Objective To investigate the CT angiography techniques of the pulmonary artery and aorta at a time.Methods Twenty-three patients who underwent the 64-slice spiral CT examinations of pulmonary and aortic angiography at a time were analyzed retrospec-tively (Group A).Also,13 cases whose pulmonary angiography showed normal (Group B)and 13 cases whose aortic angiography showed normal (Group C)enrolled in this study as control groups.The contrast media dose and the radiation dose were analyzed among three groups.The abnormal blood vessels were observed,and the CT values of the normal pulmonary artery and aorta and the number of the pulmonary 4,5 grade were compared among all groups.Results The contrast media dose in Group A was more than that in Group B or Group C,but less than the sum of that in Group B and Group C.The radiation dose in Group A was equivalent to that in Group C,which was obviously less than the sum of that in Group B and Group C.Six of 23 cases were accurately diagnosed as pul-monary embolism,1 case as pulmonary malformation,4 cases as aortic dissection whose true and false lumens clearly showed with contrast,5 cases as aortitis,and 10 cases as aortic atherosclerosis.For the cases whose angiography showed normal,there was no statistically significance of the number of the 4,5 grade of pulmonary artery and the CT values of pulmonary artery and the aorta compared with those of the control group (P >0.05 ).Conclusion The 64-slice spiral CT can be used to complete pulmonary and aortic angiography at a time,and the contrast media dose and the radiation dose can be reduced obviously.

Objective To detect the ascites CD64 index of patients with decompensated cirrhosis ,and explore the value in the di-agnosis of spontaneous bacterial peritonitis (SBP) .Methods Decompensated cirrhosis with ascites patients were divided into non-SBP group ,SBP suspected group and SBP diagnosed group .Two control groups were composed of patients with ascites culture pos-itive and non-SPB group .SBP suspected group were further grouped according to abdominal pain and the percentage of peripheral blood neutrophils .The CD64 index was detected by flow cytometry .Compared the difference of ascites CD64 index after treatment , and analyzed diagnosis performance of procalcitonin in human peripheral blood and ascites white blood cell count of SBP .Results The level of the ascites CD64 index was significantly higher in SBP diagnosed group (179 .39 ± 65 .56)and SBP suspected group (115 .49 ± 58 .42)than that of non-SBP group(26 .88 ± 26 .05)(P<0 .01) .The differences of the ascites CD64 index between SBP suspected associated with abdominal pain group and SBP suspected associated with painless group was not statistically significant (P>0 .05) .The level of the ascites CD64 index in SBP suspected with percentage of peripheral blood neutrophils elevated group was increased significantly than non-elevated group(P<0 .05) .CD64 index level in effective treatment group was significantly lower than the ineffective treatment group(P<0 .01) .The area of the ascites CD64 index under the curve was greater than procalcitonin in human peripheral blood and ascites WBC count ,and had a higher sensitivity and specificity .Conclusion The detection process of the ascites CD64 index is fast and with less influential factors ,which provides a new choice for the clinical diagnosis of SBP .

Adult ; Female ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Interferon-alpha ; adverse effects ; therapeutic use ; Nephrotic Syndrome ; etiology

OBJECTIVETo observe the changes in expression of microRNA-203 and P63 in human epidermal stem cells and KCs, and to investigate their effects and significance in the epidermal proliferation and differentiation.

METHODS(1) Five normal foreskin tissue specimens were collected from 5 patients by circumcision in Department of Urinary Surgery of the First Affiliated Hospital of Nanchang University from March to June in 2013. Then single cell suspension was obtained by separating epidermis with trypsin digestion method. The cells were divided into quick adherent cells and non-quick adherent cells by type IV collagen differential adherent method. The biological characteristics of cells were observed by inverted phase contrast microscope immediately after isolation and on post culture day (PCD) 3. The expression of CD29, keratin 19, keratin 1, and keratin 10 was identified by immunocytochemical staining. The expression of microRNA-203 and mRNA of P63 was determined by real-time fluorescent quantitative RT-PCR. The protein expression of P63 was determined by Western blotting. Data were processed with t test and Pearson correlation analysis.

RESULTS(1) Immediately after isolation, quick adherent cells were small, round, and dispersed uniformly. On PCD 3, the cells adhered firmly, and they grew in clones. Immediately after isolation, non-quick adherent cells appeared in different shapes and sizes, and dispersed unevenly. On PCD 3, the cells adhered precariously and did not show clonal growth. Quick adherent cells showed positive expression of CD29 and keratin 19, while non-quick adherent cells showed positive expression of keratin 1 and keratin 10. Quick adherent cells were identified as epidermal stem cells, and non-quick adherent cells were identified as KCs. (2)The expression level of microRNA-203 in epidermal stem cells (0.74 ± 0.20) was lower than that in KCs (3.66 ± 0.34, t =16.582, P <0.001). The mRNA expression level of P63 in epidermal stem cells (4. 16 ± 0.28) was higher than that in KCs (2.90 ± 0.39, t =5. 850, P =0.001). The protein expression level of P63 in epidermal stem cells (1.42 ± 0.05) was higher than that in KCs (0.73 ± 0.03, t =26.460, P <0. 001). (3) The expression level of microRNA-203 was in significantly negative correlation with the expression levels of mRNA and protein of P63 (with r values respectively - 0. 94 and -0.98 , P values below 0.05).

CONCLUSIONSThe expression levels of microRNA-203 and P63 in human epidermal stem cells and KCs were significantly different, which might be related to the different characteristics of proliferation and differentiation of the cells.

Cell Differentiation ; Cells, Cultured ; Epidermis ; cytology ; growth & development ; Epithelial Cells ; cytology ; metabolism ; Gene Expression Profiling ; Gene Expression Regulation, Developmental ; Humans ; Integrin beta1 ; Keratin-10 ; genetics ; metabolism ; Keratin-19 ; genetics ; metabolism ; Keratinocytes ; Male ; Membrane Proteins ; genetics ; metabolism ; MicroRNAs ; genetics ; metabolism ; Stem Cells ; cytology ; metabolism

Objective To study the expression and change of neuropeptide substance P (SP) during the wound healing of deep partial thickness scalding in diabetic rats. Methods Eighty-four Wistar rats were randomly divided into diabetes mellitus group (n=42) and control group (n=42). Diabetic rat models were established by intraperitoneal injection of streptozotocin (STZ) in diabetes mellitus group, and those in control group were intraperitoneally injected with aseptic citrate buffer solution. Deep partial thickness scalding with diameter of 2 cm on the back were prepared in all the rats. The pre-scalding and post-scalding wound specimens of different time points were obtained, and the percentages of wound closure were calculated. The wound specimens were also obtained for immunohistological staining to compare the areas with positive staining of SP, and ELISA was employed to detect the expression of SP in the wound tissues. Results The percentage of wound closure was significantly lower in diabetes mellitus group than that in control group from 7 days post-scalding (P< 0.01). The areas with positive staining of SP in diabetes mellitus group were much smaller than those in control group at different time points, which was most significant on the seventh day post-scalding[(1 350.93±99.28) μm2 vs(1 715.86± 103.41) μm2](P < 0.01). The expression of SP in the wound tissues was significantly lower in diabetes mellitus group than that in control group at different time points, which was most significant on the seventh day post-scalding[(114.04±9.96) vs(143.39±8.94)](P<0.01). Conclusion The significantly lower expression of SP in wound site may be one of the causes of delayed wound healing in diabetic rats.

Medical ethics is correlated with further development of affiliated teaching hospital.Our hospital took ‘ Bethune spirit’ and philosophy of forgiveness and kindheartedness as guidance and became the first batch of Bethune spirit model hospital of Chongqing.Teaching quality was improved by providing lectures about ‘ Bethune spirit’ for medical students and equally emphasizing medical knowledge and medical ethics education.Anti-corruption and academy governing movements with the subject of ‘ Bethune spirit’ were carried out to repel academic misdeed,with the result that clinical,teaching and scientific works were promoted and advanced.

Objective To validate the effect of anti-infective reconstituted bone xenograft (ARBX) in treating posttraumatic osteomyelitis by one-stage grafting in the adults.Methods With clinical application approval of Medical Command,Logistics Ministry of PLA,ARBX was used to treat 27 adult patients (29 lesions) with posttraumatic osteomyelitis by one-stage grafting after debridement since September 2001.The study analyzed 27 patients (29 grafts) who were followed up for average 26 months (12-63 months).Results The follow-up for average 26 months (12-63 months) in 27 patients showed that infection of 22 patients (24 lesions) was controlled and cured,except for three with failure to control the infection or with recurrence of infection,two with controlled infection but with postoperative nonunion.The infection control rate was 89.7% (26/29) and the cure rate was 82.8% (24/29) ,which were better than the results of traditional therapy.Conclusions ARBX has high osteoinductive activity and enhanced anti-infective capability,which enables it to be used as one-stage grafting to treat posttraumatic osteomyelitis in the adults.

Brain Abscess ; diagnosis ; etiology ; therapy ; Cerebellar Diseases ; diagnosis ; etiology ; therapy ; Ear Diseases ; complications ; Humans ; Male ; Young Adult

Nosocomial infection (NI) is one of the most significant complications arising after open heart surgery,and leads to increased mortality,hospitalization time and health resource allocation.This study investigated the morbidity,mortality,and independent risk factors associated with NI following open heart surgery.We retrospectively surveyed the records of 1606 consecutive cardiovascular surgical patients to identify those that developed NI.The NI selection criteria were based on the Centers for Disease Control and Prevention (CDC) guidelines.The term NI encompasses surgical site infection (SSI),central venous catheter-related infection (CVCRI),urinary tract infection (UTI),respiratory tract infection and pneumonia (RTIP),as well as other types of infections.Of 1606 cardiovascular surgery patients,125 developed NI (7.8％,125/1606).The rates of NI following surgery for congenital malformation,valve replacement,and coronary artery bypass graft were 2.6％ (15/587),5.5％ (26/473) and 13.6％ (32/236),respectively.The NI rate following surgical repair of aortic aneurysm or dissection was 16.8％ (52/310).Increased risk of NI was detected for patients with a prior preoperative stay ≥3 days (OR=2.11,95％ CI=1.39-3.20),diabetes (OR=2.00,95％=CI 1.26-3.20),length of surgery ≥6 h (OR=2.26,95％ CI=1.47-3.47),or postoperative cerebrovascular accident (OR=4.08,95％ CI=1.79-9.29).Greater attention should be paid toward compliance with ventilator and catheter regulations in order to decrease NI morbidity and mortality following cardiovascular procedures.

OBJECTIVETo evaluate the efficacy and safety of entecavir (ETV) as a long-term treatment in patients with lamivudine (LAM)-refractory chronic hepatitis B (CHB).

METHODSIn this phase II study of ETV-056, 32 CHB patients with resistance to LAM monotherapy were administered ETV at 1.0 mg/day and monitored over a period of 8 years. The virologic, serologic and biochemical responses were measured throughout the treatment course. Outcomes analysis was conducted according to intention-to-treat principles.

RESULTSAt baseline and treatment weeks 8, 12, 24, 48, 96, 144, 192, 240, and 420, the proportion of patients with HBV DNA less than 300 copies/ml was 0, 6.3% (2/32), 9.4% (3/32), 18.8% (6/32), 18.8%(6/32), 46.9% (15/32), 43.8% (14/32), 50.0% (16/32), 50.0% (16/32), and 62.5% (20/32). At treatment weeks 48, 96, 168, 192, 240, and 420, the proportion of patients experiencing virological breakthrough was 6.1% (2/32), 9.4% (3/32), 12.5% (4/32), 18.8%(6/32), 25.0%(8/32), and 28.1% (9/32). In the 8 year study period, 32.3% (10/31) of patients achieved HBs seroconversion and four patients achieved HBe seroconversion.

CONCLUSIONWhile treatment with 1.0 mg/day ETV for up to 8 years resulted in mild HBV DNA suppression and increase of HBeAg seroconversion, the safety profile of this therapy was good but the economic cost was high and virological breakthrough rates were high.

Adolescent ; Adult ; Antiviral Agents ; adverse effects ; therapeutic use ; Drug Resistance, Viral ; Female ; Guanine ; adverse effects ; analogs & derivatives ; therapeutic use ; Hepatitis B, Chronic ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Male ; Middle Aged ; Treatment Failure ; Treatment Outcome ; Young Adult