Objective To analyze the value of open tension -free hemiorrhaghy ( OTFH) and laparoscopic totally extraperitoneal prosthesis ( LTEP) repair in patients with bilateral inguinal hernia .Methods A retrospective method was used to compare the clinical data of 115 patients with bilateral hernias , of which 61 cases received LTEP and 54 cases underwent OTFH , from June 2011 to December 2013, in our hospital .Results The mean operative time of LTEP group (88.2 ±15.6 min) was longer than the OTFH group(75.7 ±21.6) min (p<0.05).The dura-tion of hospitalization in LTEP group(2.6 ±1.1) day was shorter than OTFH group(4.2 ±2.1) d (p<0.05).Hos-pitalization expense of LTEP group (12 012.0 ±2 325.2) yuan was higher than the OTFH group (9 291.3 ±2 010.1) yuan (p<0.05).The incision pain by VAS points was gradually decreased in 24 hours, 48 hours, 72 hours after op-eration, and LTEP group was significant lower than OTFH group in the same time point .In LTEP group 3 case had laceration of peritoneum but turn to no other prosthesis , and 2 cases had acute urinary retentions .11 acute urinary re-tentions occurred in OTFH group , and 2 cases had chronic pain in inguinal area and 1 cases of fat liquefaction .No recurrence was found during a follow -up period of 6 to 24 months in both of 2 groups .Conclusion Both LTEP and OTFH are safe and accessible techniques for patients with bilateral inguinal hernia .OTFH is feasible, and has short process and low cost which is suitable for primary hospitals to carry out .OTFH has the advantages of little trauma , faster postoperative recovery and less complications which is worth promoting in future .

Objective:To explore the relationship between ventilator-associated pneumonia (VAP) and neutrophil/lymphocyte ratio (NLR) before mechanical ventilation in patients with malignant tumors.Methods:A retrospective nested case-control study was conducted. Patients with malignant tumor treated by mechanical ventilation admitted to the Third Affiliated Hospital of Guizhou Medical University from February 2015 to February 2020 were enrolled. The patients with VAP were selected as the case group, and the matched non-VAP cases were selected according to 1∶2 as the control group. The clinical data were collected, and the differences of each index between the two groups were compared. The influencing factors of VAP in patients with malignant tumor were analyzed by multivariate Logistic regression.Results:During the study period, 1 271 patients with malignant tumors were treated with mechanical ventilation, of which 241 cases had VAP, and the incidence of VAP was 18.96%. There were 232 VAP patients in the case group matched 464 non-VAP patients in the control group. The clinical data of age, gender, hospitalization diagnosis, primary tumor, regional lymph node and distant metastasis (TNM) stage, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), complications, duration of mechanical ventilation, hemoglobin (Hb) and serum albumin (Alb) levels were balanced and comparable between the two groups, and the cluster nursing measures were consistent. Compared with the control group, although there was no significant difference in neutrophil count (NEU) and lymphocyte count (LYM) in the case group [NEU (×10 9/L): 3.81±1.07 vs. 3.64±1.05, LYM (×10 9/L): 2.06±0.59 vs. 2.15±0.62, both P > 0.05], NLR was significantly increased (2.07±1.05 vs. 1.89±0.96, P < 0.05), and the hospital stay was significantly longer (days: 24.84±3.81 vs. 13.19±3.98, P < 0.01). NLR, gender, age, APACHEⅡ score, TNM stage, Hb, serum Alb and duration of mechanical ventilation were included in multivariate Logistic regression analysis. The results showed that patients with elevated NLR had higher risk of VAP [odds ratio ( OR) = 1.187, 95% confidence interval (95% CI) was 1.015-1.387, P = 0.032]. In patients with VAP, NLR was negatively correlated with the time of mechanical ventilation before VAP (r = -0.327, P = 0.000), and positively correlated with the time of treatment with antibiotics after VAP (r = 0.559, P = 0.000). Conclusion:Elevated NLR in patients with malignant tumors who were on mechanical ventilation can significantly increase the risk of VAP and increase the difficulty of treatment.

It is now thought that atherosclerosis,although due to enhanced lipid deposition,is mainly the result of a series inflammatory process.Total saponins of Aralia elata (Miq)Seem(TASAES)from the Chinese traditional herb Longya Araliachinensis L.,a folk medicine used for treating various diseases, increasing energy and improving the body′s ability to prevent hypoxia in Asian countries has attracted widespread attention. However, the ability of TASAES on inflammation-triggered vascular endothelial cell injury, a key early event in the pathogenesis of atherosclerosis, and its potential mechanisms of this protection have never been demonstrated. The present study determined the anti-inflammatory and anti-apoptoticactivities and protective mechanisms of the total aralosides of Araliaelata(Miq)Seem (TASAES) ameliorate tumor necrosis factor-α (TNF-α)-induced human umbilical vein endothelial cells (HUVECs) injury. Our results indicate that TASAES pretreatment provided cytoprotective effects by suppressing TNF-α-induced HUVECs apoptosis, mitochondrial membrane depolarization, caspase-3 activation, and modulation of inflammatory factors (IL-6, MCP-1 and VCAM-1), meanwhile inhibiting NF- κB transcription. Furthermore, the effect was correlated with the activation of the PI3K/Akt signal pathway. Blocking Akt activation with the PI3K inhibitor LY294002 effectively reversed the protective effect of TASAES against TNF-α-induced cell apoptosis.Moreover,the PI3K inhibitor partially blocked the effects of TASAES on the increasing of Bcl-2 and Bcl-xl protein expression,and inactivation of Bax protein expression. In conclusion, the results showed that TASAES decreased the inflammation and apoptosis of HUVECs caused by TNF-α treatment,and PI3K played a crucial role in enhancing cell sur-vival during this process.

Adult ; Chronic Disease ; Female ; Humans ; Placenta ; pathology ; Placenta Diseases ; diagnosis ; pathology ; Pregnancy

Objective To investigate the effect of methylguanidine and 1-methylhydantoin on cells cytotoxicity, apoptosis in human renal tubular epithelial cell line (HK-2). Methods Human PTEC cell line HK-2 was used in this study. HK-2 was cultured and divided into 3 groups: Norma1 control group (A), methylguanidine group(B) and 1-methylhydantoin group (C). The cell inhibitory rate of HK-2 was detected by MTT method. The cytotoxicity of methylguanidine to HK-2 was determined by NAG release test. Cell apoptosis was evaluated by using Hoechst stain and FACS with Annexin-V/PI. Results The OD value and NAG concentration of creatinine, methylguanidine and 1-methylhydantoin group were compared with normal control group. OD value decreased and NAG concentration significantly increased(0.188±0.011, 0.176±0.010 vs 0.545±0.021, F＝1557.74, P＜0.01; 20.488±0.473, 22.225±0.565 vs 5.125±0.198, F＝3848.22, P＜0.01). By Hoechst stain, pycnosis and apoptotic body could be found when HK-2 was cultivated in methylguanidine 1-methylhydantoin group. In methylguanidine, 1-methylhydantoin group apoptotic HK-2 apparently increased, compared with that in control group (18.23±1.1581, 20.22±1.1433 vs 2.473±0.321, F＝526.06, P＜0.01). Compared with group B, the OD value in group C decreased significantly (0.176±0.010 vs 0.188±0.011,t＝2.26, P＜0.05), NAG concentration increased significantly (22.225±0.565 vs 20.488±0.473,t＝-6.67, P＜0.01), and apoptotic rate in-creased significantly (20.22±1.1433 vs 18.23±1.1581,t＝-2.762, P＜0.05). Conclusions 1-methylhydantoin has more powerful cytotoxic effect to renal tubular epithelial cells than that of Methylguanidine.

Objective To investigate the effect of different concentrations of rapamycin on the proliferation and apoptosis of glomerular mesangial cells(GMCs)and to investigate the mechanism. Methods GMCs were treated with different concentrations of rapamycin(1 μg/L,2 μg/L,4 μg/L,8 μg/L,16 μg/L).After treatment for 24 h,48 h and 72 h,cell proliferation was assessed bv MTT colorimetric assay and the growth curve was traced.After treatment for 72 h,the cell cycle distribution and the apoptotic rate of GMCs in different concentrations of rapamycin were analyzed bv flow cytometry.The effects of different concentrations of rapamycin on the mRNA and protein expression of p27 and p53 were detected by RT-PCR and Western blot respectivelyResult The low dose of rapamycin(1 μ/L)could signiticanfly inhibit the proliferation of GMCs and showed no effect on apoptosis.The high dose of rapamycin (8-16 μg/L)could significantly increase the apoptotic rate of GMCs.Rapamycin could increase the mRNA and protein expression of p27 and p53. Conclusion Rapamycin can inhibit GMCs proliferation and promote GMCs apoptosis by increasing the expression of p27 and p53.

Objective To study the endogenous glucocorticoid on rat femoral head microenvironment of 11 hydroxysteroid dehydrogenase expression ,and to discuss the influence of combined with femoral head pathological changes of the corresponding mechanism .Methods Sixty SD rats were divided into control group ,1‐month group ,3‐months group ,each 20 rats in group .1‐month group and 3‐months group inject cortisone acetate in the abdominal cavity intraperitoneal for 1‐month or 3‐months each .Im‐munohistochemical ,immunofluorescence ,Real‐time qPCR ,HE staining were employed in this study .Results From immunohisto‐chemical ,immunofluorescence ,Real‐time qPCR ,the 11 hydroxysteroid dehydrogenase content of 1‐month group and 3‐months group were higher than that of the control group(P<0 .05) .From HE staining we detected 1‐month group in the bone marrow cavity in‐creased in fat cells ,3‐months group subchondral trabecular bone density decreased ,compared with the control group(P< 0 .05) . Conclusion Supplement of corticosterone could promote rat femoral head microenvironment 11 hydroxysteroid dehydrogenase ex‐pression and subchondral trabecular bone density decrease .

Objective: To evaluate diagnostic value of three noninvasive examinations for coronary heart disease (CHD).Methods:A total of 500 subjects, who were suspected of CHD, first received diagnostic coronary angiography (CAG) and hospitalized in our department from May 2014 to May 2015, were selected.According to CAG results, they were divided into non-CHD control group (n=106), single vessel coronary disease group (n=199), double-vessel coronary disease group (n=95) and multi-vessel coronary disease group (n=100, ≥three vessel disease).Besides CAG, all subjects accomplished one of following examinations at least: (1) 24h dynamic ECG (Holter);(2) real-time three-dimensional echocardiography(RT-3DE);(3) radionuclide myocardial perfusion imaging (RMPI).Sensitivity, specificity and accuracy of these three examinations in diagnosing CHD were evaluated.Results: With CAG as the gold standard, compared with Holter and RT-3DE, there were significant rise in sensitivity(68.4%, 69.0% vs.92.9%), specificity (62.9%, 81.4% vs.88.5%) and accuracy (67.1%, 71.2% vs.91.9%) of RMPI (P<0.01 all), only specificity of RT-3DE was significantly higher than that of Holter, P=0.019.Conclusion:Noninvasive examination can be used as important method diagnosing CHD, which are important measures for noninvasive diagnosing and assessing CHD.Accuracy, sensitivity and specificity of RMPI are high, which is worth extending.

Objective To investigate the effect of hosphocreatine therapy on the plasma cardiotrophin-1(CT-1) and N terminal probrain natriuretic (NT-proBNP) in elderly hypertensive patients with heart failure. Methods A total of 76 hy-pertensive patients with heart failure, aged 65 or over, were randomly divided into treatment group and control group (n=38 for each group). The control group received routine anti-heart failure treatment. The treatment group received conventional therapy plus creatine phosphate sodium for 2 weeks. The plasma levels of CT-1 and NT-proBNP were determined in two groups. The plasma CT-1 level was measured by a double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The plasma level of NT-proBNP was tested by Rui Pu fluorescent dry quantitative analyzer. Results The plasma levels of CT-1 and NT-proBNP were significantly lower after treatment in two groups (P＜0.01). The plasma levels of CT-1 and NT-proBNP were significantly decreased in treatment group than those in control group (P＜0.05). The total effective rate was 89.47%in treatment group, which was significantly higher than that of control group (71.05%, P＜0.05). Symptoms of heart failure improved in one week (21 cases in treatment group/9 cases in control group) and in two weeks (13 cases in treatment group/18 cases in control group). Conclusion The conventional therapy plus creatine phosphate sodium can decrease the plasma CT-1 and NT-proBNP levels in elderly hypertensive patients with heart failure, which improves symptoms of heart failure in a shorter period of time.

Objective To observe the effect of Huangxiong Kangshuan capsule on serum high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) levels in patients with acute cerebral infarction. Methods Ninety-two patients with acute cerebral infarction admitted to the First Affiliated Hospital of Anhui University of Traditional Chinese Medicinefrom July 2013 to December 2016 were enrolled, and they were divided into an observation group (47 cases) and a control group (45 cases) by random number table. The control group was given conventional treatment of ischemic cerebrovascular disease, while the observation group was additionally treated by Huangxiong Kangshuan capsule orally taken, once 3 tablets, 3 times a day, on the basis of routine treatment; the duration of treatment was 2 weeks in both groups. After 2 weeks of treatment, the clinical effects of the two groups and the changes of serum hs-CRP and IL-6 levels were observed.Results After treatment, the levels of serum hs-CRP and IL-6 were decreased significantly compared with those before treatment in the two groups [observation group: hs-CRP (mg/L) was 6.18±2.17 vs. 14.11±3.01, IL-6 (ng/L): 28.10±11.47 vs. 120.83±24.51; control group: hs-CRP (mg/L) was 8.89±2.46 vs. 13.97±2.69, IL-6 (ng/L) was 49.48±16.43 vs. 115.25±24.05], and the degree of decline in the observation group was more significant than that in the control group [hs-CRP (mg/L): 6.18±2.17 vs. 8.89±2.46, IL-6 (ng/L): 28.10±11.47 vs. 49.48±16.43, bothP < 0.01]; the total effective rate of the observation group was significantly higher than that of the control group [87.2% (41/47) vs. 71.1% (32/45),P < 0.05]. Conclusion Huangxiong Kangshuan capsule can decrease the serum hs-CRP and IL-6 levels in patients with acute cerebral infarction, and has a role in brain protection and nerve function defect improvement.