnetic fields,and HFSFs that did not receive the irradiation of ELF-EMFs were used as the control group.The expression of collagen type Ⅰ (COL1A1 ) mRNA and matrix metalloproteinase-2 (MMP-2) mRNA in cultured HFSFs were detected by real-time qualitative polymerase chain reaction (real-time PCR) under different magnetic field intensites (0,0.1,0.2,0.5,1.0 mT) and different exposure time (0,6,12,24,36,48 hours).Cell proliferation assay of HFSFs was detected by the cell counting kit 8 ( CCK8 ) assay.The expression levels of COL1 A1 and MMP-2 proteins in HFSFs were further confirmed by immunofluorescence staining.Results The expression of COL1A1 mRNA was significantly down-regulated under the exposure of 0.2 mT ELF-EMFs for 6 hours,in comparison with the control group;moreover,it decreased in parallel with the increased of flux density (0.099±0.008 vs.0.050±0.004) (P =0.009 ).The expression of MMP-2mRNA was up-regulated conspicuously after exposure to 0.1 mT ELF-EMFs for 24 hours,and it increased with exposure time in comparison with the control group ( 0.009 ±0.001 vs.0.018±0.003 ) ( P =0.038 ).Proliferation of HFSFs (A450) was inhibited following the exposure to 0.2 mT ELF-EMFs for 24 hours in comparison with the control group (P =0.009 ).The expression of COL1 A1 in the experimental group was decreased,compared with the control group,but the expression of MMP-2 was increased.ConclusionsELF-EMFs inhibit the proliferation of HFSFs and expression of COL1 A1 in HFSFs,which might be one of the reasons for the development of myopia.

Objective To investigate the development status of tumor radiotherapy in Guangxi Zhuang autonomous region in order to provide reference for the decision-making of the competent administrative departments for public health.Methods A questionnaire survey was conducted by the aid of on-site inspection and telephone or Email investigation among the medical institutions in Guangxi to know the current status of radiotherapy units and settings,human resources,allocation of radiotherapy facilities,and standardization of medical practices.Results Up to the end of August 2014,radiotherapy was carried out in 39 hospitals,with other 5 hospitals under preparation for construction.Among these 40 hospitals were three-dimensional conformal radiotherapy in 38,intensity modulated radiation therapy (IMRT) in 23,and image guided radiation therapy (IGRT) in 5.There were 48 linear accelerators,15 afterloading therapy apparatus,and 4 γ-knife or X-knife in Guangxi.There were 647 professional personnel (except nurses),including 322 radiation oncologists,100 radiotherapy physicists,213 radiotherapy technologists and 12 professional engineers.There were 2 000 to 2 500 hospital beds and 20 000 cancer patients had received radiotherapy in 2013.1 600 to 2 000 people received treatment on average every day.Conclusions The present radiotherapy resources in Guangxi are insufficient and the input to radiotherapy equipment is deficient,with low proportion of cancer patients treated with radiotherapy.Because of the uneven radiotherapy quality among different hospitals,the reasonable planned development and unified diagnostic and treatment practices are required to improve radiotherapy level in Guangxi.For shortage of medical staff and high-quality physical and technical personnel,the improvements are needed by fostering and introduction of personnel.Compared with developed regions in China,the introduction of new technology is largely needed.

OBJECTIVETo explore the impact and mechanism of electro-acupuncture (EA) on olfactory ensheathing cells (OECs) transplantation of spinal cord injury (SCI) axonal regeneration.

METHODSIn the experiment, 72 adult Sprague Dawley male rats weighted (220±20) g underwent contusion and transection method to cause the T9 model of spinal cord injury, were randomly divided into four groups involving model group, EA group,OECs group,and EA+OECs group. 5% fluorescein gold (FG) solution of 0.5 µl was injected into rats' spinal cord at 4 weeks and 8 weeks after SCI, a series of tests were performed including fluorescein gold(FG) retrograde tagging, BBB scores.

RESULTS(1)The BBB scores level among four groups had no differences from the 1st day to the 1st week after the SCI (P>0.05). From the 3rd week after the SCI, the BBB scores level in EA+ OECs group were obviously higher than that of other groups (P<0.05). (2)The result of the fluorescein gold (FG) retrograde tagging showed at 4 weeks and 8 weeks after treatment FG positive nerve fibers were observed in SCI region. In EA+OECs group the number of FG positive nerve fibers was more than other three groups, and the fibers were more regularly arranged than other three groups.

CONCLUSIONThe combination of electro-acupuncture and OECs transplantation can recover the pathway of nerve conduction and promote nerve fibers regeneration and hind limb function recovery for SCI rat, and can guide the trend of the axonal regeneration.

Animals ; Axons ; physiology ; Cell Transplantation ; Combined Modality Therapy ; Electroacupuncture ; Humans ; Male ; Nerve Regeneration ; Olfactory Nerve ; physiopathology ; transplantation ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; physiopathology ; therapy

Adult ; Bone Neoplasms ; diagnosis ; surgery ; Humans ; Ilium ; Magnetic Resonance Imaging ; Male ; Osteoma, Osteoid ; diagnosis ; surgery ; Tomography, X-Ray Computed

Objective:To explore the independent risk factors of death during hospitalization in patients with acute myocardial infarction (AMI) .Methods :Clinical data of 614 cases ,who were diagnosed as AMI during hospitaliza‐tion in our hospital from 2011 to 2013 ,were retrospectively analyzed .According to AMI patients'survival or not during hospitalization ,they were divided into death group (n=62) and survival group (n=552) ,single and multi-variable Logistic regression analysis were used to analyze the relationship among baseline feature factors and thera‐peutic methods of all patients and hospital mortality .Results:The mean age was (66.58 ± 12.87) years and there were 39 males (62.9% ) among the 62 dead patients .Hospital mortality was 10.10% (62/614) .Multi‐variable Lo‐gistic regression analysis screened following factor were independent risk factors related to AMI hospital mortality :age (OR= 3.065 ,95% CI:1.188~ 7.915) ,female (OR= 2.775 ,95% CI :1.200~ 6.419) ,heart rate (OR=2.836 ,95% CI:1.405~ 5.722) ,blood glucose (OR = 1.943 ,95% CI :1.186 ~ 3.184) ,Killip class IV (OR=1.744 ,95% CI:1.211~2.513) and left main or triple -vessel coronary disease (OR= 3.157 ,95% CI :1.244 -8.014) . P < 0.05 ~ < 0.01 .Conclusion : Advanced age ,female ,rapid heart rate ,elevated blood glucose level at hospitalization ,Killip class IV and left main or triple‐vessel coronary disease may be independent risk factors of death during hospitalization in patients with acute myocardial infarction .

Objective The rapid development of radiation equipment has put forward higher requirements for protective facil -ities.The aim of this study was to research the radiation protection status of treatment equipment room in thirty -three medical units from East China area , and to put forward corresponding countermeasures to improve the level of radiation protection . Methods The li-cense and archival of X-ray machine, CT, gamma knife, accelerator, after loading therapy machine were surveyed in the thirty-three medical units .The engine room size , wall thickness , lead equivalent of protection doors , and leakage level of equipment were detec-ted.All the data were evaluated and analyzed on the basis of the corresponding national standards . Results ①The inspection pass rates of radiation treatment equipments in the first class hospitals were afterloader (100%), X-ray apparatus(99%), gastrointestinal machine(98%), CT(98%), medical processing accelerator (98%), gamma knife(97%), DSA(94%), PET-CT(94%), ECT (90%), dental engine(84%)and molybdenum target drone (84%).The inspection pass rates of radiation treatment equipments in other class hospitals were medical processing accelerator (100%), X-ray apparatus(91%), CT(89%), gastrointestinal machine (80%), DSA(80%) and (80%) gamma knife.②The qualified rates of the leakage radiation levels of radiation therapy , diagnostic radiology and nuclear medicine were 100%, 99% and 97%. Conclusion The radiation protection of treatment equipments and facilities in thirty-three medical units from East China area needs to be strengthened . We should strengthen supervision , implement the rules and regulations , strictly perform the regulation of radiation protection evalua-tion, and strengthen the training of radiation protection regulations and skills .

Objective To-identify the factors associated with radiation-induced liver disease (RILD) and to describe the probability of RILD using the Lyman normal tissue complication(NTCP) model for primary liver carcinoma(PLC) treated with hypofractionated conformal therapy (CRT).Methods A total of 109 PLC patients treated with hypofractionated CRT were prospectively followed according to the Child-Pugh classification for liver cirrhosis,93 patients in class A and 16 in class B.The mean dose of radi- ation to the isocenter was (53.5?5.5) Gy,fractions of (4.8?0.5) Gy,with interfraction interval of 48 hours and irradiation 3 times per week.Maximal likelihood analysis yielded the best estimates of parameters of the Lyman NTCP model for all patients;Child-Pugh A and Child-Pugh B patients,respectively.Results Of all the patients,17 developed RILD (17/109),8 in Child-Pugh A(8/93 ) and 9 in Child-Pugh B(9/ 16).By multivariate analysis,only the Child-Pugh Grade of liver cirrhosis was the independent factor (P= 0.000) associated with the developing of RILD.The best estimates of the NTCP parameters for all 109 pa- tients were n=1.1,m=0.35 and TD_(50) (1)=38.5 Gy.The n,m,TD_(50) (1) estimated from patients with Child-Pugh A was 1.1,0.28,40.5 Gy,respectively,compared with 0.7,0.43,23 Gy respectively,for patients with Child-Pugh B.Conclusions Primary liver cancer patients who possess Child-Pugh B cirrho- sis would present a significantly greater susceptibility to RILD after hypofractionated CRT than patients with Child-Pugh A cirrhosis.The predominant risk factor for developing RILD is the severity of hepatic cirrhosis in the liver of PLC patients.