Objective To investigate the prognostic factors in patients with sepsis and to provide the theoretical basis for clinical diagnosis and treatment. Methods A total of 141 septic patients were analyzed retrospectively. Patients were divided into two groups:those who were alive at time of ICU discharge ( survivors;n=83 ) and those who died or to give up before terminal stage ( nonsurvivors;n=58 ) . Then the clinical data were statistically ana-lyzed. Results In the death group: age, APACHE II score, blood urea nitrogen, serum creatinine, C-reactive protein were significantly higher than the survival group (P<0. 01) while albumin, pre albumin were lower than that in the survival group (P<0.01). The Logistic regression analysis illustrated: age ( > 60 years), APACHEIIscore ( >20 score) and blood urea nitrogen ( > 9 mmol/L) , serum creatinine ( > 176 μmol/L) , C-reactive protein level were independent predictors of death in patients with sepsis ( P<0 . 05 ) . Then drew the receiver oper-ating characteristic curve ( ROC curve) and analyzed the respective risk factor for predicting prognosis value of sep-sis with the help of ROC curve. Conclusion Age, high APACHE II score in early sepsis, increased urea nitro-gen, elevated serum creatinine and increased C-reactive protein levels were regarded as prognostic value indicators for adverse clinical outcomes in patients with sepsis.

Emergence and broad spread of chloroquine resistance urge human beings to change drug policy in malaria control and to find more effective new drugs. Nevertheless, chloroquine is still used in the treatment of falciparum malaria in some poor endemic regions due to economic and development reasons. It should be of great significance to un-derstand the mechanism of chloroquine resistance and find the way to reverse it in order to bring chloroquine with high efficacy and low cost back to the first line of the combat to malaria. Advent and development of resistance reversal agents provide a new clue for this purpose. When used together with chloroquine, it can partly restore the efficacy of chloroquine in resistant Plasmodium falciparum. The article summarizes the research progress on chloroquine resistance in P. falciparum and resistance reversers.

Objective To study the potentiation of chloroquine activity and mechanism by ketotifen and cyproheptadine in in vitro cultured Plasmodium falciparum Fcc SM1/yN strain. Methods In vitro cultured Fcc SM1/yN strain was added to pre-prepared drug plates at 50 ?l/well after synchronization to make final concentration of 0.312 5-2 560 nmol/L for chloroqine and of 9.80-5 000 nmol/L for ketotifen or cyproheptadine. After 34 hours' culture in 37 ℃, the number of schizonts with 3 or more nuclei was calculated among 200 parasites under microscope. Calculated half inhibitive concentration ( IC50 ) of chloroquine and every drug combination to parasite as well as chloroquine activity enhancement index ( AEI) of ketotifen (or cyproheptadin) . Time dependency of potentiation was studied. All data were analyzed statistically with SPSS 13.0. After 20 hours' action of one optimal combination dose of chloroquine/ketotifen or chloroquine/cyproheptadine, RNA of the Fcc SM1/yN strain was extracted and real-time PCR was used to determine the expression level of pfcrt and pfmdr1 genes. Results The best potentiation effect was observed with ketotifen or cyproheptadine of 625 nmol/L, with IC50 of 74.53 nmol/L for chloroquine/ketotifen and 89.7 nmol/L for chloroquine/cyproheptadine respectively, and activity enhancement index (AEI) of 0.42 for chloroquine/ketotifen and 0.30 for chloroquine/cyproheptadine respectively. Combination of 625 nmol/Lketotifen or cyproheptadine with 5 nmol/L chloroquine showed the highest potentiation potency. 6-7 hours during which ketotifen or cyproheptadine was added after chloroquine showed the highest effect, with IC50 of 67.70 nmol/L for chloroquine/ketotifen and 81.53 nmol/L for chloroquine/cyproheptadine respectively, and the AEI was 0.47 for chloroquine/ketotifen and 0.37 for chloroquine/cyproheptadine respectively. After action of chloroquine/ketotifen or chloroquine/ cyproheptadine at one optimal combination dose, expression level of pfcrt gene increased by 91% and that of pfmdr1 gene decreased by 14% respectively. Conclusion Appropriate combination of chloroquine/ketotiphen or chloroquine/ cyproheptadine potentiates chloroquine against in vitro cultured P. falciparum. 6-7 hour period is an optimal time when ketotifen or cyproheptadine was added after chloroquine. Potentiating activity of ketotifen and cyproheptadine may be related to the expression level of pfcr t and pfmdr1 genes.

AlM:To explore the efficacy and safety of mitomycin C used in trabeculectomy by analyzing intraocular pressure and blood flow.METHODS:A total of 103 patients with glaucoma were divided into 2 groups randomly, and all patients were treated with trabeculectomy, while patients in the observation group were given mitomycin C extra. At 6~12mo follow-up were completed after operation, and the clinical efficacy, complications and hemodynamic characteristics of central retinal artery were compared between groups.RESULTS: The clinical efficacy of the observation group was higher than that of the controls (P<0. 05). There was no significant difference in complication rate between groups (P>0. 05), but the complication type was differentiate to some extent. Low intraocular pressure and photophobia symptoms occurred mostly in the observation group, while cicatricial obstruction occurred mostly in the controls. Before treatment, there was no significant difference in hemodynamic characteristics between groups (P>0. 05). One month after treatment, the peak systolic velocity ( PSV) and end diastolic velocity ( EDV ) of the observation group were obviously lower, while resistance index ( Rl ) and pulsatility index ( Pl ) were higher than those of the controls, the difference was statistically significant ( P<0. 05). Six months after treatment, the PSV and EDV of the observation group were obviously higher, while Rl and Pl were lower than those of the controls, the difference was statistically significant (P<0. 05).CONCLUSlON:Mitomycin C has a short-term harmful effect on glaucoma patients after trabeculectomy, but its long-term effect is safe and reliable.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Foreign Bodies ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Pharynx ; Young Adult

Adenocarcinoma ; pathology ; Adenoma ; pathology ; Carcinoma, Adenoid Cystic ; epidemiology ; genetics ; metabolism ; pathology ; Carcinoma, Basosquamous ; pathology ; DNA, Mitochondrial ; genetics ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Incidence ; Proto-Oncogene Proteins c-kit ; metabolism ; Salivary Gland Neoplasms ; epidemiology ; genetics ; metabolism ; pathology ; Salivary Glands, Minor ; pathology ; beta-Defensins ; genetics

Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; therapeutic use ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy

BACKGROUND:The main method to treat cervical spinal stenotic myelopathy caused by various factors is posterior lamninectomy, but the postoperative effect was not satisfactory.OBJECTIVE: To observe the postoperative functional reconstruction of the cervical vertebra of the patients with cervical spinal stenotic myelopathy through expansive open-door laminoplasty.DESIGN: An observational study by comparing the changes before and after the operation.SETTING: Department of Orthopaedics of the First Affiliated Hospital of Chongqing Medical University.PARTICIPANTS: Totally 32 patients (22 male and 10 female) with multi-segment cervical spinal stenotic myelopathy were treated at the Department of Orthopaedics of the First Affiliated Hospital of Chongqing Medical University from May 1995 to May 2004. Twelve cases suffered from degenerative spinal canal stenosis caused by spinal cord type of cervical spondylosis, 18 cases suffered from developmental spinal canal stenosis and 2from ossification of cervical posterior longitudinal ligament (OPLL).METHODS: Altogether 32 cases were treated through expansive opendoor laminoplasty to the cervical spine. These patients had been followed up for 6 months after the informed consent was obtained. The spinal function was evaluated according to Japanese Orthopaedic Association 17scores before operation, 2 weeks and 3 months after the operation respectively. The radian of the cervical vertebra, the stability of the spinal column and the complications were observed with X-ray.bility of the spinal column and the complications after the operation.RESULTS: According to intention-to-treat analysis, all the 32 patients entients before and after the operation: According to the evaluation standard stipulated by Japanese Orthopaedic Association (JOA), two weeks and three months after the operation, the scoring of the spinal function was significantly higher in 12 cases of cervical spondylosis myelopathy-induced degenerative stenosis, 18 cases of developmental spinal stenosis and 2 cases of ossification of cervical posterior longitudinal ligament (OPLL)( The score was 5.2, 5.7, 5.5 points respectively before the operation; 9.2, 9.7 , 9.4points respectively 2 weeks after the operation; and 11.3 , 11.8 , 11.6dian of the cervical vertebra, the stability of spinal column, and the complications after the operation: Radiographs indicated vanished cervical anteflexion curvature and straightened cervical vertebrae in three cases, but no re-closure or unstable spine happened.CONCLUSION: Expansive open-door laminoplasty for cervical spinal canal stenosis caused by various factors can still improve and increase the spinal functional evaluation scores shortly and 3 months after the operation, and it does not affect the stability of the cervical vertebrae.

To investigate risk factors and efficacy of reoperation for neovascular glaucoma ( NVG) secondary to vitrectomy in proliferative diabetic retinopathy (PDR).
●METHODS:Seven cases (7 eyes) from October, 2009 to December, 2012 were analyzed retrospectively. All the patients had NVG after the primary vitrectomy for PDR and were performed secondary vitrectomy combined with laser photocoagulation .
●RESULTS: The mean intraocular pressure ( lOP) was (11. 21±4. 22)mmHg before primary surgery. The number of laser spots ranged from 622 to 1124 during the first vitrectomy. Cataract extraction was performed in all 7 cases and intraocular lens was implanted in 5 cases. The mean lOP was (10. 11± 3. 62) mmHg during 2mo after the primary surgery. During follow- up, all the patients had significantly progressive intraocular inflammation. Vitreous hemorrhage was not absorbed completely in 2 cases and recurrent vitreous hemorrhage occurred in the other 5 cases. Five cases had poor glycemic control and the other 2 cases had bad blood pressure control. NVG occurred in all 7cases. The mean lOP was (41. 13 ± 7. 76) mmHg before the secondary surgery. After the secondary surgery, the lOP were under control in 5 cases. For the other 2 cases, the lOP was controlled in one case by transscleral cyclophotocoagulation, another one was lost in follow-up with uncontrolled lOP.
●CONCLUSlON: Primary vitrectomy combined with lens extraction, insufficient laser speckle, unabsorbed and recurrent vitreous hemorrhage, intraocular inflammation and systemic condition may be the risk factors associated with the occurrent of NVG after vitrectomy in PDR. Secondary vitrectomy combined with sufficient retinal photocoagulation is efficiency for NVG after vitrectomy for the PDR.

Breast reconstruction after radical mastectomy significantly improves the patient' s quality of life and has become an important part of comprehensive treatments. However, there are a number of reconstruction problems. The choice of breast reconstruction after breast cancer should be considered in general. Immediate reconstruction is not superior to breast-conserving surgery, while immediate reconstruction is superior to delayed reconstruction, and choices vary between implant reconstruction and autologous reconstruction. In short, breast reconstruction should be based on the radical principle with balance of beauty.