Objective To study the correlation between hand, foot and mouth disease (HFMD) in lung-spleen damp-heat syndrome, syndrome of stagnation and steaming due to damp-heat, and syndrome of stirring wind due to toxic-heat with IL-6, PCT, CRP, CD3+, CD4+, CD8+ and NK cells.Methods Ninety patients with HFMD were randomly selected, dividing into lung-spleen damp-heat syndrome, syndrome of stagnation and steaming due to damp-heat, and syndrome of stirring wind due to toxic-heat, 30 cases for each syndrome. IL-6, PCT, CRP, CD3+, CD4+, CD8+ and NK cells were detected, and the distribution of above indicators in the three syndromes were analyzed.Results Levels of IL-6, PCT and CRP in syndrome of stirring wind due to toxic-heat were significantly higher than those in lung-spleen damp-heat syndrome and syndrome of stagnation and steaming due to damp-heat, with statistical significance (P<0.01); There was statistical significance in absolute value counting of CD3+, CD4+, CD8+ and NK cells among the three syndromes (P<0.01); There was statistical significance in the percentage of CD3+ cells in syndrome of stirring wind due to toxic-heat and lung-spleen damp-heat syndrome (P<0.01) and syndrome of stagnation and steaming due to damp-heat (P<0.05); There was statistical significance in the percentage of CD4+ cells syndrome of stirring wind due to toxic-heat and lung-spleen damp-heat syndrome (P<0.05) and syndrome of stagnation and steaming due to damp-heat (P<0.01); There was statistical significance in the percentages of CD8+ and NK cells in the three syndromes (P<0.01).Conclusion Proinflammatory cytokines, proinflammatory markers, and T cell sub-group related to HFMD in lung-spleen damp-heat syndrome, syndrome of stagnation and steaming due to damp-heat, syndrome of stirring wind due to toxic-heat are not only correlative with morbidity, but also with the severity of diseases and prognosis, which can relatively effectively evaluate the state of diseases and judge prognosis.

Objective To investigate the expression and significance of cyclin E in rectum carcinoma.Methods The expression of cyclin E was examined by immunohistochemical techniques in 42 cases of rectum carcinoma.Laboratory data were then analyzed statistically together with the related clinical and pathological data.Results The positive expression rate of cyclin E in rectum carcinoma was 66.7％(28/42).There was no significant association between cyclin E and gender,age,histological grade,pTNM stage,metastasis of lymph node (P ＞ 0.05).Conclusions The expression of cyclin E in rectum carcinoma is higher,and it may show highly associated with the occurrence and development of the rectum carcinoma.Cyclin E has no significant association with age,gender,histological grade,pTNM stage,metastasis of lymph

Objective To investigate the influencing factors for spontaneous bacterial peritonitis (SBP) in patients with acute-on-chronic liver failure (ACLF),and to provide a reference for clinical diagnosis and prognosis evaluation.Methods A retrospective analysis was performed for the clinical data of 667 patients with ACLF who were hospitalized and treated in our hospital from January 2009 to December 2014,and according to the presence or absence of SBP,they were divided into ACLF group(n =232) and ACLF-SBP group(n =435).The general information,laboratory markers,and incidence of complications were compared between the two groups.The t-test was used for comparison of normally distributed continuous data between groups,and the Mann-Whitney U test was used for non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical data between groups,and a logistic regression analysis was used to identify independent risk factors for ACLF complicated by SBP.Results The comparison of laboratory markers and comorbidities showed that there were significant differences between the two groups in albumin (Alb) (t =-4.110,P ＜ 0.001),alanine aminotransferase (U =-6.653,P ＜ 0.001),aspartate aminotransferase (t =-8.045,P ＜ 0.001),blood sodium (t =-2.879,P =0.006),prothrombin time activity (t =-2.140,P =0.037),international normalized ratio (t =1.453,P =0.042),hemoglobin (t =-3.446,P =0.001),upper gastrointestinal bleeding (x2 =48.252,P =0.002),hepatorenal syndrome (x2 =16.244,P =0.031),and pulmonary infection (x2 =13.564,P ＜ 0.001).The multivariate logistic regression analysis showed that there were significant differences in Alb (OR =1.119,95 ％ CI:1.052 ～ 1.189),platelet count (PLT) (OR =1.035,95 ％ CI:0.755 ～ 1.084),upper gastrointestinal bleeding (OR =1.117,95 ％ C1:0.072 ～ 1.135),and pulmonary infection (OR =2.275,95 ％ CI:0.978 ～ 5.292) (P =0.002,0.038,0.022,and 0.036).Conclusion In the treatment of ACLF patients,risk factors including low Alb,low PLT,upper gastrointestinal bleeding,and pulmonary infection should be prevented,and early diagnosis and intervention of these risk factors helps to reduce the incidence of SBP.

Ojective To evaluate the value of laparoscopic gastrectomy in the management of gastric diseases. Methods 18 laparoscopic gastric operation were performed in our hospital from August 2000 to April 2001. The ages of the patients ranged from 28 to 87 years. One patient received Billroth-Ⅰ gastrectomy, 7 Billroth-Ⅱ gastrectomy, 3 proximal subtotal gastrectomy, 4 distal subtotal gastrectomy and 3 total gastrectomy. Results All the operations were successfull, the duration of operation was 150～340min, the estimated blood loss was 20～120ml, and the average postoperative hospitalized days were 8 days. All patients recovered quickly without any postoperative complication. Flatus was present quickly. no death occurred in all the patients. Conclusions Laparoscopic gastrectomy is an effective and safe technique for the manaqement of gastric disease, if used properly.

Objective To investigate the surgical treatment of coronary malperfusion due to acute type A aortic dissection.Methods The clinical data of 305 consecutive patients with type A aortic dissection, who were hospitalized and underwent operation between 2004 and 2015, were analyzed retrospectively.Among that, there were 37 cases with coronary malperfusion due to aortic dissection.Results The right coronary artery was involved in 33 cases, the left in 2 cases, and both coronary arteries in 2 cases.There were 22 coronary bypass grafting using saphenous vein in 21 patients, including 20 patients with the right coronary bypass grafting and 1 patient with the left.Six patients died postoperatively, with the mortality of 16.22％.Conclusion Acute type A aortic dissection with coronary involvement is associated with high mortality rate, which is necessary to restore the coronary revascularization as soon as we can.The methods to reconstruct the involved coronary is depend on the patients' condition and experience of surgeon.

OBJECTIVETo observe the effect of total ginsenosides (TG) on monocrotaline (MCT) induced right ventricular hypertrophy rats, and to explore its correlation with calcineurin (CaN) pathway.

METHODSFifty male Sprague Dawley rats were randomly divided into the normal control group, the MCT model group, and the low, middle, high dose TG treatment groups, 10 in each group. All medication was performed by peritoneal injection for 18 days. Right ventricular peak systolic pressure (RVSP), right ventricular hypertrophy index (RVHI), and right ventricular weight/body weight (RVW/BW) were measured. Intracellular free calcium concentrations were measured by Ca2+ fluorescence indicator Fura2/AM. The atrial natriuretic factor (ANF) and CaN mRNA expression of the myocardial tissue were quantitatively analyzed by Real-time PCR. The protein expression of CaN was detected by Western blot.

RESULTSCompared with the MCT model group, preventive treatment of TG at the 3 doses could significantly reduce RVSP, RVHI, RVW/BW, and ANF mRNA expression, and decrease Ca2+ concentration in myocardial cells, CaN mRNA and protein expression in the myocardial tissue.

CONCLUSIONTG could obviously improve MCT-induced right ventricular hypertrophy, which was possibly achieved through suppressing MCT-activated CaN signal transduction.

Animals ; Atrial Natriuretic Factor ; Calcineurin ; metabolism ; Calcineurin Inhibitors ; therapeutic use ; Ginsenosides ; therapeutic use ; Heart Ventricles ; Hypertrophy, Right Ventricular ; drug therapy ; metabolism ; Male ; Monocrotaline ; Myocardium ; Myocytes, Cardiac ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Signal Transduction

Objective This report is to compare the difference outcome between total arch replacement and hemi-arch replacement for Stanford type A aortic dissection.Methods The subjects were 208 consecutive patients,including 121 who received total arch replacement(group A) and 87 who had hemi-arch replacement(group B) for Stanford type A aortic dissection from August 2001 to July 2013 in Nanjing Hospital Affiliated to Nanjing Medical University.The cardiopulmonary bypass (CPB) time,average cross-clamping time,selective cerebral perfusion(SCP) time,complications,in-hospital mortality and follow-up after surgery were retrospectively compared between the A and B groups.Results The age,sex ratio,preoperative complications do not show a significant difference between the A and B groups.The CPB time [(247.68± 58.65) min vs (212.68±60.75) min,P =0.000],cross-clamping time[(154.85±45.96) min vs(137.83± 38.91) min,P =0.000] and SCP time [(36.98± 10.62) min vs(29.85± 13.46) min,P =0.000] of group A are all longer than group B.The incidence of postoperative complications(14.0％ vs 10.3％,P =0.619) and in-hospital mortality(9.1％ vs 8.0％,P =0.791) between the A and B groups do not have a significant difference.The mean time of follow-up differed significantly between two groups [(21.86± 18.89) months vs(61.23± 38.57) months,P =0.000] and did not differ in the rate of follow-up(94.5％ vs 96.3％,P =0.585).The rate of false lumen thrombosed at the proximal descending aorta showed a significant difference between the twogroups(91.8％ vs 23.8％,P =0.000),but the rate of secondary surgical intervention (0 vs 2.3 ％,P =0.095) and follow-up death (6.4％ vs 6.3 ％,P =0.975) do not.Conclusion For the Stanford type A aortic dissection patients,surgery is the only treatment that can save lives.Total arch replacement need more time in CPB,cross-clamping and SCP,but the complications,in-hospital mortality and follow-up death do not show a significant difference compared with hemi-arch replacement,and higher rate of false lumen thrombosed have been showed in total arch replacement.

Objective To evaluate the effect of ultra-low dose naloxone on postoperative hyperalgesia caused by large-dose remifentanil.Methods Forty ASA Ⅰ-Ⅲ adult patients,scheduled for gastrointestinal surgery,were randomly assigned into 2 groups (n =20 each):large dose remifentail group (group R) and ultra-low dose naloxone group (group N).Anesthesia was induced with iv injection of remifentanil,propofol and cisatracurium and maintained with inhalation of sevoflurane and infusion of remifentanil.The patients were tracheal intubated and mechanically ventilated.In group R,remifentanil was infused at a rate of 0.25 μg· kg-1 · min-1 starting from the beginning of skin incision.The infusion rate was adjusted according to hemodynamics during operation and subsequently increased/decreased by 0.05 μg· kg-1· min-1 each time.In group N,naloxone was infused at 0.1 μg·kg-1· h-1 while infusing remifentanil,naloxone infusion was stopped at the beginning of peritoneum closure and the other treatments were similar to those previously described in group R.All patients were sent to post-anesthesia care unit after surgery and stayed there for 90 min.Morphine was given when need.The patient-controlled intravenous analgesia was used for postoperative analgesia after leaving post-anesthesia care unit.The first pain time was calculated.The morphine consumption and complications such as nausea,vomiting and pruritus were recorded at 15,30,60 and 90 min and 2,6,24,48 and 72 h after surgery.Results Compared with group R,the morphine consumption was significantly reduced at each time point after surgery,the first pain time was prolonged,and incidence of nausea was decreased (P ＜ 0.05),while no significant change was found in the incidence of vomiting and prutirus in group N (P ＞ 0.05).Conclusion Infusing ultra-low dose naloxone (0.1μg· kg-1 ·h-1) during operation can attenuate postoperative hyperalgesia caused by large-dose remifentanil in patients.

Objective To investigate the injury characteristics and prognostic risk factors of patients with craniocerebral injury so as to provide some suggestions for the improvement of medical prevention,intervention and treatment measures.Methods Trauma database system was applied to collect the medical records of 661 patients with traumatic brain injury admitted to the Department of Neurosurgery of 105th Hospital of Hefei in 2009.Their general conditions,injury characteristics and outcomes were analyzed and the risk factors affecting their outcomes were investigated by Logistic regression analysis.Results Of the patients with craniocerebral injury,the males accounted for 70％ (463/661).The patients at 45 years old or so had the highest incidence of craniocerebral injury.Patient number in the second half of one year was 1.65 times more than that in the first half of one year (412/249 ).Most patients were injured from traffic accidents (87.7％,580/661 ) and 512 patients (77.5％) suffered from multiple injuries.ISS,injury causes,age and injury incidence quarters showed close correlation with the final outcome.Conclusions The patients with craniocerebral injury demonstrates distinctive characteristics in aspects of gender,age,incidence time,injury causes,and multiple injuries,but the ultimate outcomes are related to the injury severity,injury causes,age and other factors.

Objective The purpose of this study was to investigate the correlation of high sensitivity C-reactive protein (hsCRP) and fibrinogen with carotid artery arteriosclerosis of patients with cerebral infarction. Methods One hundred and thirteen patients with cerebral infarction were assigned as study group, and 102 healthy persons as control group. The levels of serum hsCRP and Fib in the two groups were measured. The carotid artery arteriosclerosis and carotid intimal-medial thickness (IMT) were examined by color Doppler and B-ultrasound. Results The value of IMT between study group and control group was statistically significant. The positive rates of carotid artery arteriosclerosis plaque and vulnerable plaque in study group were significantly higher than those in control group (all<0.05) . The level of serum hsCRP was significantly higher in study group than that of control ( <0.05) . The level of serum Fib between study group and control group was not statistically significant ( >0.05) . Conclusion The level of hsCRP was closely related to the degree of carotid artery arteriosclerosis and the occurrence and development of cerebral infarction. But the level of Fib was not closely related to the degree of carotid artery arteriosclerosis.