Paraquat is a commonly used herbicide,which can cause acute poisoning due to misusage or suicide.The mortality of acute paraquat poisoning is high,the prognosis is poor,and there is no specific an-tidote for the poisoning.Most scholars believe that early blood purification is the first choice for the treatment of acute paraquat poisoning.However,there is not a unified standard about what kind of blood purification methods and the specific parameters should be taken for the different periods of paraquat poisoning.

Objective To explore the clinical value of video-assisted thoracoscopic mediastinal tumor resection.Methods The clinical data of 32 patients(observation group) who performed video-assisted thoracoscopic mediastinal tumor resection were retrospectively analyzed,compared them with 53 patients with mediastinal tumor who underwent traditional thoracotomy (control group).The clinical outcomes including operation time,intraoperative blood loss,chest drainage duration,postoperative hospital stay,postoperative complication and postoperative analgesia drug application were compared between two groups.Results No perioperative death was observed in two groups.There were no statistical difference in operation time between two groups [(121.9 ± 41.2) min vs.(141.7 ± 35.2) min] (P ＞ 0.05).The observation group was significantly better in the intraoperative blood loss [(116.0 ±53.2) ml],chest drainage duration [(5.2 ± 1.2) d],postoperative hospital stay [(8.5 ± 1.3) d],postoperative analgesia drug application [(0.8 ± 0.7) times],postoperative comolication (3 cases),than those of the control group [(147.2 ± 45.2) ml,(6.8 ± 2.2) d,(11.2 ± 2.4) d,(2.1 ± 0.9) times,15 cases].There were statistical differences between two groups (P ＜0.05).Conclusion Complete video-assisted thoracoscopic mediastinal tumor resection is a valuable way in the treatment of mediastinal tumor,rapidly recovery and less postoperative complication.

The key of hospital fast development is how to foster and use the talented persons,cause the hospital outstanding talent to be blooming,and form the situation which enables each person to develop his talents.The author thought that the following several points should be paid attention to:①full ensuring hospital personnel training mentality,②taking effective action and establishing the personnel training mechanism,③reasonably using and enabling eash person to develop his talents.

Objective The clinical distribution and drug resistance of isolated Acinetobacter Bauman strains were retrospectively analyzed in Xiangya Hospital Central South University in 2015,and its resistant transitions in ten years were also analyzed,to provide theoretical guidance for clinical rational use of antibiotics and control of infection.Methods 534 Acinetobacter Bauman strains were collected at Xiangya Hospital in 2015,the clinical distribution characteristics and drug resistance of Acinetobacter Bauman strains were analyzed according to specimen type,department,age and drug resistance result.Meanwhile,the drug resistance situation was compared with that in 2006 and 2011.Results The isolation rate of Acinetobacer Bauman from respiratory tract specimen was 76.78％,the tolal isolation rate from ICU,respiratory department of internal medicine,neurology department of internal medicine and neurosurgery department ward was 57.87 ％,and the infection patients over the age of 61 occupied 37.83 ％.Risperidone/Shubatan showed the best antibiotic activity with the resistance rate 3.02 ％ in ten drugs,the Acinetobacter Bauman strains were resist to other nine drugs in different level,with the percent from 50.0％ to 85.0％.The drugs of tobramycin and imipenem showed the greatest growth,with the resistance rate of 1.87％ and 11.70％ in 2006 in Xiangya hospital,increased to 69.85％ and 80.53％ in 2015,respectively.The drug of levofloxacin and cefepime also showed great growth in ten years with the increase of 58.81％ and 55.98％,respectively.Conclusion The clinical isolates of Acinetobacter Bauman strains mainly derived from respiratory tract specimen,and mainly distributed in ICU,the most infection people were from the older.The resistance rate of common drugs showed a significant increase in ten years,especially for cephalosporins and carbapenems.With the increase of multiple drug resistant strains,the monitoring of drug resistance of Acinetobacter Bauman and use of antibiotics rationally should be strengthened.

Objective To investigate roles of Homocysteine induced gene HCY2 in vascular smooth muscle cells (VSMC) Methods HCY2 was delivered into VSMC by replication defective adenovirus DNA fragmentation was investigated by DNA Laddering and cell death ELISA VSMC in sub G1 was detected by using flow cytometry Results DNA from VSMC transfected by HCY2 gene was cleaved into multiple nucleosomes and VSMC in sub G1 region increased after being infected with HCY2 Conclusion HCY2 is able to induce apoptosis in VSMC

OBJECTIVETo investigate the application of osteotomy template manufactured via 3D printing technique in bilateral sagittal split osteotomy (BSSO).

METHODSThe patient group consisted of 32 patients (17 males and 15 females) with mandibular hypoplasia who underwent a BSSO setback (Hunsuck modification; 64 splits). The mean age at the time of surgery was 23.5 years (range 1.9-35 years). All patients were scanned using cone beam computed tomography (CBCT) to create a 3D model of the mandibular, and the osteotomy template of the inner horizontal ramus of mandible bone incision was manufactured via 3D printing technique. All splits underwent operation with or without the osteotomy template by either a young doctor (attending doctor) or a doctor with extensive orthognathic surgery experience (chief doctor). The time it took to perform the mandible bone incision of the inner horizontal ramus of each group was recorded. Postoperative CBCT scan was performed, and the lingual split scale was used to assess the effect of the operation.

RESULTSPrimary healing of incisions was observed in all patients, and no serious complications occurred. The time it took to perform the mandible bone incision of the inner horizontal ramus was significantly different in the four groups (F=30.059, P<0.05), and it was longer in the group of the attending doctor without osteotomy template than in the other three groups (P<0.05). No significant difference was observed in the other groups (P>0.05). Although all splits (n=64) were performed according to the standardized protocol, only 59.38% (38/64) of the fracture lines run according to the Hunsuck's description. By contrast, only 21.88% (14/64) run through the mandibular canal and 18.75% (12/64) was split. The database was analyzed using crosstabs and via Fisher exact test. The split pattern was influenced by the application of an osteotomy template (P<0.05).

CONCLUSIONThe application of osteotomy template manufactured via 3D printing technique in BSSO was effective, which enabled the young doctor to complete the operation faster and with good results.

Objective:This study aimed to investigate the associations between single-nucleotide polymorphism (SNP) of IGF-1 and IGFBP-3 gene and risk of non-smoking female lung cancer in Chinese population. Methods:Genotyping was performed using the TaqMan method in 287 histologically confirmed non-smoking female lung cancer cases and 281 healthy controls. Results:The geno-type distributions of IGF-1 polymorphisms were significantly different between cases and controls (P<0.001). Analysis of multivariate logistic regression showed that the carriers of the CC genotype exhibited a significantly decreased risk of lung cancer in non-smoking female (adjusted OR=0.28, 95%CI:0.15-0.54). IGF-1 rs1520220 GG genotype may reduce the risk of advanced lung cancer incidence in nonsmoking female (adjusted OR=0.30, 95%CI:0.09-0.96). Log-rank test and Cox regression analyses revealed that variant geno-types of IGF-1 rs2946834 CT/TT had a significantly decreased lung cancer mortality risk compared with the homozygote CC in≥60 age group or patients with a lung tumor>3 cm. Conclusion:The IGF-1 polymorphism was associated with the risk of lung cancer and prognosis among non-smoking female. More rigorous laboratory studies of large sample population and functional studies are warrant-ed to confirm our findings.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal human cancers. Cur-rent studies on the relationship between complicated type 2 diabetes mellitus (T2DM) and PDAC prognosis have demonstrated inconsis-tent results. The present study aimed to determine the relationship between complicated T2DM and the clinicopathological characteris-tics of PDAC, and evaluate whether complicated T2DM is a significant predictor for overall survival in patients with resectable PDAC. Methods: In this study, clinicopathological characteristics were observed in 136 patients who underwent surgery for PDAC at the Shengjing Hospital of China Medical University between January 2009 and February 2011. The relationship between complicated T2DM and overall survival of PDAC patients was analyzed using univariate and multivariate analyses. Results:The median age of pa-tients was 60 years (range: 35-80 years). Among the 136 patients, 76(55.9%) were male. The prevalence of complicated T2DM was 27.9%in 136 PDAC cases. Preexisting T2DM was not associated with any of the clinicopathological characteristics (all P>0.05). Uni-variate analysis showed that complicated T2DM (P=0.045), maximum diameter (P=0.011), histological differentiation (P=0.013), pT stage (P=0.034), vessel invasion (P=0.032), and pTNM stage (P=0.030) were significantly associated with the overall survival of PDAC patients. The median overall survival time was 14.2 months for T2DM patients, and 18.8 months for non-T2DM patients. In mul-tivariate analysis, complicated T2DM [hazard ratio (HR), 1.873;95%confidence interval (CI), 1.187-2.954;P=0.007], poorly differenti-ated tumor (HR, 2.647;95%CI, 1.413-4.957;P=0.002), and maximum diameter≥4.0 cm (HR, 1.699;95%CI, 1.094-2.640;P=0.018) were the independent predictors associated with poor overall survival. Conclusion:Complicated T2DM was associated with poor prog-nosis. It could be used as a prognostic predictor in patients with resectable PDAC. If confirmed, these findings may provide a novel ap-proach for individualized adjuvant therapy.

Objective To investigate antimicrobial resistance,distribution,and carriage of carbapenemase genes of Acinetobacterbaumannii(AB)from two hospitals in Qingdao.Methods 145 AB isolates collected from two hospi-tals (78 from hospital A,67 from hospital B)were performed antimicrobial susceptibility testing,carbapenemase genes were amplified by polymerase chain reaction (PCR);homology analysis were conducted with enterobacterial repetitive intergenic consensus (ERIC)-PCR.Results AB from hospital A were generally resistant to 16 commonly used antimicrobial agents,with the lowest resistant rate of 3.85% to cefoperazone/sulbactam,followed by resist-ance rate of 16.67% to minocycline,resistant rates to the other antimicrobial agents were all>73% . AB from hos-pital B were generally resistant to 23 commonly used antimicrobial agents,but the resistance rates to minocycline and tigecycline were both 0,resistance rates to amikacin and levofloxacin were 23.88% and 38.81% respectively, resistant rates to the other antimicrobial agents were all >64% . All strains carried OXA-5 1 gene,the carriage rates of OXA-23 gene in carbapenem-resistant group were 86.76% (59/68)and 56.67% (34/60)in hospital A and B re-spectively,the difference was significant(χ2= 14.53,P<0.001);OXA-58 gene was detected in 3 isolates in hospi-tal A but not detected from hospital B. 145 AB strains were classified into 8 types,the major prevalence types were type A (n= 71)and E(n= 37);the major prevalence types in hospital A were type A (46.15% )and E(41.03% ), hospital B were type A (52.24% )and C (17.91% ).Conclusion Antimicrobial resistance of clinically isolated AB is serious and prevailed in two hospitals. OXA-23 and OXA-51 genes play an important role in AB resistance to car-bapenems.

Objective To investigate the long-term effect of direct percutaneous coronary intervention (PCI) on left ventricular remodeling in patients aged ≥75 years with acute myocardial infarction (AMI).Methods 108 cases of patients with acute myocardial infarction were collected into the study.Direct PCI were completed in patients in PCI group within 12 hours of onset.Patients in non-PCI group received conventional conservative treatment with drugs.Patients were followed up for 0.5-8.0 years,and cardiac function (NYHA) and the detected ultrasonic cardiogram were evaluated during follow-up.Results The 106 patients received follow-up.Two female patients who were not treated with PCI died during follow-up,one patient died of sudden cardiac death and another patient died of severe pneumonia.Compared with non-PCI group,direct PCI group showed that cardiac function (NYHA) grade was lower(t=3.17,P＜0.05),the end-systolic and end-diastolic volume of left ventricle were less(t=3.50、3.90,all P＜0.01),the left ventricular ejection fraction was increased (t=2.00,P＜0.05),the ventricular wall motion index was smaller (t=2.96,P＜0.01).E/A ratio was higher,E wave deceleration time was shorter,and left ventricular mass index was smaller (t=4.04,4.29,4.70,respectively,all P＜0.01),the left ventricular long and short axis diameter were decreased (t=2.30,t=5.53,P＜0.05 or 0.01),and Spherical index was increased (t=2.97,P＜0.01).Conclusions Direct PCI treatment improves chronic ventricular remodeling in elderly patients with AMI and contributes to long-term improvement in cardiac function.