There is endothelial hyperpermeability in sepsis,trauma,ischaemia-reperfusion injury,acute respiratory distress syndrome and thrombosis,while an important mechanism underlying this process is increased paracellular leakage of plasma fluid and protein because of cytoskeleton contration under the role of histamine, thrombin,vascular endothelial growth factor and activated neutrophil. Structural changes initiate with agonist-re-ceptor binding,followed by activation of intracellular signalling molecules,then phosphorylate alter the hyperme-ability of cell-cell adhesion. Targeting key signalling molecules that mediate endothelial-junction-cytoskeleton dissociation demonstrates a therapeutic potential to improve vascular barrier function during inflammatory injury.

Objective To study the histocompatibility of domestic new type nitinol alloy ventricular septal defect(VSD) occluder in order to test the feasibility for clinical application.Methods The domestic new type nitinol alloy VSD occluder was inserted into 20 healthy dogs with intravenous balanced anesthesia and tracheal intubation,assisted by animal breathing machine respiration.The dogs were given oral antibiotic and would be killed in several months after operation.According to different slaughter time(1,2,3,6 months),they were divided into 4 sections and including 5 dogs in each section.The occluder sites,the intimal coverage and the change of inflammatory cells were observed through gross anatomy,with the help of the light microscope and electron microscope.SPSS 11.0 software was used to analyze the data.Results The thickness of the endocardial enhanced with the time(P

Objective To observe and analyze the change situation of trace elements and cytokines in the patients with leukoderma.Methods Sixty-two patients with leukoderma in our hospital from June 2013 to January 2016 were selected as the observation group and contemporaneous 62 individuals undergoing physical examination were selected as the control group.Then the serum trace elements and cytokines levels were compared between the two groups and the detection results of above serum indexes in the observation group were compared among different grades and stages too.Results The serum trace elements levels of the observation group were all lower than those of the control group,the serum interleukin 10(IL-10)level was lower than that of the control group,while other serum cytokines levels were all higher than those of the control group,moreover the detecfion results of above serum indexes in the observation group had statistical differences among different grades and stages(P＜0.05).Conclusion Leukoderma has obvious effect on trace elements and cytokines and the influence of differente grades and stages of leukoderma on their expressions is inconsistent.

OBJECTIVE To find the distribution of pathogens and their antibiotics sensitivity in patients with bile duct diseases in order to guide clinical uses of antibiotics. METHODS Totally 128 bile samples were collected for bacterial cultures and sensitivity tests. RESULTS Pathogens were found in 68 samples(53.0%).The common pathogens were Escherichia coli(22.9%),Klebsiella pneumoniae(15.7%),Pseudomonas aeruginosa(11.4%) and Enterococcus faecalis(10.0%).Most bacteria were sensitive to imipenem,vancomycin,imipenem/cilastatin(Tienam),third and fourth generation cephalosporins;but resistant to penicillins,second-generation cephalosporins,macrolides and quinolones. CONCLUSIONS The most pathogenic bacteria in biles are E.coli,K.pneumoniae and Ent.faecalis and the antibiotic sensitivity tests can help clinical application of antibiotics.

Objective To discuss and evaluate the value of insertion of inferior vena cava filter in treating lower extremity deep venous thrombosis(DVT).Methods Inferior vena cava filters were placed in 46 patients with lower extremity DVT prior treatment,20 in which were treated by therapy with anticoagulation and thrombolysis,and therapy with pressure gradient,and the other 26 patients by operation and thrombolysis therapy,and therapy with pressure gradient.Whether patients occurred pulmonary embolism was observed and the form and site of filters were monitored by periodic fluoroscopy.Results Inferior vena cava filters were placed successfully in all patients,38 cases were implanted permanence inferior vena cava filter,8 cases were implanted temporary inferior vena cava filter.Symptoms and signs of DVT disappeared or remitted in 44/46 patients after treatment.None of pulmonary embolism was occurred.Follow up 2-24 months(average 13 months) for 36 cases with permanence inferior vena cava filter,there was no complication of the filter and pulmonary embolism occurred.Conclusions The method of inserting inferior vena cava filter is simple and safe,which can prevent pulmonary embolism effectually to offer sufficient safeguard for the treatment of DVT.

Air ; analysis ; Chromatography, Gas ; methods ; Phenylphosphonothioic Acid, 2-Ethyl 2-(4-Nitrophenyl) Ester ; analysis ; Workplace

ObjectiveTo investigate the popularity of the sedated gastrointestinal endoscopy in mainland China.MethodsThe survey on the popularity of the sedated gastrointestinal endoscopy was conducted with questionnaires sent by e-mails or telephones to the GI endoscopy units of three levels of hospitals.ResultsFrom May,2010 to November,2010,169 units from 28 provinces (90.3％ ) were enrolled,including 46 hospitals of grade Ⅲ,91 of grade Ⅱ and 32 of grade Ⅰ.Sedated gastrointestinal endoscopy were performed in 110 (65.1％,110/169) hospitals,i.e.93.5％ (43/46) grade Ⅲ hospitals,68.1％(62/91) grade Ⅱ hospitals and 15.6％ (5/32) grade Ⅰ hospitals.Significant difference was observed between the grade Ⅲ and the grade Ⅱ hospitals (P ＜ 0.05 ),so was between the grade Ⅱ and the grade Ⅰ hospitals ( P ＜ 0.05 ).Propofol was frequently used in sedation in 98 hospitals ( 89.1％ ).The only 9.1％( 10/110)hospitals,which had full-time anesthetists or anesthetic nurses,were all grade Ⅲ hospitals.ConclusionThere has been great progress in the popularity of sedated gastrointestinal endoscopy in mainland China during the past decade.However,it is less frequently pefformed in grade Ⅰ and Ⅱ hospitals.Shortage of full-time anesthetists is still a problem.

Objective To observe the TCM syndromes of acute exacerbation of chronic obstructive pulmonary disease (COPD) with malnutrition. Methods TCM Syndromes Questionnaire of Acute Exacerbation of COPD was formulated with TCM clinical epidemiology methods. Totally 220 cases of hospitalized patients met the inclusion criteria were divided into two groups, 120 cases of malnutrition and 100 cases of non-malnutrition. The clinical data were observed and syndrome elements of malnutrition group and non-malnutrition group were analyzed to discuss the rule of syndromes in acute exacerbation period. Results In addition to respiratory system, the frenquency of symptoms such as weight loss, shortness of breath, easy cold, aversion to wind and cold, poor appetite, abdominal distension, constipation, belching, dizziness and tinnitus, tooth loose and hair loss, soreness and weakness of waist and knees significantly increased in COPD with malnutrition, mainly involving in syndromes of spleen deficiency and incoordination between spleen and stomach. In patients with acute exacerbation of malnutrition COPD, the single syndromes were 36 cases (30%), the composite syndromes were 84 cases (70%). The simple excess syndromes were 38 cases (31.67%), the simple deficiency syndromes were 23 cases (19.17%), and the intermingled deficiency and excess syndromes were 59 cases (49.17%). Conclusion Patients with acute exacerbation of COPD with malnutrition are mainly composite syndromes and the intermingled deficiency and excess syndromes. Spleen deficiency and incoordination between spleen and stomach may be the important pathogenesis of COPD with malnutrition.

BACKGROUND:Denis B thoracolumbar burst fractures are common spinal injury and may be involved in the upper end plate injury. Fracture reduction and pedicle screw fixation are used to repair above injury. This scheme can effectively achieve the aim of correcting deformity, but the trabecular bone after crushing cannot be fuly recovered. OBJECTIVE:To observe the repair effect of fracture reduction and pedicle screw fixation + artificial bone graft in vertebral body on Denis B thoracolumbar burst fracture, and compare with fracture reduction and pedicle screw fixation alone. METHODS:Clinical data of 70 cases of Denis B thoracolumbar burst fractures, who were treated in the Department of Orthopedics, Zhangjiagang Aoyang Hospital from January 2012 to December 2014, were retrospectively analyzed. According to repair scheme, they were equaly divided into two groups. Patients in the control group received fracture reduction and pedicle screw fixation. Patients in the observation group received fracture reduction and pedicle screw fixation + artificial bone graft in vertebral body. Oswsetry Disability Index, height of anterior border of injured vertebral body, lower back pain visual analogue scale and vertebral kyphosis Cobb’s angle were compared and observed between the two groups before repair, 1 week, 3 and 6 months after repair. RESULTS AND CONCLUSION:No significant difference in Visual Analogue Scale was detected at 1 week, 3 and 6 months after repair between the observation and control groups (P > 0.05). Oswsetry Disability Index was significantly lower in the observation group than in the control group (P < 0.05). No significant difference in the height of anterior border of injured vertebral body was detected between the observation and control groups (P > 0.05). Cobb’s angle was significantly lower in the observation group than in the control group (P < 0.05). These findings suggest that fracture reduction and pedicle screw fixation + artificial bone graft in vertebral body obtained good repair effects on Denis B thoracolumbar burst fracture, not only effectively corrected Cobb’s angle and the height of anterior border of injured vertebral body, but also helped to restore normal spinal loads by filing bone in the injured vertebral body.

The hepatocellular carcinoma (HCC) is one of the most common malignant tumors.Patients with hepatobiliary cancer suffer from multiple symptoms,such as physical symptoms and psychology symptoms.In recent years,along with the further research of symptoms,the concept of symptom clusters occurred.Those two issues have always been the hot topics in recent years.Through the efforts of experts at home and abroad,there has been a part of progress in this area.However,the results are not the same.There are lots of disputes in the numbers、sequence、incidences of the symptom clusters.The paper will discuss this issue from symptom experience and symptom clusters in order to provide the reference and basis for symptom management.