Objective In order to investigate the relationship among reflux esophagitis,Barrett's e- sophagus and esophageal adenocarcinomas,the expressions of Cdx2 and MUC2 gene were studied.Methods Using immunohistochemistry,the expressions of the Cdx2 and MUC2 were detected in the esophageal mu- cosa of 30 patients with reflux esophagitis,18 patients with Barrett's esophagus and 25 patients with esopha- geal adenocareinoma.Results The positive rate and staining intensity of Cdx2 and MUC2 expressions in re- flux esophagitis,Barrett's esophagus and esophageal adenocarcinoma were significantly higher than those in normal esophageal mucosa(P

The pertinent literature on application of traditional Chinese medicine (TCM) in hemopoietic stem cell transplantation was summarized, it indicated that the intervention of TCM could raise the mobilization effect, speed up the hemopoiesis and immunologic reconstruction after transplantation, decrease the incidence of complications, and prolong the life span of patients, showing a preliminary achievement.
Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Graft vs Host Disease ; etiology ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; Postoperative Complications ; etiology ; prevention & control

Objective To clone the gene encoding protein of EspA and Stx2B from EHEC OI57:H7 by DNA recombinant technology, construct prokaryotic expression vector pET-28a ( + )-espAstx2B, express fusion protein of EspA-Stx2B and to analyze the biological and immunological characteristics of the fusion protein. Methods the sequence encoding the protein of EspA and Stx2B was amplified by PCR from the enterohemorrhagic Escherichia coli strain. The amplified products were connected with linker by recombinant technology and cloned into pET-28a( + ) vector. The vector was then transferred to the host cells E. Coli BL21 strain (DE3). Following, the protein expression was induced by IPTG. The expression quantities and style of fusion protein was then determined by SDS-PAGE. Its immunoreactivity was analyzed by Western blot. Finally, BALB/c mice were injected with the preliminarily purified recombination protein EspA-Stx2B, then oral challenged these mice with EHEC O157-SMR2 and counteracted toxic substances with O157 ultrasonic supernatant. Results The determination of the sequence encoding of the espA-stx2B fusion gene has 100% of consistency with the sequence from GenBank Sakai strain and contrivable linker. This fusion protein EspA-Stx2B was expressed as inclusion body formation and the percentage is approximately 40%. Western blot suggested the fusion protein has excellent immunoreactivity. Titer of antiserum of the mice to EspA-Stx2B increased evidently. EspA-Stx2B could not decrease bacterial number attached to the intestinal tract of mice based on fecal shedding of Oi57 in mice. In the test of death of BAI,B/c causing by conteracting toxic substances with O157 ultrasonic supernatant, immunoprotection of EspA-Stx2B rate was 66.7%. Conclusion A recombinant plasmid that has high performance on expression of EspA-Stx2B prorein was successfully constructed in present study, and the fusion protein has excellent immunoreactivity and immunogenicity. EspA-Stx2B could not decrease bacteria] number attached to the intestinal tract of mice based on fecal shedding of O157 in mice, but evidently decrease the mortality rate of the mice. The antiEspA and anti-Stx2B had immunoprotection effect by different means. These results may provide the foundation for the further development on EHEC O157:H7 double subunit vaccine.

Objective To explore the method of endovascular therapy for complicated aortic dissections.(Methods) The clinical data of 25 patients with complicated aortic dissections were analysed retrospectively.Results The patients′ ages ranged from 31-72 years with a mean of 50.2 years.Among the 25 cases,6 cases had severe ischemia of mesenteric artery,5 cases had renal artery ischemia,4 cases had severe(ischemia) of both legs,3 cases had renal arteries ischemia combined with superior mesenteric artery ischemia,2 had complicated aortic dissection combined with AAA,and in 5 cases the true aortic lumen was totally(compressed) by the false aneurysmal lumen.All patients underwent endovascular therapy,and the instant(technique) was successfully performed in all patients.Endoleak occurred in 3 cases after the stent-graft(deployment),it stopped spontaneously in 2 of them 7 days later,and 1 case with endoleak waiting for(treatment).In the other 22 patients,angiography after the operation showed that all the diseased area were sealed completely,and the viscera arterial blood supply was restored mainly via the true lumen.All the(patients) were cured and discharged.Conclusions In the management of complicated aortic dissections,(endoluminal) technique is simple,less traumatic,safe and has less complications as compared to the traditional operation.Improvement of the endoluminal technique is essential for successful treatment of these complicated cases.

Objective: To analyze the relationship between hemoglobin ( Hb ) and serum uric acid ( SUA ), so as to provide basis for preventing hyperuricemia ( HUA ) . Methods: As the research subjects, people who underwent physical examination in Zhejiang Provincial People's Hospital from January 1, 2017 to October 31, 2020 for 4 years in a row and who were non-HUA in 2017 were selected. The physical examination data were collected, including body mass index, blood pressure, blood routine, blood biochemical tests, etc. The subjects grouped by quartiles of Hb level in 2017. The occurrence of SUA elevation ( SUA increased ≥60 μmol/L from baseline ) , significantly SUA elevation ( SUA increased ≥120 μmol/L from baseline ), HUA ( SUA>420 μmol/L ) and severe HUA ( SUA ≥480 μmol/L ) in the next 3 years were taken as end events. The incidence, occurrence time and risk of end events in different Hb groups were analyzed. Results: A total of 4 073 subjects were selected and divided into 4 groups according to the Hb level from low to high, with 969 subjects in group A, 907 subjects in group B, 1 109 subjects in group C and 1 088 subjects in group D. SUA elevation was in 745 patients ( 18.29% ); significantly SUA elevation was in 105 patients ( 2.58% ); HUA was in 514 patients ( 12.62% ); severe HUA was in 94 patients ( 2.31% ). The incidence of SUA elevation and significantly SUA elevation showed a decreasing trend with the increase of Hb level ( P<0.05 ). The occurrence time of SUA elevation in group A to D was 2.788, 2.817, 2.860 and 2.814 years, and the difference was statistically significant ( P<0.05 ). There were no statistically significant differences in the occurrence time of other end events ( P>0.05 ). The multivariate Cox proportional hazards regression analysis showed that compared with group A, other Hb groups had lower risk ( HR=0.498-0.776, 95%CI:0.253-0.981 ) of SUA elevation, significantly SUA elevation and severe HUA after adjusting for gender, age, ALT, Scr, body mass index, etc. Conclusions With the increase of Hb level, the incidence of SUA elevation may decrease and the occurrence time is prolonged. Compared with the lowest Hb group, the higher Hb groups had lower risk of SUA elevation, significantly SUA elevation and severe HUA.

Objective:To investigate the effects of pre-existing antibody on seroconversion rate after influenza vaccination.Methods:This study recruited 1 900 healthy volunteers to receive influenza split vaccines in Xinjiang Uygur Autonomous region and Yunnan Province from September 2009 to October 2018. Hemagglutinin agglutination inhibition assay was used to detect the titers of specific antibodies in blood samples collected before vaccination and 28 d after vaccination and the effects of pre-existing antibody on the seroconversion to different influenza vaccine components were analyzed.Results:Trend analysis showed that with the increasing titer of pre-existing antibody, the seroconversion rates to A/H1N1, A/H3N2, B/Victoria and B/Yamagata vaccine components were gradually decreased (χ 2=121.76, P<0.001; χ 2=67.58, P<0.001; χ 2=45.25, P<0.001; χ 2=54.55, P<0.001). After adjusting for factors such as region, gender and age, multivariate logistic regression showed that pre-existing antibody titer equal to or higher than 40 was an independent factor that affected the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, and the adjusted OR (95%CI) values were 2.50(2.00-3.13)、1.64(1.35-2.00) and 2.50(1.79-3.45), respectively. Conclusions:The seroconversion rate to each vaccine component was negatively correlated with the pre-existing antibody titer. The factor that pre-existing antibody titer equal to or higher than 40 was detrimental to the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, but had no significant influence on B/Yamagata seroconversion.

Objective To observe the combined poisonous effects of fluoride and aluminum on sex hormone of male rats.Methods Sixteen weaned SD healthy male rats aged two week were selected and divided into control group,aluminum group,fluoride group,fluorine-aluminum group,four rats in each group.All rats in the experimental groups were fed with corn collected from the prevailng areas containing different fluorine contents respectively for 90 days.Serum testosterone(T)and estradiol(E2)were detected.Results Compared separatelv with the control group[(3.317±0.635)μg/L],serum T level of fluorine-aluminum group[(15.994±6.558)μg/L]was higher(P＜0.05),but aluminum[(8.134±3.134)μg/L]and fluorine[(1.868±0.367)μg/L]groups had no significant differences(P＞0.05).Compared separately with the control group[(0.319±0.072)nmol/L],E2 level of the fluorine group[(0.172±0.030)nmol/L]being lower(P＜0.05),and it was not significant differences(P＞0.05)in the control group when compared with aluminum group[(0.282±0.012)nmol/L],and fluorine-aluminum group[(0.265±0.047)nmol/L].Fluorine and aluminum interacted with each other(F=9.82,P＜0.05).Conclusion The combined poisonous effects of fluorine and aluminum may influence sex hormone levels of male rats.

Objective:To evaluate the relationship between systemic immune-inflammatory index (SII) and prognosis of acute respiratory distress syndrome (ARDS).Methods:ARDS patients from the I Medical Information Mart for Intensive CareⅢ were selected as the study objects. Patients were followed up for one year. The primary endpoint was the 30-day mortality rate, and secondary endpoints were the 90-day and one-year mortality rates. Cox proportional hazard regression analysis was used to assess SII as an independent risk factor for ARDS patients, with propensity score matching to control for confounding factors.Results:A total of 723 ARDS patients were included in this study. Patients with SII≥ 3655 had older age, lower SpO 2 levels, and higher simplified acute physiology scoreⅡ (SAPSⅡ) and sequential organ failure assessment (SOFA) scores compared to those with SII <3655. Additionally, the 30-day, 90-day, and one-year mortality rates were higher in patients with SII ≥3655. Cox proportional hazard regression analysis showed that high SII level was an independent risk factor for the prognosis of ARDS at 30 days ( HR=1.68, 95% CI: 1.19-2.36, P=0.0028), 90 days ( HR=1.46, 95% CI: 1.07-1.99, P=0.0170), and one year ( HR=1.34, 95% CI: 1.01-1.77, P=0.0425). Propensity score matching analysis further confirmed the relationship between SII and the prognosis of ARDS patients. Conclusions:SII, as a simple and easily measurable index, is an independent risk factor for the prognosis of ARDS patients.

OBJECTIVETo investigate the effects of antibiotic-PMMA (polymethyl-methacrylate) beads combined with external fixator in treatment of infected fracture nonunion.

METHODSTwenty-two cases of infected fracture-nonunions were reviewed involving 20 male and 2 female with an average age of 34.68 years (ranging 21 to 74 years). The data consisted of 9 cases of tibial fractures, 2 distal fractures of the femur, 6 femoral shaft fractures, 3 intertrochanteric fracture of the femur and 2 humeral shaft fractures. The procedure included thorough debridement to wipe out dead bone and granulation tissue, then antibiotic-PMMA bead chains imbedded into the dead space. One week later, secondary debridement was performed, antibiotic-PMMA bead chains were changed according to result of bacterial culture and susceptibility test, and fractures were stabilized with external fixator. Three months after debridement, antibiotic-PMMA bead chains were taken out and bone graft with autogenous iliac cancellous bone chips was performed.

RESULTSThe mean follow-up period was 19.98 months (ranging 15 to 28 months). Infection was controlled in 20 cases. One tibial fracture and 1 intertrochanteric fracture of the femur needed repeated debridement 2 and 3 months after bone grafting respectively,because of infection recurrence and sinus formation. All 22 cases achieved bony union averaged 15.09 weeks after bone grafting with a range of 8 to 24 weeks.

CONCLUSIONThorough debridement, imbedding antibiotic-PMMA bead chains combined with external fixator and staged bone grafting has proven to be effective and simple for treatment of infected fracture nonunion. The antibiotic bead delivers high tissue levels,obliterates dead space, aids bone repair.

Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Bone Diseases, Infectious ; drug therapy ; microbiology ; surgery ; Bone Transplantation ; External Fixators ; Female ; Follow-Up Studies ; Fractures, Bone ; complications ; drug therapy ; surgery ; Fractures, Ununited ; complications ; drug therapy ; surgery ; Humans ; Male ; Middle Aged ; Polymethyl Methacrylate ; chemistry ; Young Adult

OBJECTIVETo compare therapeutic effects between antegrade intramedullary nailing and retrograde intramedullary nailing for the treatment of humeral shaft fractures.

METHODSFrom March 1999 to October 2006, 105 patients with humeral shaft fractures were treated with locked intramedullary nail and were adequately followed up. There were 82 antegrade nailing and 23 retrograde nailing. The follow-up parameters included operation time, blood loss,fracture healing rate, healing time, complications, Constant-Murley shoulder score and Mayo elbow performance score.

RESULTSThe mean follow-up period was 31.2 months. Antegrade intramedullary nailing had significantly less blood loss than that in retrograde intramedullary nailing (P=0.002). The differences in operation time, complications, healing time and bone healing rate between he two groups had no statistical significance. Complications in the antegrade intramedullary nail group included 4 patients with nonunions, 1 patient with radial nerve palsy, and 8 patients with shoulder pains and decrement in shoulder range of motion. Complications in the retrograde intramedullary nail group included 1 patient with radial nerve palsy and 3 patients with iatrogenic fractures. For shoulder joints,the difference in the average Constant-Murley shoulder score between the two groups was statistically significant (P=0.04). For elbow joints, the average postoperative Mayo elbow performance score between these two approaches did not differ significantly.

CONCLUSIONBoth the antegrade intramedullary nailing and the retrograde intramedullary nailing are good alternatives for the treatment of humeral shaft fractures. Because of higher incidence of iatrogenic fractures, the insertion point of retrograde intramedullary nailing should be carefully prepared. With antegrade insertion, it important to bury the humeral nail below the rotator cuff to prevent the subacromial impingement, and the rotator cuff should be carefully repaired to avoid shoulder pain and improve shoulder function.

Adult ; Aged ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged