The aim of this study was to investigate the effects of co-culture supernatant of Lactobacillus casei(LC)and Bacillus subtiliis natto(BN)on intestinal micro-ecology, mucosal barrier function and immune function in mice with antibiotic-associated diarrhea(AAD). The AAD mouse model was established and the normal saline, LC, BN and co-culture supernatants were administered, respectively, for 4 days. The general conditions of the mice during the intervention were observed. The thymus and spleen weight ratios of different intervention mice were compared. The histopathological changes of the proximal colon lesions were observed. The intestinal microecology, mucosal barrier function and immune function of each group were detected. The results showed that the mice in the model group showed poor mental state, decreased feeding intake and abnormal stool characteristics, which were aggravated with the prolongation of time. After intervention, the above-mentioned states of mice in each group were improved, with the best recovery for the co-culture group. Histopathological results showed that the intestinal wall of the model group was severely damaged and villus was shedding. Cellulose-like exudation, necrosis of epithelial cells and infiltration of inflammatory cells could be seen in the model group. The pathological changes mentioned above were improved after intervention, and the co-culture group had the best effect. Compared with the control group, the thymus and spleen weight ratio, microbial diversity(Shannon)index, richness(Chao)index, Lactobacillus number, Bifidobacterium number, secretory immunoglobulin IgA(sIgA)in intestinal mucosa, interleukin(IL)-2 and IL-2/IL-4, the relative expressions of tight junction related protein-1(ZO-1)and atresia protein(Occludin)in intestinal tissue of the model group were lower, while the number of enterobacteria, enterococcus number, serum diamine oxidase(DAO)bacterial ectopic rate and IL-4 in intestinal tissue were higher(P< 0. 05). Compared with the model group, the thymus, spleen weight ratio, Shannon, Chao index, Lactobacillus number, Bifidobacterium number, sIgA in intestinal mucosa, IL-2 and IL-2/IL-4, the relative expressions of ZO-1 and Occludin in intestinal tissue of the intervention groups were higher(P< 0. 05), and the co-culture group was higher than the LC group and the BN group(P< 0. 05). There was no significant difference between the LC group and the BN group(P> 0. 05). Compared with the model group, the number of enterobacteria, enterococcus, serum DAO, bacterial ectopic rate and intestinal IL-4 in each intervention group were lower(P< 0. 05), and the co-culture group was lower than LC group and BN group(P< 0. 05). There was no significant difference between LC group and BN group(P> 0. 05). There were no significant differences in serum DAO, bacterial ectopic rate, sIgA, IL-2, IL-4 levels and IL-2/IL-4 levels between the co-culture group and the control group(P> 0. 05). The results showed that LC and BN co-culture supernatant can effectively regulate intestinal micro-ecology of AAD mice, improve intestinal mucosal barrier function, and improve intestinal and global immune function.

Objective:To analyze the value of the waveform curve and quantitative value of end-respiratory carbon dioxide partial pressure (P ETCO 2) in resuscitation monitoring of patients with general anesthesia. Methods:One hundred and forty-two patients who performed operation under general anesthesia and entered into the anesthesia recovery room in Zhejiang Xin′an International Hospital from April 2019 to September 2019 were selected. According to the method of random number table, all the 142 cases were divided into control group and observation group, with 71 cases in each group. Routine monitoring during general anaesthesia resuscitation such as blood pressure (BP), respiratory frequency (RR), blood oxygen saturation (SpO 2), arterial partial pressure of carbon dioxide (PaCO 2) was performed in the control group. On this basis, changes in P ETCO 2 waveform curve and quantitative value was continuously monitored in the observation group.The abnormal events rate, checkout time, anesthesia resuscitation time and residence time in the anesthesia recovery room of two groups during anesthesia resuscitation were recorded. Besides, the relationship between P ETCO 2 and PaCO 2 was analyzed. Results:The levels of RR, BP, SpO 2, PaO 2 in both groups were in the normal range during general anesthesia resuscitation, and P ETCO 2 in the observation group was also in the normal range. During general anesthesia resuscitation, the abnormal events rate in the observation group was was higher than that in the control group: 12.68%(9/71) vs. 7.04%(5/71); besides, the checkout time of abnormal events, anesthesia resuscitation time and residence time in the anesthesia recovery room in the observation group were shorter than those in the control group: (1.61 ± 0.52) min vs. (2.11 ± 0.69) min, (35.98 ± 10.66) min vs. (46.75 ± 15.03) min and (62.52 ± 19.63) min vs. (76.97 ± 15.41) min, there were significant differences ( P<0.05). P ETCO 2 was negatively correlated with SpO 2 ( r=-0.335, P=0.004), while P ETCO 2 was positively correlated with PaCO 2 ( r=0.751, P<0.001). Conclusions:Monitoring P ETCO 2 of patients during general anesthesia resuscitation can improve the detection rate and timeliness of abnormal events, promote the recovery of anesthesia and help to reduce the occurrence of adverse events.

Objective:To explore the efficacy of hysteroscopy combined with laparoscopy in the treatment of infertility caused by tubal obstruction (TO) and its effect on sex hormone levels.Methods:According to different surgical methods, 78 infertile patients caused by TO admitted from January 2017 to March 2019 in Zhejiang Xin′an International Hospital were divided into the treatment group (40 cases) and the control group (38 cases). The patients in the treatment group were treated with hysteroscopy combined with laparoscopy, and the patients in the control group were treated with hysteroscopy. The indicators related to the operation, unobstructed fallopian tube and pregnancy in 1 year in the two groups were compared. Serum sex hormones and stress response indicators were measured before and after the operation.Results:The operation time in the treatment group was (45.17 ± 8.76) min, which was significantly longer than that in the control group (34.01 ± 6.25) min, and the difference was statistically significant ( P<0.05). There was no significant differences in intraoperative blood loss, postoperative exhaust time, hospital stay and complication rate between the two groups ( P>0.05). After operation, the levels of serum estradiol (E 2), follicle stimulating hormone (FSH), luteinizing hormone (LH), cortisol (Cor) and hypersensitive C-reactive protein (hs-CRP) in the two groups increased significantly ( P< 0.05), while thyroid stimulating hormone (TSH) levels decreased significantly ( P<0.05). After operation, the levels of Cor and hs-CRP in the treatment group were lower than those in the control group [(22.19 ± 7.32) mg/L vs.(33.05 ± 8.24) mg/L, (7.28 ± 2.63) mg/L vs. (11.89 ± 3.84)mg/L], while the levels of E 2, FSH, LH and TSH in the treatment group were higher than those in the control group [(181.48 ± 21.24) ng/L vs. (136.00 ± 19.56) ng/L, (30.51 ± 5.76) U/L vs. (24.84 ± 6.0) U/L, (34.62 ± 6.57) U/L vs. (29.37 ± 7.25) U/L, (3.12 ± 0.65) mU/L vs. (1.93 ± 0.54) mU/L], and the differences were statistically significant ( P<0.05). The rates of complete patency of fallopian tube and intrauterine pregnancy in 1 year in the treatment group were higher than those in the control group [92.50%(37/40) vs. 76.32%(29/38), 75.00%(30/40) vs. 52.63%(20/38)], and the differences were statistically significant ( P<0.05). Conclusions:Hysteroscopy combined with laparoscopy in the treatment of infertility caused by TO is effective, and can effectively promote the recanalization of fallopian tube, improve the level of sex hormones, reduce the stress response of patients and improve the pregnancy rate.

Objective:To analyze the diagnostic and prognostic value of heparin-binding protein (HBP) combined with procalcitonin (PCT) and high sensitivity C-reactive protein (hs-CRP) in early sepsis.Methods:The clinical data of 116 patients with sepsis admitted to Zhejiang Xin′an International Hospital from August 2018 to December 2019 were retrospectively analyzed. They were divided into mild sepsis group (40 cases), severe sepsis group (46 cases) and septic shock group (30 cases) according to the severity of illness. According to the clinical prognosis, they were divided into survival group (87 cases) and death group (29 cases). In the same period, 104 outpatients were selected as control group. The levels of HBP, PCT and hs-CRP were compared in each group and the guiding value of HBP, PCT and hs-CRP in the diagnosis of early sepsis were analyzed by receiver operating characteristic (ROC) curve.Results:The levels of HBP, PCT and hs-CRP in sepsis group were higher than those in control group: (83.45 ± 11.29) μg/L vs. (4.81 ± 0.62) μg/L, (8.19 ± 1.14) μg/L vs. (0.24 ± 0.03) μg/L, (87.94 ± 13.58) mg/L vs. (1.34 ± 0.15) mg/L, and the differences were statistically significant ( P<0.05). The levels of HBP, PCT and hs-CRP were gradually increased with the aggravation of disease, and the differences were statistically significant ( P<0.05). The levels of HBP, PCT and hs-CRP in survival group were lower than those in death group: (67.94 ± 8.91) μg/L vs. (129.98 ± 18.43) μg/L, (6.46 ± 0.93) μg/L vs. (13.38 ± 1.77) μg/L, (65.19 ± 10.62) mg/L vs. (129.19 ± 22.46) mg/L, and the differences were statistically significant ( P<0.05). The ROC curve analysis showed that the area under the curve of HBP, PCT, hs-CRP and HBP + PCT + hs-CRP were 0.828, 0.835, 0.787 and 0.940, the sensitivity was 72.4%, 69.0%, 79.3% and 86.2%, and the specificity was 85.1%, 88.5%, 74.7% and 90.8%. Conclusions:HBP, PCT and hs-CRP joint detection have certain guiding value in the diagnosis of early sepsis, and can reflect the disease severity and prognosis.

Objective To study the prevalence,treatment policy and control of hypertension in patients with maintenance hemodialysis, and to analyze the influencing factors of hypertension control.Methods We studied the current status of 1382 patients with maintenance hemodialysis in 11 dialysis centers in Shanghai, among them 809 were male, and 573 were female.Hypertension was defined as systolic blood pressure(SBP) ≥ 140 and/or diastolic blood pressure (DBP) ≥90 mm Hg ( 1 mm Hg = 0.133 kPa).Those who had a history of hypertension and requiring antihypertensive therapy were also diagnosed as hypertension though their blood pressure was within normal range during the survey.Hypertension control was defined as blood pressure ＜ 140/90 mm Hg before each dialysis session.Results The prevalence of hypertension in the hemodialysis patients was 86.3%.The treatment rate and control rate in those patients were 96.8% and 25.5% respectively.More than half (50.4% ) of patients were treated with only one kind of anti-hypertensive drug, and 34.4% with 2 kinds, 14.2% with 3 kinds, 1.0% with 4 kinds or more.Calcium channel blocker (CCB) was the most frequently prescribed drug (61.0%), followed by angiotensin Ⅱ receptor blockers ( 56.4% ), centrally acting anti-hypertensive agent ( 26.4% ), beta blockers and alpha, beta-blockers( 14.0% ).The control rate of hypertension in those hemodialysis people was aggravated by the existence of coronary artery disease.The patients who need more kinds of antihypertensive agents have a poorer control rate of hypertension.The hypertension control rate elevated significantly with the adequate hemodialysis.Conclusions There is a very high prevalence of hypertension in maintenance hemodialysis patients.Although the treatment rate is high, the control rate is unsatisfactory.So the control of hypertension in hemodialysis patient is still a clinical challenge.Appropriate dialysis adequacy, reasonable use of erythropoietin, treatment of heart disease and judicious use of antihypertensive drugs may be helpful to improve the clinical outcome.

Objective To explore the impact of local lipiodol deposition in liver of miniature pigs on the shape and size of the necrotic area after microwave ablation (MWA).Methods Ten healthy miniature pigs were selected and equally divided into experimental group and control group (each n=5).In experimental group,transcatheter hepatic arterial embolization with lipiodol was done before microwave ablation,while only standard microwave ablation was performed in control group.Immediate post-ablation CT images were obtained.Long-axis diameter (LAD),short-axis diameter (SAD),sphericity index (SI=SAD/LAD) and volume of ablation zone were calculated.The size and shape of the ablated areas were compared between two groups.Results The mean LAD,SAD,SI and volume of ablation zone in experimental group ([4.21 ± 0.52]cm,[2.87±0.38]cm,0.69±0.10,[18.72±6.08]cm3) were larger than those in control group ([3.71±0.42]cm,[2.19±0.42]cm,0.60±0.09,[9.44±2.29] cm3;all P＜0.05).Conclusion Local deposition of lipiodol in liver parenchyma of miniature pigs can help to produce larger and rounder necrosis in the ablation zone.