Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the "lobular bronchi" with main bronchi. Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung. The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.
Anastomosis, Surgical ; Bronchi/*surgery ; Carcinoma, Non-Small-Cell Lung/*surgery ; Lung Neoplasms/*surgery ; Pneumonectomy/*methods ; Pulmonary Surgical Procedures/*methods ; Recovery of Function ; Treatment Outcome

Objective To analyze the subtypes of eae genes in various non-O157 Shiga toxin-pro-ducing Escherichia coli ( STEC) strains isolated in China.Methods The complete nucleotide sequences of 10 eae genes were amplified by PCR and sequenced.The BLASTn software was used to analyze the se-quences for eae gene subtyping.A phylogenetic tree was constructed based on the10 ea e gene sequences to-gether with the gene sequences of 30 different subtypes in GenBank and those of STEC strains of 7 prevalent serotypes (O157 ∶H7, O26 ∶H11, O103 ∶H2, O111 ∶H8, O145 ∶H28, O45 ∶H2 and O121 ∶H19) using MEGA 5.0.Multilocus sequence typing (MLST) was performed on the 10 STEC strains with reference to the Escherichia coli ( E.coli) MLST website ( http://mlst.warwick.ac.uk/mlst/dbs/Ecoli) for the typing of multiple loci.A minimum spanning tree ( MST) was constructed using the BioNumerics software to inves-tigate the phylogenetic relationships between the 10 eae gene-positive STEC strains in this study and hemolyt-ic uremic syndrome-associated enterohemorrhagic E.coli ( HUSEC) strains as well as all human STEC strains of O157, O26, O45, O103, O111, O121 and O145 serotypes submitted to the E.coli MLST website data-base.Results The complete nucleotide sequences of eae genes in 10 non-O157 STEC strains were 2.8 kb in length and belonged to 3 known subtypes.The predominant subtype wasβ1, accounting for 60%of the 10 STEC strains (6/10), followed byθandγ1 subtypes with two strains in each type.The eae gene sequences in certain strains were identical to those of the prevalent serotypes.Seven sequence types ( STs) were identi-fied from the 10 STEC strains carrying eae gene.Conclusion The eae genes harbored by the non-O157 STEC strains isolated from different specimens in China were diverse and had close phylogenetic relationships with the highly pathogenic and prevalent STEC strains.This study implied that the STEC strains harboring eae gene had high pathogenic potential.

Objective To investigate the tellurite resistance level,the presence of tellurite resistance (ter) gene cluster and their relationships in non-O157 Shiga toxin-producing Escherichia coli(STEC) isolates.Methods Tellurite resistance level was evaluated by plate dilution method and the ter gene cluster was tested by PCR.Results Only 5 of 39 non-O157 STEC isolates tested in this study were identified to have ter gene cluster,which showed relatively high levels of tellurite resistance ranging from 128 μg/ml to 512 μg/ml.In contrast,the other 34 isolates without ter gene cluster were sensitive to potassium tellurite and showed very low levels of tellurite resistance,the minimal inhibitory concentration (MIC) was ＜1 μg/ml for 29 isolates,8 μg/ml for 2 isolates and 2 μg/ml for 3 isolates.Conclusion Most non-O157 STEC isolates were sensitive to potassium tellurite.It could be concluded that much attention should be paid when screening the non-O157 STEC isolates using the selective medium supplemented with potassium tellurite.

Objective:To explore the effect of Naoshuning on the protein expression of Matrix metalloproteinases(MMPs) in experimental injuried brain tissue of rats. Methods:Immunohistochemistry was used to determine the changes of protein expression of MMPs. Brain tissue water content,permeability and ultramicrostructure of blood-brain barrier(BBB) were also observed. Results:Compared with the sham group,the brain tissue water and EB content of injured side and the level of MMP-2 and MMP-9 protein expression in brain tissue around contusion in model group increased obviously(all P

OBJECTIVETo investigate the molecular typing feature of enteropathogenic Escherichia coli (EPEC) strains isolated from different reservoirs in eight provinces of China from 2006 to 2014.

METHODSAccording to the time, place, reservoir, and PFGE pattern of the EPEC strains isolated from stools of humans with diarrhea, animal feces, and foods in eight provinces of China between 2006 and 2014, 149 EPEC strains were selected and characterized by multilocus sequence typing (MLST) using seven housekeeping genes provided by E.coli MLST database. Strain analysis demonstrated 56 different sequence types (STs). SeqMan II, MEGA 5.05, and eBURST V3 were applied to analyze the genetic relationships of domestic and forein existing 392 strains (243 EPEC strains included in the E.coli MLST database and 149 EPEC strains comprised in the present study).

RESULTSAmong the 56 different STs, the prevalent ST was ST-40, which included 19 (19/149, 12.8%) isolates. Nineteen new STs were identified. Eleven new alleles were detected in six house-keeping genes (adk, fumC, gyrB, icd, mdh, and purA). Six STs were simultaneously detected among EPEC strains isolated from patients with diarrhea and animals. And these EPEC strains were all aEPEC strains. Two STs were simultaneously identified among EPEC strains isolated from patients with diarrhea and foods. Also, these EPEC strains were all aEPEC strains. 33 out of 173 STs were divided into five major clone complexes by eBURST, STC-29, STC-10, STC-20, STC-28, and STC-517. The remaining EPEC strains included in the other 140 STs were part of the other clone complexes or just were singletons.

CONCLUSIONA high degree of phylogenetic heterogeneity was observed among the EPEC strains isolated in eight provinces of China. The EPEC strains with same STs of human isolates isolated from animal feces and foods were all aEPEC strains.

Animals ; China ; Diarrhea ; Enteropathogenic Escherichia coli ; Escherichia coli ; Escherichia coli Proteins ; Feces ; Humans ; Multilocus Sequence Typing ; Phylogeny

Bronchoplasty was extended to the segmental level and the effect of the multi-segmental surgery for the central non-small lung cancer was observed. The involved lobular bronchi and part of main bronchi were resected and single-layer continuous suture with 5-0 Prolene was used for suturing of the carina of the reconstructed segmental bronchi to form lobular bronchi. Then, single-layer continuous suture with 4-0 Prolene was employed to anastomose the "lobular bronchi" with main bronchi.Our results showed that the 15 bronchoplasties were successfully performed. The tumors were completely removed and postoperatively, the pulmonary functions of the patients were substantially improved. No broncho-pleural fistula and stomal stenosis took place in all the cases. The quality of life of the patients were obviously improved. It is concluded that multisegmental bronchoplasty can completely remove the tumor of central non-small-cell lung cancer and conserve more non-involved lung.The procedure is especially suitable for those patients with severely impaired lung functions and it expands the indications of surgical resection of lung cancer.

Objective To observe the center retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) in eyes with central retinal artery occlusion (CRAO) before and after treatment.Methods A total of 34 patients (34 eyes) diagnosed with CRAO by fundus fluorescence angiography (FFA) were retrospectively analyzed.There were 18 males (18 eyes) and 16 females (16 eyes).The average age was (61.42± 14.09) years.The mean onset time was (2.64±3.73) days.The mean hospitalization time was (11.92 ±4.95) days.The mean axial length (AL) was (23.53 ± 2.04) mm.The best-corrected visual acuity (BCVA),slit-lamp biomicroscopy,indirect ophthalmoscopy,fundus color photography,fundus fluorescein angiography,spectral domain optical coherence tomography (OCT) and AL measurement were performed.BCVA was converted to the logarithm of the minimum angle of resolution (logMAR).According to FFA,visual loss and the results of OCT,patients were divided into 3 groups:incomplete CRAO (15 eyes),subtotal CRAO (8 eyes),total CRAO (11 eyes).SFCT and CRT in affected and the fellow eye were measured by OCT for enhanced deep imaging.Follow up lasted for 1 month after treatment,with an average follow-up of (34.71 ± 6.82) days.The changes of S FCT,CRT,and BCVA before and after treatment were observed.The correlation between BCVA after treatment and pretreatment CRT was also analyzed.Results After 1 month of follow-up,the logMAR BCVA in incomplete group,subtotal group and total group were significantly higher than before treatment (t=3.74,3.61,3.26;P=0.004,0.009,0.017).Before treatment,the average CRT of the contralateral eyes in the total,subtotal and incomplete group were (215.00± 19.85),(224.00±22.79),(214.00±8.21) μtm,and the mean SFCT were (264.54± 121.71),(266.50±58.17),(261.86±90.95) μm.The average CRT of the affected eyes were (353.18±60.26),(280.14± 11.08),(266.63±19.65) μtm,and the average SFCT were (233.72± 111.35),(237.75 ± 53.30),(259.86±98.14) mm.Compared with the fellow eyes,the average CRT in the 3 groups were thickened,and the difference were statistically significant (t=8.274,3.694,11.577;P＜0.001,0.008,＜0.001);the average SFCT in the total group was decreased,the difference was statistically significant (t=-2.138,P=0.048).The mean CRT among the 3 groups of eyes was statistically significant (F=1 2.02,P＜ 0.001).There was no significant difference in the average SFCT (F=0.178,P=0.838).After 1 month follow-up,the mean CRT in the total,subtotal and incomplete group were (231.18 ± 49.28),(219.16± 21.34),(217.86± 24.98) μm,and the average SFCT were (239.81 ± 109.57),(241.86±42.81),(260.57±91.67) μan.Compared with before treatment,the average CRT in the three groups of eyes were decreased,the difference were statistically significant (t=13.032,3.711,4.970;P＜0.001,0.008,0.003);the difference in mean SFCT were not statistically significant (t=-0.785,-0.202,-0.078;P=0.466,0.845,0.940).Correlation analysis showed that BCVA after treatment was positively correlated with pretreatment CRT (odds ratio=0.578,P=0.002).Conclusion CRAO resulted in CRT in the preliminary stage and became thinner after receiving treatments.There exists a positive correlation between visual outcome and CRT before receiving treatments.

We accidentally found an unusual case of a middle aged Tibetan woman who had eight metallic foreign bodies (eight needles) in her head, chest and abdomen. These needles were not related to any surgical intervention or trauma. The diagnosis "metallic foreign bodies" cannot usually be made in an acute setting. Some patients may present chronic symptoms, such as infection or pain. However, in some cases, the patients do not have any symptoms.
Abdominal Cavity ; Adult ; Female ; Foreign Bodies ; diagnostic imaging ; Humans ; Incidental Findings ; Metals ; Radiography ; Skull ; Thoracic Cavity

Obejctive To investigate the consistency and reproducibility ofmacular perfusion parameters in early diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).Methods A prospective cross-sectional observational study.Forty-six patients (46 eyes) diagnosed with mild nonproliferative DR were included in this study.There were 24 males and 22 females,with the mean age of 59.16± 10.32 years.Two macular scan sizes of 3 mm× 3 mm and 6 mm× 6 mm were performed by the same operator,and the same test was performed by another operator.The superficial retinal layer (SRL) and deep retinal layer (DRL) in the foveal avascular zone (FAZ) and vessel density (VD) were quantified.The consistency of the two scan sizes and the reproducibility of the same scan size were also evaluated.The consistency was determined by the intraclass correlation coefficient (ICC).If the intraclass correlation coefficient (ICC)＞0.80,consistency was good;if 0.4≤ICC＜0.8,consistency was general;if ICC＜0.40,consistency was poor.Results In the 3 mm × 3 mm and 6 mm × 6 mm scanning sizes,the mean results of the two examiners were calculated.The FAZ of SRL were 0.39±0.13 mm2 and 0.42±0.15 mm2,FAZ of DRL were 0.74±0.22 mm2 and 0.89±0.23 mm2.The VD of SRL were (32.23±2.86)％ and (31.91 ±3.01)％,VD of DRL were (43.73 ±4.64)％ and (45.12± 5.49)％.The consistency analysis showed that the ICC of SRL-FAZ and DRL-FAZ were 0.920 and 0.812,respectively;the ICC of VD were 0.833 and 0.830,respectively.The consistency was good.The reproducibility analysis of different examiners in the same scan size was better in the consistency of SRL FAZ and VD.Conclusion OCTA in two scanning sizes to measure FAZ and VD of early DR has good consistency and reproducibility.

Objective:To explore the incidence and factors of the influence of preoperative related factors on postoperative orthopedic evaluation, through the evaluation of thoracic shape orthopedic evaluation of children pectus excavatum, during plate implantation after Nuss procedure.Methods:From April 2012 to April 2019, the clinical data were analyzed retrospectively for 159 hospitalized cases of Nuss procedure for pectus excavatum in Xi’an Children’s Hospital.The mean age was(6.8±3.4) years old(3.2-17.0 years old); males 124, females 35; Haller index 4.0±1.0(2.7-7.5); 6 cases(4%) were poor orthopedic evaluation with the thoracic shape, males 5, femal 1; 23 cases (14%) were average satisfied with the thoracic shape, males 16, femals 7; 130 cases (82%)were good orthopedic evaluation with the thoracic, males 103, femals 27. Follow-ups were conducted for at least 2 years, Retrospective analysis of the relationship between postoperative thoracic satisfaction and age, gender, Haller index, how the plates were placed during surgery and symmetry of funnel chest, t test and χ2 test were used for statistical analysis. Results:There were statistically significant differences between thoracic orthopedic evaluation after postoperative and classification of pectus excavatum ( P=0.001), and poor orthopedic evaluation after asymmetric pectus excavatum operationand ; There were no significant differences in gender, Haller index, surgical method and how the plates were placed during surgery( P>0.05). However, it can be seen from the mean and percentage that with the decrease of age, and the increase of Haller index, the orthopedic evaluation gradually becomes worse. Conclusion:According to our single-center study, asymmetric pectus excavatum is a factor for poor orthopedic evaluation during plate implantation after Nuss, especially for young children and children with larger Haller index.