OBJECTIVETo investigate the changes in plasma levels of thrombomodulin (TM) and D-dimer (DD) in children with different types of Mycoplasma pneumoniae pneumonia (MPP), and their role in the pathogenesis of MPP in children.

METHODSFifty-two children with MMP were divided into lobar pneumonia (n=30) and interstitial pneumonia groups (n=22) and another 30 healthy children were selected as the control group. Plasma levels of TM and D-D were measured using enzyme-linked immunosorbent assay and latex-enhanced immunoturbidimetric assay, respectively.

RESULTSThe lobar pneumonia, interstitial pneumonia and control groups had median plasma TM levels of 23.83, 15.56 and 8.78 μg/L respectively, with significant differences between the three groups (P<0.01). The lobar pneumonia and interstitial pneumonia groups had significantly higher plasma TM levels than the control group (P<0.01), and the lobar pneumonia group had a significantly higher plasma TM level than the interstitial pneumonia group (P<0.05). Median plasma D-D levels in the lobar pneumonia and interstitial pneumonia groups were significantly higher than the reference value (P<0.01). The lobar pneumonia group had a significantly higher plasma D-D level than the interstitial pneumonia group (0.35 μg/mL vs 0.13 μg/mL; P<0.01), and the percentage of patients with elevated plasma D-D levels was significantly higher in the lobar pneumonia group than in the interstitial pneumonia group (87% vs 59%; P<0.05).

CONCLUSIONSChildren with MPP, especially those with lobar pneumonia, have increased plasma levels of TM and D-D. This suggests that damage to vascular endothelial cells and blood hypercoagulability may be involved in the pathogenesis of MPP.

Adolescent ; Child ; Child, Preschool ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Humans ; Male ; Pneumonia, Mycoplasma ; blood ; Protein Multimerization ; Thrombomodulin ; blood

OBJECTIVETo explore the feasibility and short-term efficacy of laparoscopic-assisted D3 lymph node dissection for right colon cancer with a medial-to-lateral approach.

METHODSClinical data of 61 patients with right colon cancer undergoing D3 lymph node dissection from March 2006 to June 2010 were analyzed retrospectively. Among them,29 underwent laparoscopic-assisted right hemicolectomy (LARH group) and 32 underwent open right hemicolectomy (ORH group). The number of lymph node harvest, operative details, and complication rate were compared between the two groups.

RESULTSThe mean number of lymph node harvest did not differ significantly between the two groups (16.9±3.8 vs. 15.4±3.6). As compared to ORH group, although the operative time was significantly longer [(214.4±37.9) min vs. (193.3±28.8) min] in LARH group, the mean blood loss [(83.4±38.0) ml vs. (192.7±43.6) ml], time to first flatus [(44.6±20.8) h vs. (70.4±80.0) h], time to resumption of soft diet[(32.5±10.6) h vs. (59.7±10.4) h], and postoperative hospital stay [(11.2±2.2) d vs. (13.8±2.8) d] were more favorable(all P<0.05). Complication rate was lower in LARH group(10.4% vs. 9.4%), however the difference was not statistically significant.

CONCLUSIONSLARH with D3 lymph node dissection is oncologically comparable with ORH for right colon cancer. It is a safe and feasible procedure associated with rapid postoperative recovery.

Aged ; Colectomy ; methods ; Colonic Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo search the anti-inflammatory fraction of Albizia julibrissin.

METHODInflammatory model of Kunming mice ear edema induced by croton oil and determination combined with the LC-MS-MS-guided fractionation and isolation were used.

RESULTThe n-butanol fraction (AJ-B) obtained from the ethanolic extract of the Cortex albiziae was the major active fraction. The lignan glycosides fraction (AJ-B-1), which was further isolated from AJ-B, showed significant anti-inflammatory activity and exhibited dose-dependent relationship in the dose of 5 to 20 mg x kg(-1).

CONCLUSIONThe method of bioassay-guided fractionation and isolation combined with the LC-MS-MS determination may be of benefit to the logical studies on the bioactive fractions or constituents of traditional Chinese materia medica.

Albizzia ; chemistry ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; analysis ; isolation & purification ; therapeutic use ; Biological Assay ; methods ; Butanols ; Chromatography, High Pressure Liquid ; methods ; Croton Oil ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; therapeutic use ; Edema ; chemically induced ; drug therapy ; Glycosides ; analysis ; isolation & purification ; therapeutic use ; Lignans ; analysis ; isolation & purification ; therapeutic use ; Male ; Mice ; Phytotherapy ; Plant Bark ; chemistry ; Plants, Medicinal ; chemistry ; Tandem Mass Spectrometry ; methods

This paper expounds how the tractor for the fracture reduction works. The clinical results show that the traction apparatus is a labour-saving and time-saving orthopedic device with simple operation and few suffering to patients.
Arm Injuries ; diagnostic imaging ; surgery ; Equipment Design ; Fracture Fixation ; instrumentation ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Leg Injuries ; diagnostic imaging ; surgery ; Radiography ; Traction ; instrumentation ; methods

OBJECTIVETo establish a RP-HPLC method for determination of glycosides in Traditional Chinese Medicine Liu-wei Di-huang.

METHODThe samples were analyzed on an ODS column at 30 degrees C, with mobile phase of methanol/water (33:67) at flow rate 1.0 mL.min and detection at wavelength of 236 nm.

RESULTThree major components reached base-line separation and were identified to be mononiside, loganin, paeoniflorin. Respectively for the three components, linear correlations were found between peak areas and concentrations in the ranges of 7.4-60, 7.7-62 mg.L-1 and 8.5-68 mg.L-1, and the recoveries were 98.8%, 98.3%, 99.6%.

CONCLUSIONThe established method is proved to be suitable for simultaneous quantification of three major glycosidic components in Liuwei Dihuang decoction and can be used for evaluation of the quality of Liuwei Dihuang preparations.

Benzoates ; analysis ; Bridged-Ring Compounds ; analysis ; Chromatography, High Pressure Liquid ; methods ; Cornus ; chemistry ; Dioscorea ; chemistry ; Drug Combinations ; Drugs, Chinese Herbal ; analysis ; chemistry ; Glucosides ; analysis ; Iridoids ; analysis ; Monoterpenes ; Plants, Medicinal ; chemistry ; Quality Control ; Rehmannia ; chemistry

OBJECTIVETo study CXCR3 and CCR5 chemokine receptor expression in spleens of patients with primary immune thrombocytopenia (ITP) and its clinical significance.

METHODSThe splenectomy specimens from 10 ITP patients (ITP group) and 8 patients with traumatic splenic rupture (normal control group) were studied. Immunohistochemistry (IHC) was used to study the positive rate of CXCR3 and CCR5. Western blot was performed to detect CXCR3 and CCR5 protein expression, while real-time polymerase chain reaction (RT-PCR) was conducted to analyze their mRNA expression.

RESULTSThe positive rate of CXCR3 and CCR5 were both higher in ITP group (90% and 100%, respectively) than those in control group (75% and 87.5%, respectively)(P < 0.05). The differences were statistically significant (P < 0.05). Protein and mRNA level of CXCR3 in ITP group were 3.0 and 3.5 times as high as those in control group, respectively. Those of CCR5 in ITP group were 1.2 and 1.7 times as high as those in control group, respectively.

CONCLUSIONHigh expression of CXCR3 and CCR5 may play a part in the splenic immune disorders in patients with ITP.

Adolescent ; Adult ; Case-Control Studies ; Child ; Female ; Humans ; Male ; Middle Aged ; Receptors, CCR5 ; metabolism ; Receptors, CXCR3 ; metabolism ; Spleen ; metabolism ; Thrombocytopenia ; immunology ; metabolism ; Young Adult

AIMTo study the effect of Dehydrocorydaline and Verapamil (Ver) on intracellular free calcium concentration of myocardial cell ([Ca2+]i) under hypoxic condition.

METHODSWe adopted guinea-pig heart Langendorff instillation. The myocardial cells were isolated by collagenase (Type I, sigma)and marked by fluorescence ratio imaging. The suspension of myocardial cells was assigned to six groups: DHC, Ver, and control were each two. Each three groups was exposed to hypoxia and normoxia before determination of [Ca2+]i.

RESULTS(1) In normoxia state, [Ca2+]i was 120.5-8.3 nml/L (n = 20).( 2) In hypoxia state, the increased [Ca2+]i of myocardial cells was proportional to the time (degree) of hypoxia. Correlation coefficient (r) was about 0.98. (3) Under the condition of normoxia DHC and Ver decreased [Ca2+]i. (4) DHC was obviously slow the increase of [Ca2+]i after hypoxia.

CONCLUSIONIn normoxia and hypoxia, DHC decreases the increased [Ca2+]i. It can prevent intracellular calcium overload. We believe DHC may improve self-protected performance of myocardial cells.

Alkaloids ; pharmacology ; Animals ; Calcium ; metabolism ; Cell Hypoxia ; Female ; Guinea Pigs ; Male ; Myocytes, Cardiac ; drug effects ; metabolism

OBJECTIVETo investigate the efficacy and safety of sunitinib on the management of gastrointestinal stromal tumors (GIST) patients with imatinib resistance.

METHODSClinical data of 48 patients with imatinib-resistant GIST received sunitinib therapy from May 2008 to April 2012 in the Union Hospital of Fujian Medical University were analyzed retrospectively. Eighteen patients received 50 mg/d of sunitinib in a protocol of 4/2 (4 weeks on and 2 weeks off) [50 mg/d (4/2)], and 30 patients received a protocol of 37.5 mg of sunitinib continuous daily dose (37.5 mg/d CDD).

RESULTSThe median duration of sunitinib administration of all the 48 patients was 56 weeks, and the short-term efficacy was evaluated at 24 weeks after the initial treatment according to the Choi criteria. The response rate was 27.1% (13/48), including 1 case with complete response (CR), 12 cases with partial response (PR), and 21 cases with stationary disease (SD). The disease control rate was 70.8% (34/48). The mean follow-up time of 48 patients was 89 weeks. The median progression-free survival (PFS) and overall survival (OS) were 48 weeks and 92 weeks respectively. Stratified analyses indicated that the median PFS of patients previously treated by imatinib 400 mg/d and >400 mg/d were 53 weeks and 35 weeks respectively (P=0.018), and the median OS of these two groups were 157 weeks and 71 weeks respectively (P=0.003). Patients with exon 11 mutations had a significantly shorter OS compared with those with exon 9 mutations (71 weeks vs 157 weeks, P=0.008). Hand-foot syndrome was the most common adverse effect (25/48, 52.1%), followed by nausea (24/48, 50.0%), fatigue (23/48, 47.9%), neutropenia(21/48, 41.7%). The sub-group analysis of two protocols of sunitinib administration showed that the incidence of diarrhea and hand-foot syndrome were higher in 50 mg/d (4/2) group than those in 37.5 mg/d CDD group (P=0.027, P=0.048).

CONCLUSIONSSunitinib is effective for the patients with imatinib-resistant GIST. After 400 mg/d imatinib treatment failure, sunitinib should be prescribed instead of increased dosage of imatinib. Patients with KIT exon 9 mutations present better prognosis than those with KIT exon 11 mutations. The protocol of sunitinib 37.5 mg/d CDD possesses better safety.

Adult ; Aged ; Benzamides ; therapeutic use ; Drug Resistance, Neoplasm ; Female ; Gastrointestinal Neoplasms ; drug therapy ; Gastrointestinal Stromal Tumors ; drug therapy ; Humans ; Imatinib Mesylate ; Indoles ; therapeutic use ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use ; Pyrroles ; therapeutic use ; Retrospective Studies ; Treatment Outcome

Background::It is crucial to improve the quality of care provided to ICU patient, therefore a national survey of the medical quality of intensive care units (ICUs) was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to 2019.Methods::This was an ICU-level study based on a 15-indicator online survey conducted in China. Considering that ICU care quality may vary between secondary and tertiary hospitals, direct standardization was adopted to compare the rates of ICU quality indicators among provinces/regions. Multivariate analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSIs), and catheter-associated urinary tract infections (CAUTIs).Results::From the survey, the proportions of structural indicators were 1.83% for the number of ICU inpatients relative to the total number of inpatients, 1.44% for ICU bed occupancy relative to the total inpatient bed occupancy, and 51.08% for inpatients with Acute Physiology and Chronic Health Evaluation II scores ≥15. The proportions of procedural indicators were 74.37% and 76.60% for 3-hour and 6-hour surviving sepsis campaign bundle compliance, respectively, 62.93% for microbiology detection, 58.24% for deep vein thrombosis prophylaxis, 1.49% for unplanned endotracheal extubations, 1.99% for extubated inpatients reintubated within 48 hours, 6.38% for unplanned transfer to the ICU, and 1.20% for 48-hour ICU readmission. The proportions of outcome indicators were 1.28‰ for VAP, 3.06‰ for CRBSI, 3.65‰ for CAUTI, and 10.19% for in-hospital mortality. Although the indicators varied greatly across provinces and regions, the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 years. The overall mortality rate has dropped from 10.19% to approximately 8%.Conclusions::The quality indicators of medical care in China’s ICUs are heterogeneous, which is reflected in geographic disparities and grades of hospitals. This study is of great significance for improving the homogeneity of ICUs in China.

Objective To assess the prevalence,demographic characteristics,risk factors and protective factors on major depression disorder(MDD)among the affected people in the epicenter,7 months after the 2008-earthquake in Wenchuan,China.Methods Stratified multistage cluster randomization was conducted to choose 14 503 subjects aged 15 years or over in the city of Dujiangyan,Beichuan county and Qingchuan county,Sichuan province.We used the general health questionnaire(GHQ-12)as the screening instrument,and the structured clinical interview for DSM-Ⅳ-TR axis Ⅰ disorder-patient edition(SCID-Ⅰ/P)as the tool for diagnosis.Results There were 180 persons diagnosed as MDD with other 13 asymptomatic ones.The point prevalence of MDD was 1.27% and the lifetime prevalence was 1.36%.Risk factors were including:being female(OR=1.56,95%CI:1.136～ 2.143,P＜0.05),co-morbidity with somatic diseases(OR=4.02,95%CI:2.75-5.90,P＜0.05),wounded in the earthquake(OR=3.29,95%CI:1.92-5.65,P＜0.05),property loss up to 10 000-20 000 Yuan(OR=2.09,95%CI:1.18-3.69,P＜0.05),property loss up to＞20 000 Yuan(OR=2.54,95%CI:1.38-4.68,P＜0.05),death or missing of family members(OR=3.79,95%CI:2.08-6.89,P＜0.05)and in middle-age(OR=2.31,95%CI:1.38-3.86,P＜0.05)etc.Having had a job seemed to be a protective factor(OR=0.60,95%CI:0.43-0.83,P＜0.05).Conclusion Major depressive disorder appeared to be a common psychiatric disease in these quake-stricken areas,that causing serious problems.Sustained follow-up and care provided to the affected people in these areas were of extreme importance.