Autoimmune Diseases ; diagnosis ; etiology ; therapy ; Humans ; Immunoglobulin G ; adverse effects ; blood ; chemistry

Objective To investigate the applicetion value of combined ultrasonic scalpel in laparoscopic cholecystectomy(LC).Methods 140 patients with acute and chronic cholecystitis,gallbladder stone patients,received intraoperative ultrasound combined electrosurgical knife,suction devices auxiliary red line LC.The clinical effects were observed.Results 138 cases were completed cholecystectomy.Blood loss ( 8.16 ± 1.85 ) ml,operation time(38.13 ±4.35) min,Postoperative hospital stay(3.25 ± 1.18)d,4 cases of intraoperative rupture of the gallbladder,Hepatobiliary burns in 1 case,2 cases because of dense adhesions around the gallbladder and gallbladder more extensive anatomical triangle unclear laparotomy.Conclusion The rational use of combined high-frequency ultrasonic scalpel knife,suction devices auxiliary red laparoscopic cholecystectomy,surgical conditions that meet medicalrecords,are safe and reliable,quicker recovery can be achieved by minimally invasive medical treatments.

Antineoplastic agents-induced pulmonary toxicity is one of important reasons causing respiratory failure,which clinical manifestations are pulmonary inflammation,allergic reaction,vascular permeability reaction and pulmonary vascular disease.All of these may be caused by drug toxicity,immune response and increased capillary permeability and so on.Because of the nonspecific performance,it is important to exclude the other lung diseases.Once the diagnosis is clear,the antineoplastic gents should be immediately stopped and the patients should be timely administered high-dose eorticosteroid therapy.How to reduce the pulmonary toxicity induced by antineoplastic agents is becoming one of the future focuses about antineoplastic agents research.

Objective To assess the role of MRI in the preoperative characterization and local staging of testicular neoplasms.Methods A retrospective study of 24 patients suspected of testicular neoplasm was conducted.The histological diagnosis of testicular neoplasms was made and local extension of testicular malignancy was evaluated.The MRI findings were correlated with the pathologic results.Results Histological examination revealed 26 intratesticular lesions,14 of which were nalignant,including 4 cases of diffuse large B cell lymphoma,7 cases of seminoma,2 cases of embryonal carcinoma,one case of teratoma.Twelve lesions were benign,including 5 cases of epidermoid cyst,2 cases of simple cyst,2 cases of inflammatory granuloma,2 cases of testicular mediastinal tubular expansion and one case of testicular pseudo fibroma.Six malignant testicular tumors were confined within the testis,4 invaded the testicular tunicae or epididymis,2 invaded the spermatic cord,and 2 invaded the scrotal wall.The accuracy of MRI in the diagnosis of intratesticular lesions was 92％.The accuracy of MRI diagnosis in the local staging of testicular tunors was 86％.Conclusions MRI is highly accurate in the preoperative characterization and local staging of testicular neoplasms.It is of great significance to the clinical diagnosis and treatment.

Objective To evaluate effectiveness of clinical pharmacists'intervention in perioperative antimicrobial use in type Ⅰ incisional surgery.Methods Clinical data of 1398 patients undergoing type Ⅰ incisional surgery in a hospital between January and December 2014 were analyzed retrospectively,633 patients who underwent surgery between January and June were as pre-intervention group,765 patients who underwent surgery between July and December were as post-intervention group (clinical pharmacists were assigned to strengthen the management and control of rational antimicrobial use),antimicrobial prophylaxis between pre-intervention group and post-interven-tion group were compared.Results In pre- and post-intervention groups,antimicrobial prophylaxis were 56.71%and 28.37% respectively(χ2= 113.26,P<0.05). Rational selection rates of antimicrobial types were 60.45% and 89.86% respectively,rational rates of administration time were 49.58% and 82.49% respectively,the rates of anti-microbial prophylaxis course≤24 hours were 11.42% and 29.95% respectively,>24 hours were 88.58% and 70.05% respectively,combination antimicrobial use were 10.31% and 0 respectively,the differences between before and after intervention were all statistically significant (all P<0.05). Incidence of surgical site infection in pre-and post-intervention groups were 0.79% (5/633)and 0.26% (2/765)respectively(P= 0.255).Conclusion Through clini-cal pharmacists'intervention in perioperative antimicrobial prophylaxis in type Ⅰ incisional surgery,antimicrobial prophylax-is rate decreased dramatically,antimicrobial management is more standardized,scientific and systematic.

Air Pollutants ; analysis ; Dust ; analysis ; Environment Design ; Environmental Monitoring ; instrumentation

Objective To investigate the clinical features, diagnosis and treatment of acute mesenteric isehe-mic disease. Methods Clinical data of 15 patients with acute mosenteric ischemic disease were analyzed retrospective-ly. Results Operation was performed on 14 patients and 1 patient received conservative treatment, 9 cases recovered and 5 died postoperatively. Conclusion Color ultrasound and selective angiography are effective examinations for early diagnosis of acute mesenterie ischemic disease. Early resection of necrotic bowel and application of anticoagulant post-operatively are effective to reduce the mortality. Conservative treatment is still effective for elective patient.

Objective To observe the protection of Chaishao Chengqi decoction to the intestinal mucosal barrier in rats with severe acute pancreatitis.Methods 72 SD rats were randomly divided into normal control group,SAP group and Chaishao Chengqi decoction therapeutic group.10%L-arginine was injected into the rats abdominal to establish SAP models. Chaishao Chengqi decoction 1ml.kg-1 was injected into the rats' stomach of therapeutic group and repeated injections were given per 6 hours until the rats were executed. Normal control group and SAP group were given isodose stroke-physiological saline solution. Specimens were get at 6,12,24 and 48h for detections:①Pathological change of pancreas and Ileal mucous membrane;②Apoptotic index of Ileal mucous membrane;③TNF-α contents of blood serum. Results Apoptotic index of Ileal mucous membrane in SAP group was significantly higher than Normal control group and therapeutic group(P＜0.05);TNF-α contents of SAP group was significantly higher than normal control group and theraroup(P＜0.05);Pathological lesion of pancreas and Ileal mucous membrane of therapeutic group was slighter than SAP group.Conclusions Our experiment suggested that excessus apoptosis of intestinal mucosa was one of the main mechanisms of mucosal barrier function disorder in SAP. Chaishao Chengqi decoction has a protective effect on the intestinal mucosal barrier function.

[Objective]To explore the relationship between Pglycoprotein,survivin expression and chemotherapy outcome.[Method]The expressions of P-glycoprotein,and of survivin were examined by the immunohistochemistry in 38 specimens of preoperation biopsy of osteosarecomas.[Result]The response rate of the P-glycoprotein positive group was lower than that of P-glycoprotein negative group.The response rate of the survivin overexpression group was significant lower than survivin was found to be more valuable in predicting chemotherapy results.[Conclusion]The expressions of P-glycoprotein,and of survivin are clearly associated with osteosarcomas response to chemotherapy in osteosarecoma and survivin is a more valuable parameter.

[Objective] To compare the expression of matrix metalloproteinase 2(MMP-2)and matrix metalloproteinase 9(MMP-9)induced by alumina and ultra-high-molecular-weight polyethylene(UHMWPE)wear particles,and investigate the role of MMP-2 and MMP-9 in the mechanism of the periprosthetic osteolysis induced by wear debris during aseptic loosening.[Methods]Seventy-two Kunmin mice were divided into 3 groups(24 per group)in a murine air pouch model of inflammation.The air pouches were injected with 3ml of suspension containing 1?108 /ml alumina particles in group A,while UHMWPE particles in group B,and control pouches received 3ml of sterile PBS.All animals were sacrificed at 3、7、14 days after injection.Histological changes and cell counting were assessed by light microscope.RT-PCR and immunohistochemistry method were applied to detect the gene and protein expression of MMP-2 and MMP-9 in the pouches.[Results]Increased cell infiltration and MMP-2,MMP-9 mRNA and immunoreactivity expression were detected in group A and B,and compared to control group,cell number and gene and protein expression of MMP-2 and MMP-9 in group A and B was significantly higher(P