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.

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

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.

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.

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: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.

Objective To discuss the feasibility of non-invasive quantitative evaluation of hepatic fibrosis by contrast-enhanced ultrasonography (CEUS) parameters. Methods CEUS of liver and liver biopsy were performed in 86 patients. CEUS parameters including area under curve of portal vein/hepatic artery(Qp/Qa) ,perfusion intensity of portal vein/hepatic artery(Ip/Ia), decreasing rate of liver parenchyma perfusion (β) and perfusion time of portal vein (Tp) were calculated based on CEUS images. Differences of the four parameters among stages of hepatic fibrosis were analyzed by ANOVA and Spearman rank correlation test was applied to analyze correlation between parameters and hepatic fibrosis stages. Areas under receiver operating characteristic (ROC) curves were calculated to evaluate the diagnostic accuracy of parameters. Results Tp and β had increasing tend while Ip/Ia and Qp/Qa had declining tend from S0 to S4.They were significantly correlated with fibrosis stage( P ＜0.05＝. The areas under ROC curves of Ip/Ia were 0.931 (≥S1) ,0.884(≥S2 ) ,0.820(≥S3 ) and 0.846(S4 ) respectively. The areas under ROC curves of Qp/Qa were 0.914(≥S1),0.813(≥S2),0.845(≥S3) and0.869 (S4) respectively. Conclusions CEUS parameters of liver parenchyma Ip/la, Qp/Qa, Tp and β are related to fibrosis stages. Ip/Ia and Qp/Qa provide a reliable,non-invasive method for evaluating fibrosis stages.

Background Diclofenac sodium eye drops,pranoprofen eye drops and bromfenac sodium hydrate eye drops are three clinical commonly used nonsteroidal anti-inflammatory drugs(NSAIDs).The variation of cytoxicity among these drugs and whether the cytoxicity is related to the supplements are also unknown.Objective This study was to compare the cytotoxicity of three non-steroidal anti-inflammatory eye drops and their active components with cultured human corneal epithelial cells (HCECs) in vitro,and to discuss toxic origins of these drugs.Methods HCECs were cultured in different drugs with the final concentration of 0.10％,0.05％,0.02％ and 0.01％.Cell proliferation was evaluated by MTT assay.Then,0.002％ eye drops (1∶50) was added,and the migration and damage of the cells were deceted by transwell migration assay and lactate dehydrogenase (LDH) assay.Results The cytotoxicity of three nonsteroidal anti-inflammatory eye drops on HCECs was concentration-dependent (all at P=0.00).Diclofenac sodium eye drops showed the most dominant effects on the proliferation,migration and damage of HCECs among the three eye drops,while bromfenac sodium eye drops showed the least effect on the cell damage (proliferation:Fdrug =20.25,P=0.00;migration:F =103.43,P =0.00;damage:Fdrug =164.16,P =0.00).Compared with the eye drops,their active components showed less cytoxicity.Pranoprofen appeared the least effects on the proliferation,migration and damage of HCECs (proliferation:Fdrug =332.27,P =0.00;migration:F =332.27,P =0.00;damage:Fdrug=154.83,P=0.00).Conclusions The cytotoxicity ofdiclofenac sodium eye drops is more obvious than that of pranoprofen eye drops or bromfenac sodium hydrate eye drops.The cytotoxicity of the three eye drops originates from their supplements or the interaction between the supplements and active components.