Objective To investigate the risk factors of pneumonia in patients with non ST segment elevation-acute cononary syndromes (NSTE-ACS).Methods A total of 183 cases with NSTE-ACS was divided into pneumonia and non-pneumonia groups.The possible risk factors were screened firstly,then nonconditional logistic model multivariate analysis was used to investigate risk factors including age,sex,weight,smoking,chronic obstructive pulmonary disease (COPD),hypertention,diabetes,left ventricular failure,renal failure,low serum albumin,early revascularization and early rehabilitation exercise on the occurrence of pneumonia in NSTE-ACS.Results The differences were statistically significant in factors including age,smoking,COPD,diabetes,left ventricular failure,renal failure,low serum albumin,early revascularization,and early rehabilitation exercise between two groups (P ＜ 0.05).By analysis of logistic,risk factors on the occurrence of pneumonia in NSTE-ACS were age,smoking,COPD,diabetes,left ventricular failure,renal failure,and low serum albumin(P ＜0.05).Early revascularization and early rehabilitation exercise were the protective factors to avoid pneumonia.Conclusions Left ventricular failure,age,smoking,COPD,diabetes,renal failure,and low serum albumin were the risk factors of pneumonia occurred in NSTE-ACS,but early revascularization and early rehabilitation exercise were the protective factors to avoid pneumonia.Actively treating the risk factors and early initiating the protective factors can effectively reduce the incidence of pneumonia.

[Objective] To observe the effect of TCM on bladder cough.[Method]Take the principles of removing pathogens to stop cough,reinforcing essential qi to nourish deficiency and considering both the superficial and inside,and divide 54 cases into 5 types:attacked externally with wind cold,with wind heat,with dryness,overheat of liver fire and both deficiency of lung and kidney,make treatment by differentiation of signs.[Result]38 cases were cured,6 had marked effect,6 were effective,4 had no effect,and the total effective rate was 92%.[Conclusion]TCM has obvious cure effect in treating bladder cough.

Coma ; diagnosis ; etiology ; Female ; Humans ; Hyperparathyroidism, Primary ; complications ; diagnosis ; Male ; Middle Aged

Objective:To observe the efficacy and safety of Qingpeng ointment in the prevention and treatment of chemotherapeutic phlebitis. Methods:Totally 72 patients with non-small cell lung cancer undergoing chemotherapy after pneumonectomy were randomly divided into control and observation groups. The control group was treated with the conventional therapy to prevent phlebitis, and on the basis of conrentional therapy the observation group was treated with Qingpeng ointment at the injection site and along with the vein be-fore the chemotherapy, at the beginning of the chemotherapy, during the chemotherapy and after the chemotherapy in the same day and on the next day. The treatment course was 3 days. The incidence of phlebitis, hierarchical cases, VAS score and pain duration between the groups were compared, and the adverse drug reactions were observed. Results:The pain degree and duration induced by phlebitis showed no significant differences between the groups(P>0. 05), while the pain degree and duration in the observation group were de-creased when compared with those in the control group. The incidence of phlebitis in the observation group was obviously lower than that in the control group with statistically significant difference (P <0. 05). No adverse reactions were found with the external use of Qingpeng ointment. Conclusion:Qingpeng ointment has certain efficacy with high safety in the prevention of tumor-chemotherapeutic phlebitis, which can improve patients’ compliance, and is worthy of promoted application in clinics.

Objective To evaluate the imaging manifestations in diagnosis lipoma of upper alimentary canal.Methods 8 cases with lipoma of upper alimentary canal were performed by barium meal and dual-contrast gastrointestinography(n=8),ultrasound(n=1),computed tomography(n=2)and endoscopy(n=5).Results (1)Barium meal and dual-contrast gastrointestinography could diagnose benign space-occupation of upper alimentary canal.(2)Ultrasound and endoscopy could diagnose benign space-occupation.(3)The density of fat of lesion could well be displayed by computed tomography and contrast-enhenment computed tomography and lipoma could be diagnosed before opertion.Conclusion The combination of gastrointestinography,endoscopy and computed tomography can be regarded as the first procedure for diagnosis lipoma of upper alimentary canal.

Objective To explore the effect of the mutant and expression level of N-ras on chronic myelogenous leukemia. Method We investigated the mutant by direct sequencing in a K562 human chronic myelogenous leukemia cell line, with determination of the expression level of N-ras mRNA in K562 by RT-PCR. Result No single point mutation was detected in K562 cell line, furthermore, the expression level of N-ras gene is abnormaly high in contrast to normal human. Conclusion Our results indicated that the expression level of N-ras gene was obviously high in K562 cell line, and the underlying mechanism was not only mutation, so that further investigation is called for.

Objective To investigate surgical treatment for tumor involved inferior vena cava at the upper segment of kidney.Methods The clinical data of 35 patients with tumor involved inferior vena cava at the upper segment of kidney who were admitted to Changhai Hospital affiliated to the Second Military Medical University from January 2007 to May 2015 were retrospectively analyzed.All the patients received preoperative imaging examinations to insure the site and range of inferior vena cava involvement at the upper segment of kidney.Renal cell carcinomas with inferior vena cava involvement were found in 19 cases,leiomyosarcomas of inferior vena cava in 5 cases,leiomyomatosis involving inferior vena cava in 3 cases,adrenocortical carcinoma involving inferior vena cava in 3 cases,liver cancer involving inferior vena cava in 2 cases,right adrenal pheochromocytomas in 2 cases,retroperitoneal fibrosarcoma involving inferior vena cava in 1 case.According to tumor involvement types,the different surgical approaches,planes and method of inferior vena cava exclusion,reconstruction method and prevention of tumor embolus detachment were selected.Patients were followed up by outpatient examination and telephone interview till May 2015.Results Among 19 patients with renal cell carcinomas with inferior vena cava involvement,10 patients were placed inferior vena cava filters through internal jugular vein before surgery,10 patients underwent total hepatic vascular exclusion and 9 patients underwent intrahepatic inferior vena cava exclusion.All the 19 patients received tumor resection and inferior vena cava embolectomy.Of the 5 patients with leiomyosar-comas of inferior vena cava,3 patients underwent total hepatic vascular exclusion and 2 patients underwent intrahepatic inferior vena cava exclusion.The diseased segments of 5 patients were resected,including 4 patients of artificial vascular graft and 1 patient complicated with resection of right kidney receiving simple ligation of inferior vena cava and left renal vein at proximal and distal tumors.Of the 3 patients with leiomyomatosis involving inferior vena cava,2 patients received total hepatic vascular exclusion and 1 was treated surgically under cardiopulmonary bypass.All the 3 patients underwent inferior vena cava embolectomy and hysterectomy.Three patients with adrenocortical carcinoma involving inferior vena cava and 2 patients with liver cancer involving inferior vena cava underwent total hepatic vascular exclusion.Among the 5 patients,4 had direct suture after tumor removal combined with partial inferior vena cava resection,and 1 had patch repair after partial inferior vena cava resection.Two patients with right adrenal pheochromocytomas were exposed proximal and distal lifting devices of inferior vena cava without clamp,and the tumors were peeled off completely.Intraoperative death happened in the patient with retroperitoneal fibrosarcoma involving inferior vena cava who was prepared to undergo intrahepatic inferior vena cava exclusion but encountered intraoperative pulmonary embolism due to tumor thrombus shedding.Thirty-four patients of 35 patients underwent operation successfully without serious perioperative complications and a patient died in the perioperative period.The mean operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were 2.8 hours (range,1.5-5.0 hours),2 000 mL (range,400-5 000 mL) and 9.2 days (range,6.0-16.0 days).Thirty-four patients were followed up for a median time of 12 months (range,1-60 months).During the follow-up period,a patient with leiomyosarcomas of inferior vena cava and 2 patients with adrenocortical carcinoma involving inferior vena cava died of tumor recurrence,a patient with liver cancer had tumor recurrence,other patients were tumor-free survival.Conclusions Inferior vena cava at the upper segment of kidney is not contraindication for tumor resection.The appropriate way to expose,clamp and reconstruct are selected to safely remove the tumor based on extension and method of tumor involving inferior vena cava.

Objective To study the chemical constituents of Ophiorrhiza rosea.Methods The chemical constituents in O.rosea were extracted with 90% methanol,isolated and purified by column chromatography on silica gel,alumina gel,MCI gel,and macroporous resin adsorption.All the compounds were identified based on spectral analyses(MS,1H-NMR,and 13C-NMR).Results Eleven compounds were isolated from O.rosea.They were characterized as Harman(Ⅰ),2-hydroxy-3-hydroxymethylanthraquinone(Ⅱ),1hydroxy-2-hydroxymethylanthraquinone-3-O-?-D-glucoside(Ⅲ),1-hydroxy-2-hydroxymethylanthraquinone-3-O-?-D-primeveroside(Ⅳ),ursolic acid(Ⅴ),3?,19,24trihydroxy-12-ursen-28-oic acid(Ⅵ),19,23-dihydroxy-3-oxo-12-ursen28-oic acid(Ⅶ),3?,24-dihydroxy-12-oleanen-28-oic acid(Ⅷ),3,20-epoxy-3?,16-dihydroxy-15-oxo-7-pimaren-19,6-olide(Ⅸ),?-stigmasterol-3-O-?-D-glucoside(Ⅹ),and ?-sitosterol(Ⅺ).Conclusion This is the first report on the chemical constituents of O.rosea to find that it contains plentiful alkaloid Harman,multiform of triterpenes and anthraquinones.

Objective To discuss the best resistance factors of paclitaxel(Taxinol)on benign biliary scar fibrosis,in order to provide an effective basis for clinical prevention and treatment of benign biliary scar fibrosis.Methods Human bile duct epithelial cells were cultured in vitro,the prepared PTX at 0.001 uM,0.005 uM,0.1 uM,0.5 uMand 1 uMconcentration were separately added into cells for 48 h.The half inhibitory rate of BEC (IC50) were determined by MTT and the optimal concentration were confirmed.Human bile duct epithelial cells were cultured in 0 h,24 h,48 h and 72 h,the inhibitory rate of BEC at 100 nM,250 nM,and 500 nM PTX-Chitosan Sustained release membranes and the optimal concentration of PTX were determined by MTT and the optimal concentration of PTX-SRM were obtained.Human bile duct epithelial cells were cultured for 48 h and 72 h,the mRNA and protein expression ofα-SMA,E-cadherin,Vimentin were detected by Western Blot and Real-time PCR methods.Results The optimum resistance concentration of PTX to benign biliary scar was 250 nM.PTX and PTX-SRM could effectively inhibit the proliferation and transformation of BEC,and the best effective treatments to resist benign biliary scar fibrosis were low and middle concentrations of PTX-SRM,the best drug loading were 100 nMand 250 nM.The inhibition duration of PTX-SRMon BEC was longer than PTX alone(P<0.05).Conclusion The inhibition of PTX-SRMon BEC proliferation and transformation is better than the single drug of PTX,which provides a new scientific and feasible method for clinical prevention and treatment of benign biliary scar.

Objective:To introduce the experience and clinical efficacy of a new type of negative pressure suction ureteroscope in the treatment of upper ureteral calculi, and compare it with traditional rigid ureteroscope and flexible ureteroscope lithotripsy.Methods:From January 2018 to January 2020, 160 patients with upper ureteral incarcerated calculi who were treated in Shengjing Hospital Affiliated to China Medical University were included in this study, and their clinical data were retrospectively analyzed.There were 50 cases in the rigid ureteroscope group, 54 cases in the flexible ureteroscope group and 56 cases in the new negative pressure combined ureteroscope group.The differences of operation time, hospital stay, stone free rate and postoperative complications were observed and compared among the three groups.According to whether the maximum diameter of the stone is more than 1.5 cm, the subgroups were analyzed to further compare the curative effect of the three groups.Results:All the 160 operations were completed successfully and none of them were converted to open surgery.The stone free rate of the new negative pressure suction ureteroscope Group (90.0% (18/20))was higher than that of the flexible ureteroscope Group (61.9% (13/21)) and the rigid ureteroscope Group (55.6% (10/18)), χ 2=8.49, P<0.001). The stone free rate in the first month after operation was also superior (96.4% (54/56), 77.7% (42/54), 74.0% (37/50), χ 2=5.48, P=0.01). The stone subgroup analysis showed that when the stone diameter increased (>1.5 cm), the net stone rate of the new negative pressure suction ureteroscope Group [91.6% (22 / 24)] was better than that of the flexible ureteroscope Group (62.5% (15/24)) and the rigid ureteroscope Group (50.0 (8/16))(χ 2=6.480, P=0.001). Conclusion:Compared with the traditional ureteroscopic lithotripsy, the new negative pressure suction ureteroscopic lithotripsy has higher initial and overall stone free rate, and higher safety factor.For the patients with stone diameter>1.5 cm, the new negative pressure suction ureteroscope lithotripsy has more advantages.