Objective To investigate the aetiology of acute exacerbations of COPD (AECOPD),and the effects of moxifloxacin in the treatment of AECOPD.Methods Patients with stable COPD based on GOLD criteria were included in the study.Sputum collected at first exacerbation was analyzed for bacteria count and culture.IL-6,IL-8 and TNF-?were measured by enzyme- linked immunosorbent assay (ELISA).Eligible patients were randomized to receive moxifloxacin (400 mg qd for 5 days) or ce- faclor (250 mg q8h for 7 days).Efficacy parameters were evaluated at 7 and 14 days after treatment initiation and 1 year later. Results Of the 46 patients with moderate or severe COPD (male 38,moderate 24),21 (45.65%) were microbiologically evalu- able at baseline.The main pathogen was Haemophilus influenzae (10/21).Clinical efficacy rate was 87.0% in moxifloxacin group and 82.6% in cefaclor group.Bacterial eradication rate was 80.0% and 72.7% respectively.The difference between groups was not statistically significant in terms of clinical or microbiological efficacy.In moxifloxacin arm,the frequency of ex- acerbation was 2.6?1.0,significantly lower than control arm (3.5?1.4,P

AIM: To observe the effect of combined goniosynechialysis in treating absolute glaucoma after trabeculectomy.
METHODS:Phacoemulsification combined goniosynechialysis was performed on 16 patients ( 16 eyes ) with absolute glaucoma after trabeculectomy, and they were followed up for 6 ~12mo, The postoperative intraocular pressure ( IOP ) and anterior chamber depth, preoperative and postoperative medication types (quantity), preoperative and postoperative 1 month's status of anxiety and depression, symptoms of ocular surface were observed. RESULTS: The IOP decreased significantly after phacoemulsification combined goniosynechialysis. The mean IOP was 35. 00±15. 43mmHg preoperatively, and it was 12. 00±6. 69mmHg, 15. 00±4. 26mmHg and 15. 3±5.2mmHg on 1d, 6 and 12mo after the surgery. The statistic difference was found between preoperative and postoperative (t=6. 22, P<0. 05). The anterior chamber depth was 1. 45 ± 0. 19mm before the surgery, and increased to 3. 37±0. 13mm after the surgery (t=6. 65, P<0. 05). After the surgery, 2 patients needed two kinds of drugs, 2 patients needed one kind of drug. After 12mo of follow-up, anxiety and depression status were improved in all 16 patients. Subjective discomfort symptoms of 16 patients such as eye bilges, eye pain were relieved. All of the patients' eyeballs were preserved, and no serious complications.
CONCLUSION: Phacoemulsification combined goniosynechialysis in treating absolute glaucoma after trabeculectomy is a safe and effective surgical option.

OBJECTIVE Recent studies have demonstrated that the Nlrp3 inflammasome serve as a central role in the pathogenesis of cardiovascular diseases and endothelial dysfunction occurs in association with several cardiovascular risk factors. Given the demonstrated anti-inflammatory effects of aspirin, the present study was designed to test whether aspirin diminish NLRP3 inflammasome activation and prevent endothelium injury and associated coronary artery damage during LPS. METHODS Mouse carotid arterial endothelial cells (CAECs) were cultured and treated with 0.1-3 mmol·L-1 of aspirin in response to LPS (2 μg·mL-1) stimuli. After 24 h, the Nlrp3 inflammasome complexes consist of varied proteins were analyzed by WB. NO and T-AOC in the supernatant was detected by ELISA. Intracellular reactive oxygen species (ROS) generation for 24 h was observed by DCF fluorescence. The mice were treated with aspirin (12.5 mg·kg-1 per day, 62.5 mg·kg-1 per day, 125 mg·kg-1 per day) and dexametha?sone (0.0182 mg · kg- 1 per day) for 7 d. The level of IL- 1β,IL- 18 protein was detected by ELISA. RESULTS Immunofluorescence results showed the colocalization of Nlrp3 with ASC or caspase 1 decrease in a concentration- dependent manner. Meanwhile, the expression of Nlrp3 and caspase 1 protein was decreased with the concentration of aspirin, but no changes the expression of ASC protein. Nlrp3 protein levels in CAECs were 0.33- 0.8- fold and cle- caspase 1 protein levels in CAECs were 0.48-1-fold compared to those in LPS stimulation when treated with 0.1-3 mmol·L-1 aspirin for 24 h (P<0.01). Aspirin significantly antagonized the effect of LPS on NO (1.22-1.91-fold that of LPS stimulation, P<0.01) and T-AOC expression (1.02-1.90-fold that of LPS stimulation, P<0.01). As the different concentration of aspirin treated, the generation of ROS was 0.51-1.10-fold that of LPS stimulation (P<0.01). In vivo data shown the level of IL-1β, IL-18 protein from serum are in concordance with the level of Nlrp3 inflammasome activation. CONCLUSION We conclude that aspirin has anti- inflammatory properties, protecting CAECs from LPS-induced injury by inhibition of NLRP3 inflammasome activation through ROS pathway.

Acupuncture Therapy ; Acute Disease ; Fatal Outcome ; Hemorrhage/mortality* ; Humans ; Needles/adverse effects* ; Pharynx/injuries* ; Postoperative Complications ; Postoperative Hemorrhage/etiology*

Objective To analyze the influence factors of medical staff blood-bome occupational exposure by structural equation modeling,in order to improve medical staff of blood-borne occupational exposure protection performance of the system to provide the theory basis for operation.Methods The influence factors of medical staff blood-borne occupational exposure and their correlation were analyzed by exploratory factor analysis and structural equation modeling fitting.Results Model fitting was ideal,hospital decision-makers and department management directly affected the behavior intention of medical staff,department management greatly influenced by the behavioral intention to the medical personnel,path coefficient was 0.27.Hospital decision-makers of behavioral intention to the medical personnel directly affect smaller,path coefficient was 0.03,but its indirect impact on behavioral intention by department management.Behavioral intention of occupational exposure protection action,the path coefficient was 0.80,behavioral intention determined the basic medical personnel blood-borne occupational exposure protection behavior.Conclusions Hospital should improve the system of standards and to establish effective communication channels,at the same time enhance the care ability.Enforcement departments should improve the standard system,equipped with adequate safety equipment,for the medical staff to provide the best working environment,so as to improve the medical staff of blood-borne occupational exposure protection behavior compliance.

OBJECTIVETo compare the clinical effects of circumcision and the foreskin-deglove plus shaft-fix (FDSF) procedure in the treatment of phimosis or redundant prepuce in obese adult males (body mass index [BMI] ≥ 28 kg/m²).

METHODSForty-four obese adult men with phimosis or redundant prepuce underwent circumcision (n = 24) or FDSF (n = 20) according to their own wishes. The patients in the circumcision and FDSF groups were aged (26.38 ± 4.24) and (26.90 ± 3.14) years, with BMIs of (27.77 ± 0.77) and (28.07 ± 2.28) kg/m² and penis lengths of (3.51 ± 0.46) and (3.50 ± 0.59) cm, respectively. The operations were performed under local anesthesia with lidocaine plus ropivacaine mesylate.

RESULTSThe operation time of circumcision was (28.04 ± 2.65) min and that of FDSF was (45.45 ± 3.49) min. At 6 months after surgery, normal penile erection was found in all the patients, the penis length was significantly longer in the FDSF than in the circumcision group ([5.01 ± 0.73] vs [3.70 ± 0.47] cm) , and the rate of satisfaction with penile appearance was markedly higher in the former than in the latter group (3.25 ± 0.71 vs 2.83 ± 0.56).

CONCLUSIONThe foreskin-deglove plus shaft-fix procedure under local anesthesia with lidocaine and ropivacaine mesylate may achieve desirable penile erection and appearance in the treatment of phimosis or redundant prepuce in obese adult patients.

Adult ; Amides ; Anesthetics, Local ; Body Mass Index ; Circumcision, Male ; methods ; Foreskin ; abnormalities ; surgery ; Humans ; Lidocaine ; Male ; Mesylates ; Obesity ; complications ; Operative Time ; Penile Erection ; Penis ; abnormalities ; Phimosis ; surgery

Objective To improve treatment success rate and prognosis for patients with bifrontal contusions by intracranial pressure monitoring.Methods A retrospective analysis was conducted on 79 cases of bifrontal contusions admitted between October 2004 and April 2012.The patients were divided into intracranial pressure monitoring group (n =40) and group without intracranial pressure monitoring (n =39),according to the treatments.Significance of high coronary craniotomy timing,surgical strategy and intracranial pressure monitoring in the diagnosis,treatment and prognosis was analyzed.Results The intracranial pressure monitoring group showed a significantly shorter period concerning osmotic dehydration [(14.24 ± 7.93) days vs (21.61 ± 11.97)days,P＜0.01],ICU stay [(14.38 ±7.56)days vs (24.71-± 17.94)days,P＜0.01] and total hospital stay [(17.20 ±8.09)days vs (33.92 ± 21.70)days,P＜0.01] as well as a better GOS [(4.15 ± 1.22) points vs (3.69 ± 1.56) points,P ＜ 0.05],as compared with group without intracranial pressure monitoring.Conclusions Craniotomy,especially decompressive craniectomy,is one of the most important treatment means to control cranial pressure and ensure cerebral perfusion pressure in patients with bifrontal contusions (in particular the moderate and severe ones).Besides,intracranial pressure monitoring is conducive to selection of surgery timing and is instructive to combined treatment,such as osmotherapy,intracranial pressure controlling and assurance of cerebral perfusion pressure.

Background Oxygen-induced retinal neovascularization is the main pathological basis for many retinal vascular diseases.Research showed that light exposure at night can suppress retinal neovascularization in oxygen-induced retinopathy(OIR),but there were few reports discussing its effect on ROP.Objective This study aimed to observe the effect of light exposure at night on retinal neovascularization in an OIR mouse model.Methods Sixty-four newborn C57 BL/6J mice were randomly divided into four groups,with 16 mice for each group.OIR models were established by rearing the newborn C57BL/6J mice with their mothers in a(75±2)％ oxygen environment from postnatal day 7(P7)to Pl2,and then transferred to room air.In the OIR model group,the environmental illumination level was the same as the normal control group,and the model mice were exposed to 100 lx light at night in the OIR+ light exposure group.In the simple light exposure group,normal mice were reared in room air and were exposed to light at night from P12 to P17.All the mice were sacrificed on P17,and retinal flat mounts were prepared to assess the oxygen-induced changes of retinal vessels using the adenosine diphosphatase(ADPase)histochemical technique.The amount of proliferative neovascularization was quantified by counting the number of endotheliocyte nuclei in new vessels extending from the retinal inner limiting membrane into the vitreous in ocular cross-sections.The expression of the vascular endothelial growth factor(VEGF)protein was detected by immunohistochemistry.Real-time PCR analysis was performed to examine the expression of VEGF mRNA.The rearing and usage of the animals complied with the Statement of ARVO.Results Less free-vascular areas and new blood vessels were seen in the OIR+light exposure group compared with the OIR model group.On day 17 of the mouse life,the number of the endotheliocyte nuclei in new vessels extending from retinal inner limiting membrane were 0.97±0.83,1.00±0.72,38.57±5.01 and 16.92±3.39 in the normal group,simple light exposure group,OIR model group and OIR+light exposure group,respectively,showing significant differences among them(F =78.767,P =0.000).The number of nuclei in the OIR+light exposure group were less than that of the OIR model group(t=20.446,P＜0.01).Immunochemistry showed that the expression of VEGF in retina was weaker in the OIR+light exposure group than the OIR model group.The relative expression values of VEGF mRNA were 1.00±0.00,0.94±0.07,2.08±0.50 and 1.43±0.21 in the normal group,simple light exposure group,OIR model group and OIR+light exposure group,respectively,showing a significant difference (F=11.268,P =0.003),where the VEGF mRNA level in the OIR+light exposure group was lower than that of the OIR model group(t =20.163,P＜0.05).Conclusions Light exposure at night can weaken retinal neovascularization in OIR mice

Animals ; Carcinogens ; toxicity ; Female ; Lung Neoplasms ; chemically induced ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Inbred Strains ; Sensitivity and Specificity ; Urethane ; toxicity

Animals ; Cadmium Chloride ; toxicity ; Dose-Response Relationship, Drug ; Estradiol ; toxicity ; Female ; Organ Size ; drug effects ; Rats ; Rats, Sprague-Dawley ; Uterus ; drug effects ; pathology