1H-nuclear magnetic resonance spectroscopy ( 1H-NMRs ) analysis was performed on serum specimens obtained from 60 preoperative patients with esophageal squamous cell carcinoma ( ESCC )and 30 healthy controls, and supernatant from 2 ESCC cell lines Eca-109 and TE-13.The characteristic fingerprint was profiled with 1H-NMRs data in healthy controls.Serum 1H-NMRs from 60 preoperative patients with ESCC were measured and compared with the 1H-NMRs from 30 healthy controls.We found some specific peaks in 1H-NMRs profile of serum specimens from ESCC patients, especially at 1.0-1.2 mg/L and 3.4 - 3.6 mg/L.The results were verified by the 1H-NMRs measurement on the supernatant from 2 ESCC cell lines Eca-109 and TE-3.Our results suggest that this two absorption peaks may be characteristic for ESCC and 1H-NMRs analysis on serum specimens may provide information for early diagnosis of ESCC.

Objective To investigate healthcare-associated infection(HAI)in different departments in a children’s hos-pital,and provide scientific basis for effective prevention and control of HAI in children.Methods By bed-side visiting and medical record reviewing,survey on HAI prevalence rate was conducted among hospitalized patients in a given day in 2012, 2013,and 2014 respectively,and surveyed data of three years were analyzed.Results HAI prevalence rates in 2012,2013, and 2014 were 6.52%,5.59%,and 5.85% respectively,there was no significant difference (χ2 =1.02,P =0.60);the average HAI prevalence rate in three years was 5.98%,there was significant difference in average HAI prevalence rate among different departments(χ2 =291.83,P <0.001 ),the top 4 departments of HAI prevalence rate was hematology (27.49%),cardiothoracic surgery (21.13%),neonatal intensive care unit (16.43%),and pediatric intensive care unit (12.76%);the main infection sites were lower respiratory tract (58.44%),upper respiratory tract (22.63%),and gas-trointestinal tract (6.58%);the main pathogens causing HAI was Klebsiella pneumoniae (n=32,28.32%),followed by Acinetobacter baumannii (n=9,7.96%),Escherichia coli (n=9,7.96%),and Pseudomonas aeruginosa (n=7,6.19%). Conclusion Strengthening prevention and control intervention of HAI in high risk departments has important significance to reduce the incidence of HAI in children’s hospital.

ObjectiveTo compare the efficacy of laparoscopic and open left lobectomy.MethodsThe clinical data of 92 patients who received left lobectomy at the First Affiliated Hospital of Harbin Medical University from May 2010 to June 2011 were retrospectively analyzed.Of the 92 patients,42 received laparoscopic left lobectomy (laparoscopic group ) and 50 received open left lobectomy (open group ). The advantages and disadvantages between laparoscopic and open left lobectomy were compared. All data were analyzed using the t test,chi-square test or by calculating the Fisher exact probability.ResultsTwenty-nine patients received left lateral lobectomy and 13 patients received left hemihepatectomy in the laparoscopic group. One patient was converted to the open group becaused of the injury of the middle hepatic vein.Thirty-three patients nnderwent left lateral lobectomy and 17 underwent left hemihepatectomy in the open group.The tumor-free resection margin of the laparoscopic group was ( 1.6 ± 0.6 ) cm,which was significantly longer than ( 1.2 ± 0.4 ) cm of the open group (t=3.81,P＜0.05).The volume of operative blood loss of the laparoscopic group was (158 ±89)ml,which was significantly smaller than (292 ± 172)ml of the open group (t =4.56,P ＜ 0.05 ).The time of postoperative pain control,time to bowel function recovery and duration of hospital stay were ( 1.2 ± 0.3 )days,(23 ± 4)hours,( 7.5 ± 2.8 ) days in the laparoscopic group,which were significantly shorter than ( 2.0 ± 1.1 ) days,(4.9 ± 7 ) hours,( 11.3 ± 4.2 ) days in the open group,respectively ( t =4.57,21.31,5.00,P ＜ 0.05 ).The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) at postoperative day 1 were increased,while the increase of AST and ALT in the open group were greater than that in the laparoscopic group (t =6.73,5.03,P ＜0.05).The postoperative prothrombin time in the open group was significantly longer than that before operation (t =2.32,P ＜ 0.05 ).The incidence of postoperative complications and total hospital costs were 7％ (3/41) and (2.5 ±0.7) ×104 yuan in the laparoscopic group,which were lower than 8％ (4/50) and (2.6 ±0.6) × 104 yuan in the open group,but no significant difference was observed (t =0.74,P ＞0.05).One patient in the open group died of multi-organ dysfunction syndrome caused by acute hepatic failure.ConclusionLaparoscopic left lobectomy is safe and effective,and it has the advantages of small trauma,quick recovery of patients and significant overall efficacy when compared with open left lobectomy.

Objective To investigate the incidence of atherosclerotic renal artery stenosis (ARAS), the relationship between ARAS and cerebral artery stenosis, and the risk of ARAS in patients with brain infarction. Methods The clinical data of 1 650 brain infarction patients were analyzed, which were carried out digital subtraction angiography(DSA) of cerebral and renal artery.The incidence of ARAS was counted out, and the relationship was analyzed between the different degree and number of cerebral artery stenosis and the rate of RAS. The demographic characteristics and the common risk factors of atherosclerosis were recorded, and the risk factors of ARAS were analyzed. Results The rate of ARAS in moderate stenosis group and severe stenosis and occlusion group of cerebral artery were all significantly higher than that in mild stenosis group and no stenosis group (all P < 0.01). The rates of ARAS in severe stenosis and occlusion group were significantly significantly higher than those in moderate stenosis group (P < 0.01). The rates of ARAS in 2 branch stenosis group and ≥3 branch stenosis group were both significantly higher than those in no stenosis group and 1 branch stenosis group (P < 0.01). The rates of ARAS of ≥3 branch stenosis group were significantly higher than those in 2 branch stenosis group (P<0.05). The rate of ARAS of 1 branch stenosis group were significantly higher than those in no stenosis group (P < 0.05). Age, hypertension, moderate or more artery stenosis or occlusion, and≥2 branch stenosis was independent risk factor of ARAS. Conclusions The incidence of ARAS increasesd with the increase of the degree of cerebral artery stenosis and the number of branch involved.Older age, hypertension, moderate or more artery stenosis or occlusion, and≥2 branch stenosis is risk factor for ARAS.

Objective To evaluate the effects of ulinastatin on hemorrhagic shock and resuscitation ( HS∕R)?induced acute lung injury in rats. Methods Fifteen SPF adult Sprague?Dawley rats, aged 2-3 months, weighing 300-400 g, were divided into 3 groups ( n=5 each) using a random number table:sham operation group ( group S ) , HS∕R group and ulinastatin group ( group U ) . Carotid arteries were cannulated for blood pressure monitoring and blood?letting. HS∕R was induced by blood?letting and maintained for 1 h, followed by resuscitation with autologous blood transfusion and infusion of normal saline. After cannulation of carotid arteries ( T0 ) , at 5 min after hemorrhagic shock ( T1 ) , before resuscitation ( T2 ) , at 5 min after the expected blood pressure was achieved following resuscitation ( T3 ) , and at 30 min, 1?5 h and 2?5 h after resuscitation ( T4?6 ) , arterial blood samples were collected for determination of interleukin?6 ( IL?6 ) and tumor necrosis factor?α ( TNF?α) concentrations ( by enzyme?linked immunosorbent assay) . Arterial blood samples were collected at T0 , T2 and T6 for blood gas analysis. The pH value, partial pressure of arterial carbon dioxide ( PaCO2 ) , HCO-3 and base excess ( BE) value were recorded, and oxygenation index ( PaO2∕FiO2 ) was calculated. Lungs were removed at T6 , and pulmonary specimens were obtained for examination of pathological changes which were scored, and nucleus was extracted for determination of nuclear factor?kappa B ( NF?κB ) p65 expression by enzyme?linked immunosorbent assay. Results Compared with group S, the pH values, HCO-3 , BE values and OI were significantly decreased, and PaCO2 , plasma IL?6 and TNF?α concentrations, expression of NF?κB p65 in lung tissues, and pathological scores were increased in U and HS∕R groups. Compared with group HS∕R, the plasma concentrations of IL?6 and TNF?α, expression of NF?κB p65 in lung tissues, and pathological scores were significantly decreased, and no significant changes were found in parameters of blood gas analysis in group U. Conclusion Although ulinastatin can alleviate HS∕R?induced acute lung injury, it is insufficient to improve lung oxygenation in rats.

ObjectiveTo investigate the effect of pneumatic circulation treatment on lower extremity swelling and blood flow velocity after hip replacement.Methods48 patients after hip replacement were divided into two groups: treatment group (n=24) and control group (n=24). The treatment group received pneumatic circulation treatment and continuous passive motion, while the control group only received continuous passive motion 2 d after operation, all patients wearing elastic stockings. Circumference of the affected leg was measured and Visual Analogue Scale (VAS) was assessed, and Doppler ultrasonography was to check the blood flow velocity of femoral and deep veins in lower limb before, 3 d and 7 d after rehabilitation.ResultsThere was no difference in circumference, VAS, and the lower limb blood flow velocity between the two groups before operation (P>0.05). There was significant difference in circumference and VAS 3 d after treatment (P<0.01), and a significant difference in circumference and blood flow velocity (P<0.01) but no difference in VAS (P>0.05) 7 d after treatment between the two groups.ConclusionPneumatic circulation treatment may facilitate to eliminate lower extremity swelling and prevent deep vein thrombosis after total hip replacement.

ObjectiveTo compare the efficacy and safety of sequential intravenous moxifloxacin treatment against cefoperazone/sulbactam in patients with acute biliary tract infection. MethodsA prospective, randomized, non-blind, multi-centric study was performed to compare the efficacy and safety of moxifloxacin 400 mg Ⅳ once daily to cefoperazone-sulbactam (2 g q12 hours) and metronidazole 250 ml once daily to treat patients, from March- December 2009 in 13 hospitals, with acute biliary tract infection.The primary efficacy variable was clinical cure rate after the end of a 5 - 14 day treatment period,bacteriologic outcomes and adverse reaction effects were also determined.ResultsA total of 319 subjects were enrolled, 282 of whom were eligible for protocol efficacy analyses ( 138 moxifloxacin, 144 comparator).Demographic and baseline medical characteristics were similar between the 2 groups. Clinical success rates were 86.2％ for moxifloxacin and 84. 7％ for the comparator(P =0. 7192). Pathogens (55 moxifloxacin, 61 comparator) were isolated from bile or blood cultures and the predominant strains were E. coli, Klebsiella species and Enterococcus species. Bacterial eradication rates were 85.4％ ( 37 of 55 ) with moxifloxacin versus 82. 0％ (50 of 61 ) in the comparator group ( x2 = 0. 2568, P = 0. 6123 ). Both treatments were safe and well tolerated. ConclusionsE. coli, Klebsiella species and Enterococcus species were the most common bacteria isolated from bile or blood from patients with acute biliary tract infection. Moxifloxacin monotherapy has high clinical and bacteriological efficacies and safety for the treatment of acute biliary tract infection.

Objective:To dynamically observe the effect of N-acetylserotonin (NAS) on the expression of tumor necrosis factor-α (TNF-α) protein in retina of retinal ischemia reperfusion injury (RIRI) rats, and to explore the mechanism.Methods:By using random number table method, 90 healthy male Sprague-Dawley rats were divided into sham operation group ( n=10), RIRI group ( n=40), and NAS group ( n=40). The right eye was as the experimental eye. In the RIRI group and NAS group, the anterior chamber high intraocular pressure method was used to establish the RIRI model. In the NAS group, 10 mg/kg NAS was injected intraperitoneally before modeling and 30 minutes after modeling. At 6, 12, 24, 72 h after modeling, hematoxylin-eosin staining was used to observe the pathological changes of the retina, and the retinal ganglion cells (RGC) were counted. Each group was detected by immunohistochemical staining and Western blot about the relative expression of TNF-α, nuclear factor E2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) protein in the rat retina. Oneway analysis of variance was used for differences between groups. The general linear regression method was used to analyze the correlation between the relative expression changes of TNF-α protein and the changes of Nrf2 and HO-1 protein expression after NAS intervention. Results:Optical microscope observation revealed that the retinal edema of rats in the RIRI group was observed at 6, 12, and 24 h after modeling; the thickness of the retina in the NAS group was significantly thinner than that in the RIRI group, and the difference was statistically significant ( F=9.645, 477.150, 2.432; P<0.01). At 6, 12, 24, and 72 h after modeling, the retinal RGC counts in the NAS group were significantly higher than those in the RIRI group, and the difference was statistically significant ( F=12.225, 12.848, 117.655, 306.394; P<0.05). The results of immunohistochemical staining and Western blot showed that 6 h after modeling, the relative expression of TNF-α protein in the retina of the RIRI group increased significantly compared with that in the sham operation group, reaching a higher level at 12 h, and decreased at 24 and 72 h. But all were significantly higher than the sham operation group, the difference was statistically significant (immunohistochemical staining: F=105.893, 1 356.076, 434.026, 337.351; P<0.01; Western blot: F=92.906, 534.948, 327.600, 385.324; P<0.01). At different time points after modeling, the relative expression of TNF-α protein in the retina of the NAS group was significantly lower than that of the RIRI group (immunohistochemical staining: F=15.408, 570.482, 21.070, 13.767; P<0.05; Western blot: F=12.618, 115.735, 13.176, 111.108; P<0.05), but still higher than the sham operation group (immunohistochemical staining: F=40.709, 151.032, 156.321, 216.035; P<0.01; Western blot: F=33.943, 79.729, 74.057, 64.488; P<0.01), the difference was statistically significant; 12 h after modeling, Nrf2 in the retina of the NAS group (immunohistochemical staining: F=51.122, P<0.05; Western blot: F=33.972, P<0.05), HO-1 (immunohistochemical staining: F=30.750, P<0.05; Western blot: F=18.283, P<0.05) protein relative expression was significantly higher than that of RIRI group, and the differences were statistically significant. The results of linear regression analysis showed that the difference in the number of TNF-α + cells in the RIRI group and the NAS group was negatively correlated with the difference in the number of Nrf2 + and HO-1 + cells ( r 2=0.923, 0.936; P<0.01). Conclusions:NAS can inhibit the expression of TNF-α protein in the retina of RIRI rats and reduce RIRI. The mechanism may be related to the Nrf2/HO-1 pathway.

Objective To explore the effect of cognitive education and behavioral intervention in solid-state high resolution esophageal manometry (HRM) examination. Methods From April 2016 to June 2017, 60 patients with solid-state HRM in the gastrointestinal motility room at the First Affiliated Hospital of Jiaotong University were as the research object. The 60 patients were divided into control group and experimental group with 30 cases each by the method of random numbers. The conventional methods was used in control group to conduct informed counseling before the examination and the coordination guidance in the examination. The conventional methods and cognitive behavioral intervention was used in experimental group at the same time. The successful rate of intubation, the time used for the examination, discomfort symptoms during intubation, the patient's satisfaction in the whole check process and self-evaluation of intubation pain experience in two groups of patients were compared. Results The time used in the experimental group examination was (28.50±8.75) min, and the control group was (33.13± 5.49) min. The difference between the two groups was statistically significant (t=2.584, P=0.015). In the experimental group, the number of nausea, vomiting, and coughing in the intubation process was 11, 0, and 1, respectively, and the control group was 20, 6, and 7, respectively. The difference was statistically significant (χ2=5.406, 4.630, 5.192, all P<0.05). In the experimental group, the scores of the 2, 3, 4, 5, 7, 8, 10, 11, 12, and 13 items of the intubation pain experience self-evaluation in the examination process were (1.00 ± 0.64), (1.37 ± 0.85), (2.80 ± 0.96), (1.50 ± 0.51), (0.87 ± 0.63), (0.77 ± 0.50), (0.60 ± 0.56), (1.07 ± 0.25), (0.57 ± 0.57), (1.50 ± 0.63) points, and the 2, 3, 4, 5, 7, 8, 10, 11, 12 and 13 scores of the control group they were (1.50 ± 0.51), (2.03 ± 0.76), (3.50 ± 0.82), (2.03 ± 0.76), (1.20 ± 0.61), (1.03 ± 0.41), (0.83 ± 0.53), (1.23 ± 0.43), (0.87 ± 0.57), (2.00 ± 1.05) points, respectively. The difference was statistically significant (t=-4.130--2.140, all P<0.05). Conclusions HRM is an important test before the clinical application of a wide range of clinical applications for the detection of esophageal motility disorders and gastroesophageal reflux disease. The degree of patient cooperation with the operation directly affects the high-resolution esophageal manometry test results and self-experience. Medical staff can give patients cognitive education and behavioral intervention before examination, which can effectively reduce the symptoms and pain caused by intubation, improve patient compliance, shorten the time for examinations, improve work efficiency, and improve patient satisfaction. It is worth further promotion and application in clinical examination.

Objective To evaluate the clinical outcomes of induced membrane technique in the treatment of traumatic segmental bone defects.Methods From May 2011 to January 2016,we treated 10 patients with traumatic segmental bone defect of the lower limb.They were 7 men and 3 women,with an average age of 41.6 years (from 18 to 61 years.The bone defects involved 8 tibias and 2 femurs;the mean length of the bone defects was 5.1 cm (from 2 to 15 cm).All the segmental bone defects were teated by induced membrane technique.At the first stage,the bone defects were filled with antibiotic-impregnated cement spacer after thorough debridement,the limb was fixated with external fixtor,and soft tissue repair was performed in 5 patients.On average all the patients received emergency treatment at the first stage 8.1 hours (from 4 to 13 hours) after trauma.At the second stage,after the cement was removed,the bone defects were filled with cancellous autografts.An allograft was used when the autograft was not adequate enough.The external fixtor was exchanged by internal fixation in one patient according to his soft tissue condition and will;the exteranl fixation was retained in the other 9 patients.Results The average follow-up was 2.8 years (from 1.0 to 5.5 years).Bone healing was achieved in 9 patients after an average of 7.1 months (from 5 to 9 months),and nonunion happened in one patient whose bone graft had been not sufficient enough.Stress fracture occurred in one patient 7 months after bone healing,but it responded to conservative management.One patient reported numbness on the anterolateral thigh of the donor site.Pin tract infection occurred in 3 patients.Follow-ups revealed no limb length discrepancy or deep infection.Conclusion Induced membrane technique is a simple and reliable technique for the treatment of traumatic segmental bone defects.