ObjectiveTo explore the relationship between anastomotic leakage of patients undergoing colonic surgery and the collagen metabolism of colonic wall.Method We measured the overall collagen content of colonic tissue by biochemistry and detected the collagen I, III, MMP-1,MMP-13 by immunohistochemistry in 16 patients with anastomotic leakage compared with 16 control cases. Resultthe overall collagen content and collagen I,III of colonic wall in the leakage group were lower than those in the control group (t=3.417,t=2.841, t=2.261,P

Objective To investigate the surgical treatment of coronary malperfusion due to acute type A aortic dissection.Methods The clinical data of 305 consecutive patients with type A aortic dissection, who were hospitalized and underwent operation between 2004 and 2015, were analyzed retrospectively.Among that, there were 37 cases with coronary malperfusion due to aortic dissection.Results The right coronary artery was involved in 33 cases, the left in 2 cases, and both coronary arteries in 2 cases.There were 22 coronary bypass grafting using saphenous vein in 21 patients, including 20 patients with the right coronary bypass grafting and 1 patient with the left.Six patients died postoperatively, with the mortality of 16.22％.Conclusion Acute type A aortic dissection with coronary involvement is associated with high mortality rate, which is necessary to restore the coronary revascularization as soon as we can.The methods to reconstruct the involved coronary is depend on the patients' condition and experience of surgeon.

As a key aspect of quality of life in patients w ith stroke, the clinical research of sexual function and sexual satisfaction is stil rare. The rehabilitation goals in patients w ith stroke usualy include recovering functional activities and improving quality of life, how ever, it is not yet know n about the recovery of sexual function. This article review s the epidemiology, etiology, risk factors, clinical manifestations, treatment and rehabilitation of sexual dysfunction in male patients w ith stroke.

Humans ; Pulmonary Embolism ; diagnosis ; therapy ; Venous Thromboembolism ; diagnosis ; therapy

Objective To study drug resistance of carbapenem-resistant Klebsiella pneumonia ( CRKP) in neonates hospitalized in the neonatal unit , and to identify the risk factors for CRKP colonization in neonates .Methods Totally 108 neonates with Klebsiella pneumonia colonization admitted in Department of Neonates , the Second Hospital of Tianjin Medical University during January 2012 and June 2014 were enrolled in the study , including 23 cases with CRKP colonization ( case group ) and 85 cases with carbapenem-sensitive Klebsiella pneumonia (CSKP) colonization (control group).Chi-square test and fisher exact test were used to compare the differences in resistance to 21 antibiotics between CRKP and CSKP . Univariate analysis and Logistic regression analysis were performed to identify the risk factors for CRKP colonization in neonates .Results All of the CRKP strains were resistant to penicillins , cephalosporins and SMZco, and 95.7% and 87.0% of the CRKP strains were resistant to meropenem and imipenem , respectively.All of the CRKP strains were susceptible to amikacin , gentamicin, ciprofloxacin and tetracycline, but were highly resistant to the rest 16 antibiotics compared with CSKP strains (all P<0.05). Univariate analysis showed that 14 factors were associated with CRKP colonization: exposure to cefoxitin (χ2 =20.053, P<0.01), sputum suction (χ2 =15.817, P<0.01), gastrointestinal decompression (χ2 =10.731, P<0.01), nasogastric feeding (χ2 =15.146, P<0.01), invasive procedure (χ2 =22.572, P<0.01), birth weight (χ2 =6.026, P<0.05), frequency of sampling for CRKP/CSKP (χ2 =18.577, P<0.01), hypertension of pregnancy (χ2 =8.698, P<0.01), premature birth (χ2 =4.904, P<0.05), prenatal hospitalization experience (χ2 =8.396, P<0.01), adequacy for gestational age (χ2 =7.295, P<0.05), gestational age (χ2 =7.294, P<0.05), rupture of membranes (χ2 =9.397, P<0.01), length of hospitalization (χ2 =14.649, P<0.01) and admission to the neonatal intensive care unit (NICU) (OR=11.050, P<0.01).Multivariate Logistic regression analysis showed that hypertension of pregnancy (OR=9.718, P<0.01), rupture of membranes ( <24 h) (OR=6.640, P<0.01) and admission to NICU ( OR=4.119, P<0.05) were independent risk factors for CRKP colonization .Conclusions CRKP strains are highly resistant to most antibiotics .Preventing hypertension of pregnancy and rupture of membranes , and monitoring bacterial resistance in NICU may help to reduce the occurrence of CRKP colonization and dissemination .

Objective To investigate the alternation of left ventricular systolic function in patients underwent transcatheter aortic valve implantation operation(TAVI) by three-dimensional speckle tracking technology (3D-STI).Methods Totally 20 patients with severe aortic stenosis were enrolled.All the subjects underwent successful TAVI operation.The real-time 3D full volume datasets on apical four-chamber view were acquired on before,7 days and 1 month after TAVI.Left ventricular global longitudinal strain(GLS),regional peak systolic longitudinal strain(LS),regional peak systolic circumferential strain(CS) and regional peak systolic radial strain(RS),were analysed using off-line TomTec software,the differences among the three groups were compared.Results Compared with the preoperation,aortic valve blood flow velocity (AV),mean aortic valve pressure gradient(mPAG) of 7 days after operation decreased significantly.Threedimensional left ventricular ejecation fraction(3D-LVEF) among the patients whose 3D-LVEF under 50％had a remarkable increase and whose 3D-LVEF exceed 50％ before operation had no significant change,while 1 month after operation the 3D-LVEF had a significant improvement compared with the preoperational data regardless of 3D-LVEF under 50％ or not.The GLS and LS of all segments of 7 days after TAVI were higher than pre-operation(all P ＜0.05),and it had a further improvement 1 month after TAVI.Conclusions LV systolic function had improvement early after TAVI.3D-STI is a new,convenient way to detect the global and regional left ventricular systolic function of TAVI patients.

Objective To investigate the micminnammatory state and its relationship with atherosclerosis and cardiac function in patients on continuous ambulatory peritoneal dialysis(CAPD). Methods Sixty-seven CAPD patients,27 non-dialytic stage 5 chronic kidney disease(CKD 5)patients and 27 gender and age matched healthy controls wore enrolled in this cross-sectional study.Clinical data and biochemical parameters were collected.Serum interleukin-6(IL-6)and IL-10 levels were measured by enzyme-linked immunosorbent assay(ELISA).High-sensitivity C-reactive protein(hs-CRP)was measured by immunoturbidimetry.Prevalence of atherosclerosis was detected by carotid uhrasonography while cardiac function was detected by echocardiography. Results Serum levels of inflammatory biomarkers were elevated significantly in CAPI)and CKD 5 patients as compared with healthy controls[IL-6(ng/L):2.400,1.515 vs 0.698;IL-10(ng/L):1.988,1.958 vs 0.277;hs-CRP(mg/L):1.090,1.345 vs 0].Left ventricular mass index(LVMI),myocardial performance index(Tei index 0.75±0.31,0.66±O.27 vs 0.52±0.23)in CAPD and CKD 5 patients increased significantly.The prevalence of carotid artery atherosclerosis and left ventricular hypertrophy(LVH)in CAPD and CKD 5 patients was significantly higher than that in healthy controls.No significant difference of the ultrasonic parameters was found between CAPD and CKD 5 patients.In CAPD patients,IL-6 was positively correlated with Tei index,whereas IL-10 was negatively correlated with INMI and was positively correlaled with ejection fraction(EF).In a multiple regression model,IL-6,self-rating depressive scale(SDS)score and pulse pressure were independent predictors of carotid artery atherosclerosis.Similarly,IL-6 and primary hypertension were independent correlates of Tei index in CAPD patients. Conclusions Microinflammatory state exists in either non-dialytic CKD 5 patients or CAPD patients and it is associated with atherosclerosis and cardiac distunetion.IL-6 is an independent risk factor of atherosclerosis and increased Tei index in CAPD patients.

The effect of astaxanthin on N(Ω)-nitro-L-arginine methyl ester (L-NAME) induced preeclampsia disease rats was investigated. Thirty pregnant Spraque-Dawley rats were randomly divided into three groups (n = 10): blank group, L-NAME group and astaxanthin group. From day 5 to 20, astaxanthin group rats were treated with astaxanthin (25 mg x kg(-1) x d(-1) x bw(-1)) from pregnancy (day 5). To establish the preeclamptic rat model, L-NAME group and astaxanthin group rats were injected with L-NAME (125 mg x kg(-1) x d(-1) x bw(-1)) from days 10-20 of pregnancy. The blood pressure and urine protein were recorded. Serum of each group was collected and malondialdehyde (MDA), superoxide dismutase (SOD) and nitric oxide synthase (NOS) activities were analyzed. Pathological changes were observed with HE stain. The expression of NF-κB (nuclear factor kappa B), ROCK II (Rho-associated protein kinase II), HO-1 (heme oxygenase-1) and Caspase 3 were analyzed with immunohistochemistry. L-NAME induced typical preeclampsia symptoms, such as the increased blood pressure, urinary protein, the content of MDA, etc. Astaxanthin significantly reduced the blood pressure (P < 0.01), the content of MDA (P < 0.05), and increased the activity of SOD (P < 0.05) of preeclampsia rats. The urinary protein, NO, and NOS were also decreased. HE stain revealed that after treated with astaxanthin, the thickness of basilal membrane was improved and the content of trophoblast cells and spiral arteries was reduced. Immunohistochemistry results revealed that the expressions of NF-κB, ROCK II and Caspase 3 in placenta tissue were effectively decreased, and HO-1 was increased. Results indicated that astaxanthin can improve the preeclampsia symptoms by effectively reducing the oxidative stress and inflammatory damages of preeclampsia. It revealed that astaxanthin may be benefit for prevention and treatment of preeclampsia disease.

Objective To establish the early warning model for apostasis of postoperative patients with cerebral tumor, predict the risk of apostasis, so as to realize the early control and prevention. Methods Nine hundreds and ninety-five cerebral tumor patients were enrolled in a prospective investigation, the clinical data were collected and analyzed to make the early warning model by Logistic regression analysis. Results Collected 995 valid questionnaires, 149 cases(15.6%, 149/995) need unplanned transfer to ICU, 50 cases(5.0%, 59/995) need unscheduled second operation. The early warning model was established by Logistic regression analysis based on pupil, Glasgow Coma Scale(GCS) score, Modified Early Warning Score(MEWS) three indicators associated with disease progression:Z=0.1×pupil+0.8× GCS score+2.5×MEWS.Then the effectiveness of the model was verified by ROC curve, and the results showed that the area under the curve was 0.852(95%CI 0.816-0.887), sensitivity was 80.5%, specificity was 80.5%, accuracy was 85.0%, Youden index was 0.61, positive likelihood was 4.128, negative likelihood was 0.242. Conclusions The early warning model can predict the apostasis events of postoperative patients with cerebral tumor, also can prevent the complications and improve the quality life of patients.

Objective · To study the metabolite profiles on patients of ischemic stroke using metabonomics approach. Methods · The serum samples from the 29 patients with ischemic stroke and 31 healthy controls were analyzed by gas chromatography time-of-flight mass spectrometry (GC-TOFMS) coupled multi-dimensional statistical methods to find differential metabolites in two groups. Results · Orthogonal partial least squares analysis (OPLS) model was generated based on identified metabolites and shown clear discrimination from patients and healthy controls. Some serum metabolite levels were significantly altered in patients. Six up-regulated metabolites included γ- aminobutyric acid, glutaric acid, glyceric acid, gluconic acid, lactobionic acid, and cholesterol, and nineteen down-regulated metabolites included citric acid, aconitic acid, malic acid, succinic acid, β-alanine, and glycerol-3-phosphate. Conclusion · Amino acid metabolism, glycometabolism and tricarboxylic acid (TCA) cycle are disturbed in patient of ischemic stroke. The metabonomic approach has great potential to understand the underlying mechanisms of stroke in ischemic patients.