To investigate the diagnosis and treatment of renal trauma, a retrospective analysis of 300 patients with renal trauma was carried out. Among them, 274 (91 3%) had blunt renal injuries and 26 (8 7%) had penetrating injuries; 123 (41%) had multiple complicated intraabdominal injuries and 56 (18%) had concomitant shock. The positive rate was 48 7% by regular dose IVU examination and 90 9% by double dose IVU, 79 3% by ultrasonography, and 95 7% by CT. One hundred and eighty five patients were cured by conservative treatment. Fourteen patients died. B ultrasound could be conveniently used for primary assessment of renal injuries, while CT showed rapid and accurate condition of a renal trauma patient. The treatment depends on the severity of the injury. The conservative treatment was employed in most cases which present slight or moderate injury with no evident massive bleeding. Severe injury required surgical exploration. The operative approach was done through a transabdominal incision, which made it relatively easy to explore the abdominal contents and to manage the injured kidney. It was also very important to control shock and prevent other severe complications in the early stage of the treatment.

Objective To investigate the changes of plasma microRNA-223 (miR-223) in pediatric severe pneumonia patients and its relationship with severe pneumonia.Methods There were 50 children with severe pneumonia enrolled in the study (observation group),and 50 healthy children were selected as control group (normal control group).The expression levels of plasma miR-223 were detected by real time polymerase chain reaction.The relationship between miR-223 and procalcitonin (PCT),C-reactive protein (CRP),tumor necrosis factor-α (TNF)-α,and interleukin (IL)-10 were analyzed.The predictive value of miR-223 in plasma,PCT,and CRP to severe pneumonia was evaluated by receiver operating characteristic (ROC) curve.The relationship between miR-223,T cells,TNF-α,and IL-10 was analyzed.Results The plasma miR-223 expression levels in observation group were upregulated compared to those in the normal control group [(16.01 ± 5.17) × 10-4 mg/L vs (5.44 ± 2.21) × 10-4 mg/L,t =7.46,P ＜ 0.01].The CRP and PCT expression levels in severe pneumonia patients were higher than those of the normal control group [z =5.496,5.198,P ＜0.05,orP ＜0.01].The expressions of CD4+ CD25+Treg,miR-223,and IL-10 in observation group were higher than those of normal control group (P ＜0.05).The expression of CD4 + CD25 + Treg,miR-223,and IL-10 in the death children were higher.There was a positive correlation between miR-223 and IL-10 (r =0.335,0.571,P ＜ 0.01).The sensitivity and specific degrees to predict the severe pneumonia in mir-223,PCT,and CRP were 83.79％,86.12％,66.68％,91.05％,78.01％,and 44.23％,respectively.miR-223 was better than PCT and CRP to predict severe pneumonia in children.Conclusions The expression levels of plasma miR-223 in children with severe pneumonia could reflect the immunity,and it can be used as early prognostic markers to reflect the severity of inflammation in some degree.

Objective To evaluate the efficacy and safety of human glucagon-like peptide-1 analogue liraglutide in newly diagnosed type 2 diabetes mellitus (T2DM) with glycosylated hemoglobin A1c (HbA1c) ＞ 9％.Methods This was an open-labelled,randomized,parallel-group,treat-to-target trial.Newly diagnosed T2DM patients with HbA1c ＞ 9％ were enrolled.These patients were treated with metformin with repaglinide and randomized to receive once-daily liraglutide (LIRA,n =25) or the insulin glargine (IGla,n =24) at bedtime.Efficacy and safety were assessed and compared after 18-month treatment.Results (1) Compared with the baseline,patients with LIRA had significantly reduced mean body weight,BMI and waist circumference (P ＜ 0.01),whereas,the above indexes were increased (P ＜ 0.01) in patients treated with IGla.(2) After 18 months of treatment,fasting plasma glucose (FPG),2-hour plasma glucose after a 75g oral glucose load(2hPG) and HbA1c were significantly improved in all patients (P ＜ 0.01),with 2hPG,mean blood glucose (MBG),the largest amplitude of glycemic excursions (LAGE),mean amplitude of glycemic excursions (MAGE) were significantly lower in LIRA group than in IGla group (all P ＜ 0.05).(3) HOMA-IR decreased in both groups (P ＜ 0.05).However,△I30/△G30,AUCCP180 and Matsuda index were only significantly increased in patients treated with LIRA (respectively,4.88 ± 1.55 vs 7.60 ± 1.91,9.23 ± 2.66 vs 13.18 ± 2.72,39.28 ± 20.35 vs 54.64 ± 23.34,all P ＜ 0.01),while HOMA-IR reduced(4.41 ± 1.58 vs 3.52 ± 1.44,P ＜0.05).But in IGla group only HOMAIR was reduced (4.92 ± 1.84 vs 4.57 ± 1.80,P ＜0.05).The index of △I30/△G30,AUCCP180 and Matsuda index in LIRA group are higher than those of indexes in IGla group(respectively,7.60 ± 1.91 vs 4.18 ± 1.00,13.18 ± 2.72 vs 10.53 ± 2.68,54.64 ± 23.34 vs 41.65 ± 17.84,all P ＜ 0.05),while HOMA-IR is lower (3.52 ± 1.44 vs 4.57 ± 1.80,P ＜ 0.05).(4) The rate of HbA1 c ≤ 6.5 ％ and the dosages of oral anti-diabetic drugs in LIRA group were significantly better than that in IGla group.(5) No significant differences were observed in hypoglycemic episodes and adverse events between two groups.Conclusion It seems that liraglutide is superior to insulin glargine in newly diagnosed T2DM patients with HbA1c ＞ 9％ in improving beta-cell function,insulin sensitivity and glucose homeostasis.

Adult ; Angioplasty, Balloon ; methods ; Arteriovenous Malformations ; complications ; therapy ; Heart Septal Defects, Ventricular ; complications ; therapy ; Humans ; Jugular Veins ; Male ; Vena Cava, Inferior ; abnormalities

Arterio-Arterial Fistula ; surgery ; Cardiac Catheterization ; Cardiac Surgical Procedures ; Catheterization ; Coronary Vessels ; Heart Ventricles ; Humans ; Male ; Middle Aged

The cultivation of general practitioner is a key to improve China's community-based medical and health care system.Zunyi Medical University,in the process of cultivating tuition-free students with the mode of serving and staying in the countryside after their graduation,always upholds the principles of being oriented by post competence,being led by medical humanities,optimizing featured courses about general practitioner,carrying out students-centered teaching methodology,focusing on training students' autonomous learning ability,and fully building the practical teaching system,so as to strive to cultivate high-quality talents in the field of general medicine to make them better serve the rural community-based medical institutions.

Objective To evaluate the effects of different concentrations of hydroxyethyl starch (HES) 130/0.4 applied for different time periods on injury to human renal tubular epithelial cells.Methods Human renal kidney epithelial cells HK-2 at the logarithmic growth phase were seeded in 96-well plates at a density of 1 × 105 cells/ml (0.1 ml/well),in culture flasks (5 ml/flask) or in cluture dishes (5 ml/dish).HK-2 cells were randomly divided into 4 groups (n=49 each) using a random number table:control group (group C) and 0.3％,1.5％ and 3.0％ HES 130/0.4 groups (H1,H2 and H3 groups).In H1,H2 and H3 groups,HK-2 cells were incubated with 0.3％,1.5％ and 3.0％ HES 130/0.4,respectively.The equal volume of PBS was added to the culture medium in group C.At day 1,3,5 and 7 of incubation,the cell viability was measured.At day 3,5 and 7 of incubation,cell apoptosis was detected,and apoptosis rate was calculated.On day 7 of incubation,the cells were stained with toluidine blue for examination of intracellular HES deposition (under light microscope) and pathological changes (with transmission electron microscope).Results Compared with group C,the cell viability was significantly decreased on day 5 and 7 of incubation,and apoptosis rate was increased on day 3,5 and 7 of incubation in group H3,and no significant difference was detected in the parameters mentioned above in H1 and H2 groups.Microscopic examination showed that intracellular HES deposition was observed in H2 and H3 groups,and pathological changes were obvious,and apoptotic cells were also found in H3 group.Conclusion Application of high-concentration HES 130/0.4 for a long period can lead to injury to human renal tubular epithelial cells,however,application of high-or low-concentration HES 130/0.4 for a short period produces no influence on the cells.

Objective:To study the role of adhesion molecules in the pathogenesis of polymyositis. Methods:The abnormal expression of adhesion molecules on T cells in peripheral blood and muscle fibers from patients with myositis was analyzed by two colour immunofluoresence and RT PCR methods respectively. Results:The expression of adhesion molecules including lymphocyte function associated antigen 1(LFA 1 ),very late antigen 4(VLA 4) on T cells in peripheral blood and intercellular adhesion molecule l(ICAM 1) on muscle fibers from patients with myositis was markedly higher than that in the healthy control group. Conclusion: These findings suggested that adhesion molecules may be responsible for the migration of T cells and destraction of muscle fibers.

Objective: To investigate the effects of methylation of KISS1 gene promoter and KISS1 expression on biological characteristics of colorectal cancer HCT116 cells induced by methyltransferase inhibitor 5-aza-2′-deoxycytidine (5-Aza-dC). Methods: The promoter methylation status of KISS1 gene and its mRNA and protein expressions in HCT116 cells were detected by methylation-specific PCR, real-time fluorogenic quantitative-PCR and Western blotting, respectively; after treatment with 5-Aza-dC in vitro. The abilities of invasion and migration of HCT116 cells were detected by Transwell assay, and the cell proliferation was detected by Cell Counting Kit-8 (CCK-8). Results: The demethylation of KISS1 promoter was induced after treatment with 5-Aza-dC. The expressions of KISS1 mRNA and protein in HCT116 cells were significantly increased in a dose-dependent manner after treatment with different doses of 5-Aza-dC for 5 days as compared with those without treatment with 5-Aza-dC (P < 0.05). The differences in the expressions of KISS1 mRNA and protein were not statistically significant between 5 μmol/L of 5-Aza-dC intervention group and 10 μmol/L of 5-Aza-dC intervention group (P > 0.05). The abilities of invasion and migration of HCT116 cells after 5-Aza-dC treatment were also reduced (P < 0.05). Conclusion: The DNA methyltransferase inhibitor 5-Aza-dC can reverse the methylation of KISS1 promoter, and reduce the abilities of invasion and migration of HCT116 cells by up-regulating the expression of KISS1. Copyright© 2014 by TUMOR.

Anal Canal/surgery* ; Anorectal Malformations ; Constriction ; Fecal Incontinence ; Humans ; Rectal Prolapse