Objective This study aims to analyze midterm survival and to assess the midterm mortality following acute kidney failure (AKF) of patients undergoing surgical treatment of acute type A aortic dissection.Methods Clinical data of the patients who underwent Sun's procedure from February 2009 to March 2015 were collected.Patients with preoperative dialysis were excluded.Data including preoperative cardiovascular diseases,serum creatinine leve1 and CPB time were gathered.The patients were divided into the group of AKF and the group of non-AKF accounting to require dialysis.The group of AKF was follow-up by phone.Midterm mortality was studied with Cox analysis and midterm survival was estimated by Kaplan-Meier analysis.Results 524 patients underwent aortic surgeries which AKF was occurred in 51 (51/524,9.7％) patients.Hospital mortality was 23.5％ (12/51) in AKF group which seven death were strokes,three death were lower-extremity ischemia and two death were low cardio output.There were 2 patients dead with multi organ failure and paraplegia in first year.One reoperation patient because of anastomotic fistula was dead in fifth year.Only diabetes was independently associated with midterm mortality.Midterm survival for patients with AKF was 56％ during a median follow-up of 30.5 months.Survival was equal between the subgroups of Cr ＞ 200 mol/L and Cr ＜ 200 mol/L(P =0.741).Conclusion AKF after acute aortic dissection was a severe complication and the incidence was 9.7％.In patients with AKF,diabetes was associated with increased mortality across follow-up.Five years survival was 56％ not effected by preoperative Cr.

Objective To compare positional and volumetric differences of internal gross tumor volume (IGTV) delineated separately by three approaches based on four-dimensional CT (4DCT) for the primary tumor of non-small cell lung cancer (NLCLC). Methods Twenty-one patients with NLCLC underwent big bore 4DCT simulation scan of the thorax. IGTVs of the primary tumor of NSCLC were tumor on the MIP images were delineated to produce IGTVMIP. The position of the target center, the volume of target, the degree of inclusion (DI) and the matching index (MI) were compared reciprocally between IGTV10, IGTVEI+EE and IGTVMIP. Results Average differences between the position of the center of IGTVs on direction of x,y and z axes were less than 1 mm, with no statistically significant difference. The volume of IGTV10 was larger than that of IGTVEI+EE, the difference was statistically significant (t=2.37,P=0.028);the volume of IGTV10 was larger than that of IGTVMIP, but the difference was not statistically significant(t=1.95 ,P=0.065). The ratio of IGTVEI+EE with IGTV10, IGTVMIP with IGTV10 were 0.85±0.08 and 0.92±0.11, respectively. DI of IGTVEI+EE in IGTV10, IGTVMIP in IGTV10 were 84.78% ± 8. 95% and 88.47% ±9.04%. MI between IGTV10 and IGTVEI+EE, IGTV10 and IGTVMIP were 0.85 ±0.09, 0.86±0. 09, respectively. Conclusions The center displacement of the IGTVs delineated separately by the three different techniques based on 4DCT images are not obvious; IGTVEI+EE and IGTVMIP can not replace IGTV10 , however , IGTVMIP is more close to IGTV10 comparing to IGTVEI+EE . The ratio of GTVEI+EE with IGTV10 is correlated to the tumor motion vector. As the vector increases, the ratio of GTVEI+EE with IGTV10decreases, especially for small tumors.

Objective To analyze the independent risk factors associated with acute kidney injury(AKI)after Sun’s pro-cedure in the patients with acute aortic dissection .Methods Clinical data of 400 patients who underwent Sun ’ s procedure from February 2009 to August 2013 were collected.Data included preoperative GFR, Cleveland values, CPB time and fluid balance of 24 h intra and after operation were gathered .The patients were divided into the group of AKI and the group of non-AKI accounting to the changing of serum creatinine.Results AKI was occurred in 150(37.5%) patients.Hospital mortality in AKI group was significant higher than that in the non-AKI group(11.3% vs.2.4%, P<0.05).Univariable analysis re-vealed male, BWI, hypertension, preoperative MAP,WBC, eGFR, Cleveland value, cardiopulmonary bypass time, intra and postoperative fluid balance for 24 h have significant difference between 2 groups.Multivariate logistic regression analysis showed hypertension, Cleveland value, cardiopulmonary bypass time and fluid balance were independent risk factors for AKI .Conclu-sion AKI after acute aortic dissection was a severe complication .Hypertension, Cleveland value, cardiopulmonary time and fluid balance were associated with AKI.

Objective To investigate the effects of liposome mediated intraocular gene transfection of endostatin on the inhibition of the development of choroidal neovascularization (CNV) in a rat model. Methods Experimental CNV model in Brown Norway rats was induced by laser photocagulation. The recombinant eukaryotic expression plasmid pSecTagA hEndostatin or control plasmid pSecTagA and liposome complexes were injected into the subretinal space of the model rats. In situ hybridization and immunohistochemical observation confirmed the presence of endostatin mRNA and protein expression two weeks after injection. Intraocular and serum levels of endostatin were measured by enzyme linked immunosorbent assay. The intensity of fluorescein leakage from the photocoagulated lesions was studied at 13 d after photocoagulation. The area of CNV was measured using high molecular weight FITC dextran (MW2?10 6) for high resolution angiography in RPE choroid sclera flat mounts. In addition, sections of CNV lesions were studied by light microscopy and endoglin (CD105) immunohistochemical evaluation. Results The retina, RPE, choroidal were infected by subretinal delivery of the pSecTag hEndostatin and expressed the endostatin. Two weeks after intraocular injection, the level of endostatin in the whole eye homogenates were (50 14?3 43) ng/eye and (31 5?2 21) ng/eye, respectively. Fluorescein leakage from the CNV lesions decreased significantly as compared with that in the control groups. The average area of CNV at the sites of the Bruch's membrane rupture showed significant difference in eyes injected with endostatin as compared with that in the control eyes. Endothelial cells demonstrated strong immunoreactivity of CD105 in CNV lesions in the control eyes. Conclusion Liposome mediated endostatin gene transfection can significantly inhibit the development of CNV.

Objecttve To compare the positional and volumetric differences of planning target volumes(PTVs)based on axial three-dimensional CT(3D-CT)and four-dimensional CT(4D-CT)for the primary tumor of non-small cell lung cancer(NSCLC).Methods Sixteen NSCLC patients with lesions located in the upper lobe and 12 patients with lesions in middle and lower lobes,totally 28 patients, initially underwent three-dimensional CT scans followed by 4D-CT scans of the thorax under normal free breathing.PTVvector was defined on gross tumor volume (GTV) contoured on 3D-CT and its motion vector. The clinical target volumes(CTVs)were created by adding 7 mm to GTVs,then, internal target volume (ITVs)were produced by enlarging CTVs isotropically based on the individually measured amount of motion in the 4D-CT,lastly,PTVs were created by adding 3 mm setup margin to ITVs. PTV4D was defined on the fusion of CTVs on all phases of the 4D data.The CTV wag generated by adding7 mm to the GTV on each phase.then,PIVs were produced by fusing CTVs on 10 phases and adding 3 mm setup margin.The position of the target center,the volume of target and the degree of inclusion(DI)were compared reciprocally between the PTVvector and the PTV 4D The difference of the position,volume and degree of inclusion of the targets between PTVvecter and PTV4D were compared,and the relevance between the relative characters of the targets and the three-dimensional vector was analyzed based on the groups of the patients. Results The median of the 3 D motion vector for the lesions in the upper lobe was 2.8 mm, significantly lower than that for the lesions in the middle and lower lobe ( 7.0 mm, z = - 3. 485, P < 0. 05 ). In the upper lobe group there was only significant spatial difference between the PTVvector and PTV4D targets in the center coordinate at the x axe (z = -2. 010, P < 0. 05 ), while in the middle and lower lobes there was only significant spatial difference between the PTVvector and PTV4D targets in the center coordinates at the z axe (z = -2. 136,P <0.05). The median of ratio of PTV4D and PTVvector, of the upper lobe group was 0. 75, significantly higher than that of the middle and lower lobes group (0. 52, z = - 2. 949, P < 0. 05 ).A significant correlation was found for the motion vector and the ratio of PTV and PTV4D in both groups ( r = - 0. 638, - 0. 850, P < 0. 05 ). For all patients, the median of D[ of PTV4D in PTVvector was 66. 39% ,while the median of DI of PTVvector, in PTV4D was 99. 55% , both showed a positive significant correlation with the motion vector (r = -0. 814,0. 613 ,P < 0. 05). Conclusions PTV4D defined based on 4D-CT simulation images is obviously less than PTV defined based on 3D-CT simulation images. The ratio and DI of both targets are related with the three-dimensional motion vector of the tumor.

OBJECTIVETo analyze and identify fatty acids in the seeds of Sterculia lychnophora.

METHODThe compositions was isolated and determined by GC-MS technique, and area normalization method was used to make quantitative analyze of the content of compositions.

RESULTS21 Fatty acids and 5 other compositions were isolated and determined.

CONCLUSIONThe major fatty acids are 9,12(Z,Z)-octadecadienoic acid(37.96%), hexadecanoic acid(24.77%), 9-(Z)-octadecenoic acid(19.77%) and octadecanoic acid(5.01%).

Fatty Acids, Nonesterified ; chemistry ; isolation & purification ; Fatty Acids, Unsaturated ; analysis ; Gas Chromatography-Mass Spectrometry ; Palmitic Acid ; analysis ; Plants, Medicinal ; chemistry ; Seeds ; chemistry ; Sterculia ; chemistry

Objective To evaluate the clinical efficacy and safety of entecavir joint peginterferon α-2 a in the treatment of chronic hepatitis B.Methods The 80 cases of chronic hepatitis B patients were randomly divided into control group ( n =40 ) and treatment group ( n =40 ) . Patients in control group were given peginterferonα-2a 0.5 mL, once a week.Patients in treatment group were plused with oral entecavir 0.5 mg on the basis of control group, once a day.A course of treatment was a month in two groups, 12 courses of treatment. Respectively in the treatment of 3, 6, 12 months and 6 months after treatment, the hepatitis B virus ( HBV) DNA negative rate and alanine aminotransferase ( ALT) normalization rate of two groups were tested.After treatment, the clinical efficacy and incidence of adverse drug reactions of the two groups were compared.Results After treatment, the total effective rate of treatment group was significantly higher than that of control group ( 92.50% vs 67.50%, P<0.05).The treatment of 3, 6, 12 months and 6 months after treatment,the HBV DNA negative rate and ALT normalization rate of treatment group were significantly higher than those of control group (P<0.05).Adverse drug reactions in two groups had no significant difference (P>0.05).Conclusion Entecavir combined with peginterferonα-2a in the treatment of chronic hepati-tis B had distinct clinical efficacy and good safety.

OBJECTIVETo understand the epidemic characteristics and viral antibody level among healthy people of Japanese B encephalitis (JE) in Henan province in 2010.

METHODSA total of 433 selected JE cases in Henan province in 2010 were analyzed by descriptive epidemiological method. Xinyang and Luoyang were selected as survey sites in 2010.12 administrative villages were randomly selected from both cities. As the investigation objects, 519 healthy people from the two cities were randomly selected by eight age groups:less than one year old, 1 - 2 years old, 3 - 4 years old, 5 - 6 years old, 7 - 14 years old, 15 - 19 years old, 20 - 59 years old, and above 60 years old. A total of 1008 samples of blood specimens were collected both in May and November, and JE viral antibody was detected by micro-cytopathic effect neutralization test.

RESULTSThe incidence rate of JE was 0.46/100 000 (433/94 130 434) in Henan province in 2010.97.69% (423/433) of the patients were found between July and September, and 81.06% (351/433) were distributed in Nanyang, Xinyang, Luoyang, Zhumadian and Zhoukou city. Children aged 0 to 14 years were the primarily affected group (82.22%, 356/433), the people above 15 years old accounted for 17.78% (77/433) of whole cases in Henan province, but the same group accounted for 65.79% (50/76) of whole cases in Luoyang city, which obviously higher than the percentage in Henan province (χ(2) = 79.57, P < 0.05). Most patients were scattered children in Henan province, accounting for 58.89% (255/433). In Luoyang city, most patients were peasants, accounting for 44.74% (34/76). The antibody positive rate of JE among health people above 15 years old in Luoyang city was 48.94% (46/94), which was lower than it in Xinyang city at 97.78% (88/90). The difference showed statistical significance (χ(2) = 55.42, P < 0.05). The antibody positive rate among healthy people under vaccination was 50.41% (61/121), which was obviously higher than that among people without vaccination, at 16.67% (6/36) in Luoyang city. The difference showed statistical significance (χ(2) = 12.92, P < 0.05). The antibody positive rate among healthy people under vaccination was 67.11% (51/76) in Xinyang city, which was obviously higher than that among people without vaccination, at 46.39% (45/97). The difference showed statistical significance (χ(2) = 7.40, P < 0.05).

CONCLUSIONThe incidence of JE showed seasonal and regional characteristics, there were differences among ages and occupations. The difference was consistent with the difference in viral antibody level among health people in Henan province and Luoyang city.

Adolescent ; Adult ; Antibodies, Viral ; blood ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Encephalitis Virus, Japanese ; immunology ; Encephalitis, Japanese ; blood ; epidemiology ; immunology ; Humans ; Incidence ; Infant ; Middle Aged ; Young Adult

Hypertension and osteoporosis(OP)are common diseases in middle-aged and elderly people,and the number of patients with both diseases has gradually increased in recent years.Because the onset of the disease is hidden,it is easy to cause fractures and serious complications of heart,brain and kidney in the later stage,which not only seriously damages the quality of life of patients,but also increases the difficulty of clinical treatment.Therefore,it is particularly necessary to strengthen the research on this disease.More and more studies have found that the disorder of intestinal flora will lead to the occurrence of OP,while the intestinal flora of patients with hypertension is obviously out of balance.Therefore,this paper thinks that intestinal flora may be the key influencing factor of hypertension complicated with OP,and the imbalance of intestinal flora will lead to the imbalance of short-chain fatty acid metabolism,immune inflammatory reaction and increased sympathetic nerve activity,thus causing the imbalance of bone homeostasis and promoting the occurrence of OP.Therefore,it is suggested that regulating intestinal flora may be a new way to intervene hypertension complicated with OP.

OBJECTIVETo explore the appropriate strategies which are suitable for the areas with diverse health and economic resource settings in China by estimating the life outcomes and cost-effectiveness of several cervical cancer screening strategies.

METHODSMarkov model was used to calculate the long-term effectiveness, utility, benefit and cost among screened and unscreened cohorts in rural and urban areas, and then analyses of cost-effectiveness, cost-utility and cost-benefit were performed. The assessed screening strategies were acetic acid of visual inspection combined with Lugol's iodine staining (VIA/VILI), conventional Pap smear and simple HPV DNA testing (careHPV) in rural areas, and conventional Pap smear, simple HPV DNA testing (careHPV), HPV DNA testing (HC2) and liquid-based cytology (LBC) alone or combined with HPV DNA testing (LBC+HC2) in urban areas. We estimated the life outcomes and cost-effectiveness of the above screening strategies at one-year, 3-year and 5-year intervals.

RESULTSAll of the screening strategies were effective to decrease cervical cancer mortality and to increase life years, with a trend of shorter screening interval having better effectiveness. However, no matter in urban or rural areas, compared with careHPV testing at 5-year interval, the costs of other screening strategies were 1.28 - 13.86 folds, 1.31 - 14.14 folds, and 1.27 - 12.80 folds higher to avoid one death, to save a year of life, and a QALY, and the benefit per cost of other screening strategies was 9.9%-90.2%.

CONCLUSIONScareHPV testing at 5-year interval has the best cost-effectiveness performance and the highest benefit-cost ratio with the moderate life outcomes. It is the optimal cervical cancer screening strategy to be generalized in our country. careHPV testing at 3 years interval can be considered in more developed areas to achieve better effectiveness.

Acetic Acid ; Adult ; Cervical Intraepithelial Neoplasia ; diagnosis ; economics ; epidemiology ; virology ; China ; epidemiology ; Cost-Benefit Analysis ; Cytological Techniques ; DNA, Viral ; analysis ; Early Detection of Cancer ; economics ; methods ; Female ; Human Papillomavirus DNA Tests ; Humans ; Iodides ; Markov Chains ; Mass Screening ; economics ; methods ; Middle Aged ; Models, Biological ; Models, Statistical ; Papanicolaou Test ; Quality-Adjusted Life Years ; Rural Population ; Urban Population ; Uterine Cervical Neoplasms ; diagnosis ; economics ; epidemiology ; virology ; Vaginal Smears