Objective To investigate the correlation of HIF-1α and hypoxia in keloids fibroblasts, and to investigate the mechanism that hypoxia promotes abnormal scarring by HIF-1α pathway. Methods Keloid fibroblasts cultured in vitro were placed in an incubator with different O2 concentrations. After 24 h, the keloid fibroblasts were collected for further study. Western blotting was performed to detect the expression of HIF-1α in the keloid fibroblasts. Results Relative amounts of HIF-1α in keloid fibroblasts cultured under O2 concentrations at 20 %, 10 %, 5 % and 1 % were 0. 007 ±0. 006, 0. 133 ±0. 006, 0. 537±0. 015 and 0. 903±0. 021, respectively. It indicated that hypoxia could increase the expression of HIF-lα in keloid fibroblasts. Conclusions Hypoxia can induce the expression of HIF-1α in fibroblasts of keloids. Moreover, there still is a positive relation between hypoxia and the expression of HIF-1α. Therefore, a close relationship exists between abnormal scarring and HIF-1α pathway by hypoxia.

Objective To evaluate the role of curved-cutter-stapler in anus-preserving for low rectal cancer.Methods The clinical data of 32 patients with low rectal cancer from June 2007 to December 2008 who received low anterior resection and ultra low anterior resection by using curved-cutter-stapler were reviewed retrospectively.Results No operation death case,complete cutting and safe closure in all cases,one case was complicated with anastomotic leakage,and one case of rectovaginal fistula.Thirty patients were followed up 4 to 22 months after the operation,with an average time of 12.6 months,no hemorrhea of pelvic cavity and anastomotic stoma or anastomotic stenosis cases.Conclusion Curved-cutter-stapler has the advantages of complete cutting,safe closure and low complications,and easy being used in anus-preserving operation for low rectal cancer,which can increase the rate of anus-preserving.

Objective To understand and analyze the infection status of human parasites in Nanchang City, so as to offer a scientific basis for control of parasitic disease. Methods In 2014, a survey was performed according to the scheme of The 3rd National Survey of Principal Human Parasites. Intestinal parasites were surveyed among the residents in Jinxian County and Anyi County, Qingyunpu District and Qingshanhu District in Nanchang City, including the soil-transmitted nematodes (Ascaris lumbricoides, Trichuris trichiura and hookworm), Enterobius vermicularis, tapeworm and intestinal protozoa. Clonorchis sinensis was surveyed among the residents in Qingyunpu District and Qingshanhu District. Toxoplasma gondii was surveyed among the residents in two rural areas (Nanchang County and Xinjian County) and two urban areas (Donghu District and Xihu District). The ovums of the soil-transmitted nematodes, Clonorchis sinensis , tapeworm and other helminths were examined by the Kato-Katz, while Enterobius vermicularis among children was examined by cellophane anal swab, trophozoites and cysts of intestinal protozoa by saline smearing and iodine smearing , and IgG antibodies of Toxoplasma gondii by enzyme-linked immunosorbent assay (ELISA). Results Intestinal parasites were surveyed among 2424 residents in the whole city, in which 2414 residents were tested for the infection of soil-transmitted nematodes and tapeworm;1875 residents were tested for intestinal protozoa infection;74 children were tested for eggs of Enterobius vermicularis; 539 residents were tested for Clonorchis sinensis; and 2400 residents were tested for Toxoplasma gondii. Six kinds of intestinal parasites were found citywide, with a total infection rate of 9.49% (230/2424). The infection rate of soil-transmitted nematodes was 8 . 70% ( 210/2414 ) , in which the infection rate of Ascaris lumbricoides was 0.04% (1/2414), the rate of Trichuris trichiura was 0.91% (22/2414), and of hookworm was 7.83%(189/2414). The infection rate among 3 - 6 years old children of Enterobius vermicularis was 22.97% ( 17/74 ) . Tapeworm and Clonorchis sinensis were not found . The infection rate of intestinal protozoa was 0.21%(4/1875). The positive rate of Toxoplasma gondii's IgG antibody was 5.17% (124/2400). Conclusions In Nanchang City, the infection rate of soil-transmitted nematodes (Ascaris lumbricoides, Trichuris trichiura) and intestinal protozoa was lower. However, the infection rates of hookworm, Toxoplasma gondii and Enterobius vermicularis among 3 - 6 years old children are increasing in local areas. That should be the focus in prevention and control of parasitic disease in the future.

Objective To investigate the characteristics of pathogen distribution and drug resistance of pulmonary infection in hemorrhagic brain injury patients from neurosurgical intensive care unit (NICU).Methods Clinical data of 234 patients with hemorrhagic brain injury hospitalized in NICU from March 2013 to September 2014 were retrospectively analyzed.According to the incidence of pulmonary infection,the patients were divided into pulmonary infection group and non-pulmonary infection group.Parameters estimated were admission GCS,sex,age,history of smoking,time of coma,duration of mechanical ventilation,NICU length of stay.Patients in pulmonary infection group were analyzed on the distribution of pathogens and incidence of drug resistance.Results A total of 158 patients (67.5％) had pulmonary infection.Among them 60 cases (38.6％) were found to be co-infected including infection with two pathogens in 26 cases (16.5％),three pathogens in 19 cases (12.0％),and four and more pathogens in 16 cases (10.1％).Age and smoking increased the incidence of pulmonary infection (P ＜ 0.05).Time of coma,duration of mechanical ventilation,and NICU length of stay were prolonged in pulmonary infection group than in non-pulmonary infection group (P ＜ 0.05).A total of 219 strains of pathogens were isolated from the patients in pulmonary infection group.Specifically,there were 193 strains of gram negative bacteria (88.1％),13 strains of gram positive bacteria (5.9％),and 13 strains of fungi (5.9％).Gram negative were sensitive to amikacin,imipenem,cefoperazone/ sulbactam and ciprofloxacin.Staphylococcus aureus isolated were 100％ sensitive to vancomycin,linezolid and teicoplanin,and were completely penicillin resistant.Fungi were not resistant to voriconazole,itraconazole,ketoconazole,fluconazol,and amphotericin B.Conclusions High incidence of pulmonary infection is noted among the hemorrhagic brain injury patients in NICU,and the pathogens are diverse dominated by Gram negative bacteria.Incidence of multi-drug resistant pulmonary infection is high,indicating that the key point is to choose antibiotics rationally based on drug sensitivity test.

Objective To investigate the efficacy and safety of hypertonie saline enhanced radiofrequency ablation (RFA) in the treatment of liver cancer. Methods The clinical data of 42 patients with primary liver cancer (n = 28) or metastatic liver eancer (n = 14) who had been admitted to First Affiliated Hospital of Nanjing Medical University from September 2001 to December 2007 were collected. Forty-eight lesions were detected with a diameter ranging from 1.2 cm to 7.5 cm. RFA electrode and 20G needle were pricked into the target lesion under the guidance of B ultrasound or computed tomography (CT) through percutaneoas puncture or open approaches. An amount of 5-10 ml hypertonie saline was infused through the needle at regular intervals during RFA. All patients were followed up for 3-79 months. Contrast-enhanced ultrasound and CT scanning were performed postoperatively to determine the efficacy of RFA. The levels of alpha-fetoprotein (AFP) before and after treatment were compared using t test, and the survival of the patients were analyzed using a Kaplan-Meier survival curve. Results The AFP expression changed to negative in 14 out of the 18 AFP-positive patients, with statistical difference (t =7.703, P <0.05). The complete necrosis rate of tumors was 94% (45/48), and the necrosis rate of tumors with diameter of ≤4.0 cm reached 100% (35/35). The incidence of complication was 5% (2/42). No perioperative mortality occurred. The 1-, 2-, 3-year survival rates were 91%, 85% and 70%, respectively. Conclusions Hypertonic saline enhanced RFA in the treatment of liver cancer was proved to be safe and effective.

Thirty four patients with decompensated cirrhosis received umbilical blood stem cell transplantation via hepatic artery from December 2008 to August 2009. The symptoms and biochemical testing results were observed before and after stem cell transplantation. One month after the transplantation,appetite was improved in 32 patients ( 94% ), physical capacity improved in 29 patients ( 85% ) and the abdominal distention relieved in 28 patients (82%). Abdominal B-ultrasonography showed that ascites decreased in 15 cases(60% ), and disappeared in 9 cases(36% ). Six month later the mean serum albumin levels were increased from ( 30. 9 ± 0. 6) g/L to ( 35.5 ± 2. 5 ) g/L( P ＞ 0. 05 );alanine aminotransferase levels decreased from (57 ±7) U/L to (46 ± 10) U/L(P ＞0. 05);total bilirubin decreased from (47 ±5 )μmol/L to (25 ±4) μmol/L(P =0. 017);prothrombin time decreased from ( 17.9 ±0. 7) s to ( 16. 4 ±1.3) s (P ＞ 0. 05 ). Hemophagocytic syndrome developed in one case but no severe adverse reactions occurred. The results indicate that umbilical blood stem cell transplantation may improve liver function in various degrees with safety for patients with liver cirrhosis.

"Mistreatment by warming therapy" refers to various symptoms/syndromes caused by improper use of fire methods mentioned in Treatise on Febrile Diseases, which are similar to damaged yin induced fire-heat syndrome (injury of yin, consumption of qi, loss of yin, consumption of body fluid) manifested after radiotherapy and/or chemotherapy in modern clinics. Better efficacy was obtained in treating various symptoms/syndromes by using nourishing yin purging fire method. In this paper authors focuses on exploring guiding significance of using "Mistreatment by warming therapy" in treating non-small cell lung cancer (NSCLC).
Carcinoma, Non-Small-Cell Lung ; therapy ; Humans ; Lung Neoplasms ; therapy ; Medicine, Chinese Traditional ; Practice Guidelines as Topic ; Syndrome

Objective To evaluate the olfactory functions in patients with Parkinson's disease (PD) with a smell identification test developed for the Chinese population and to examine possible factors contributing to PD patients' olfactory performance.Methods Fifty-five patients with idiopathic and nondementia PD and 55 demographically matched healthy controls (HC) were recruited and their olfactory identification tested using the Chinese Smell Identification Test developed by the Institute of Psychology at Chinese Academy of Sciences.Results Olfactory identification score was significantly lower (t =-6.827,P＜0.01) in the PD group (19.3 ±5.4) as compared with the HC group (26.5 ±5.7).Of all PD patients,63.6％ scored over 1 SD below the age norm.In particular,of those with Hoehn-Yahr ratings between 2 to 3,77.8％ scored over 1 SD below the age norm.Receiver operating characteristic (ROC) curve analysis indicated that a cut-off score of 22.5 on the Chinese Smell Identification Test distinguished between PD patients and HC with a sensitivity of 74.6％ and specificity of 70.9％.Within the PD group,age,education,Hoehn-Yahr rating and Mini-Mental State Examination score were not found to correlate with olfactory performance (all P ＞ 0.05).Conclusion PD patients in China show significant impairment of olfactory identification,which is effectively captured by the Chinese Smell Identification Test.

Objective To compare a prospective ECG-gated high-pitch spiral technique (Flash) and conventional retrospective ECG-gated spiral technique for the image quality of coronary artery stent and radiation dose with a dual source CT.Methods One hundred and fifty five coronary stents in one hundred and twenty patients (mean age 64.9 ± 10.6 years,heart rates≤65 bpm) were examined using a dual source CT.All patients were divided in two groups,receiving either Flash or conventional coronary artery CT angiography separately.After images of coronary artery were reconstructed using both the smooth (B26) and sharp (B46) kernel,the coronary stent image quality and stent lumen were scored by two observers individually using four point scale (1 = excellent,4 = unvaluable) .The effective radiation dose of volume CT dose index (CTDIvol,mGy) and dose length product (DLP,mGy x cm) were also calculated for each patient.x2-test analysis of image quality and t-test analysis of radiation dose were used respectively for statistical difference between two groups.Results Interobserver agreement for stent image quality was good (Kappa =0.764,P＜0.001).The mean scores were 1.61 ±0.77 and 1.65 ±0.82 in Flash group and conventional group respectively.There was no significant difference in image quality between the two groups (x2 = 0.865,P = 0.834).The effective radiation dose in Flash group was significantly lower than that in conventional group.The mean values of CTDIvol were 3.24 ± 1.21 in Flash group and 31.26 ± 10.79 in conventional group (t = 19.83,P < 0.001) ,and the mean values of DLP in Flash group and conventional group were 54.61 ±19.88 and 468.30 ± 174.88,respectively (t = 18.06,P < 0.001).Conclusions Compared with the conventiaonal coronary artery CT angiography,the Flash coronary artery CT angiography technique has a similar coronary stent image quality,but at a lower radiation dose in patients with heart rates lower than 65 beats per minute.

ObjectiveTo assessment the value of strain ratio(SR) in differentiating benign and malignant breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.MethodsElastosonography was performed on 64 patients with breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.SR (strainnormal neighboring tissues /strainbreast lesion) was calculated by the software equipped with the ultrasonic machine.Pathology of the lesions after biopsy or operation was considered as standard,SRs of benign and malignant breast lesions were compared with independent-samples t test.The diagnostic value of SR was evaluated by receiver operating characteristic (ROC) curve analysis.Results SRs of 34 benign breast lesions and 30 malignant breast lesions were 2.85 ± 1.30 and 5.03 ± 2.50 respectively,there was significant difference between them( t =- 4.29,P =0.000).Area under the curve of diagnosing benign and malignant of breast lesions was 0.875 for SR( P ＜0.0001).If the cut-off point of SR was 3.26,the sensitivity in differentiating breast lesions was 83.33％,while the specificity was 82.35％.Conclusions SR is a helpful elasticity parameter for differentiating benign and malignant breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.