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*

A total of 1 100 patients underwent renal transplantation in the Organ Transplantation Center,Second Affiliated Department of General Hospital of Chinese PLA between 1988 and 2008 were collected,and retrospective analysis was performed in five female patients with malignant tumor,which appeared at 68 months (20-132 months) following renal transplantation,including 2 with renipelvic and uretal cancer and 3 with bladder cancer. Two of the 3 patients with bladder cancer presented homolateral renipelvic and uretal metastasis. Three cases and 1 case of upper uretal cacer were observed at the homolateral or heterolateral of kidney grafts respectively. The main characteristic of sign was iterative and painless gross hematuria. The 5 patients underwent renal transplantation with intravesical instillation therapy and nephrectomy. All patients were survived without rejection in the 1-62 months follow-up. The incidence of malignancy in renal allograft recipients is much higher than that in normal ones,which is related to the long term use of immunosuppressants. Urinary epithelial cancer is the main complicating carcinoma and the first choice of treatment is surgical operation. Based on the normal renal grafts function,the dose of immunosuppressants should be as low as possible,Moreover,radiotherapy or chemiotherapy should be adopted according to the types and stages of tumor complicating renal transplantation.

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

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.

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.

Objective To study the pathologic feature and rational diagnosis and treatment of Mirizzi Syndrome. Method The clinical data of 43 cases treated by surgery were retrospectively analysed. Results All the 43 cases underwent operation, including partial cholecystecomy in 8 cases, cholecystectomy in 16cases , cholecystectomy plus common bile duct exploration with T tube drainage in 9 cases, choledochojejunostomy in 10 cases. Of the 43 cases, 36 cases were followed up for 1～5 years. Of them, 29 cases were in excellent, 6 cases in good and 1 case in poor. Conclusions The pathologic type of Mirizzi Syndrome is variant. It is difficult to make a definite diagnoses before operation. So vary imaginal technique should be adopted. Different operative procedures should be used according to patients' pathologic type.

Objective To study an improved automated method for isolation and purification of large amounts of human pancreatic islets from large mammals,and try to create conditions for preparation and isolation of large amounts of human islets.Methods An improved automated system was used to isolate and purify panreatic islets of sogs.Under the general anaesthesia(GA) condition,the pancreas of the dogs was via in situ vascular perfused using cold HC-A solution and then removed en bloc with duodenum and spleen.Then they were placed in cold UW aolutian.Intraductal collagenase-Ⅴ and pefabloc(4 ℃) was delivered with controlled perfusion.lslets were dissociated in system of Ricordi Chamber and purified islets separated with Ficoll density gradient centrifugation under controlled temperature.Digestion time,islets remaining trapped in exocrine tissue,final islet purity,insulin and C-pep secretory activity,and islet recovery were observed.The purified islets were observed under light microscope and electronic microscope after 24 h culture.Results The digestion time rate was(25.0?6.0) min,islets remaining trapped in exocrine tissue was(9.4?2.4)%,final islet purify rate was(89.7?3.5)%,islet recovery after digestion was(17.2?3.6)?104 IEQ/pancreas.Islet recovery after purification was(8.3?2.0)?104IEQ/pancreas.Insulin and C-pep secretory activity of the purified islets and their ultrastructure after 24 h culture were ideal.Conclusions Our improved automated method and facilities for isolation of canine pancreatic islets are reliable,The morphology and function of the procured islets are excellent and they can foreseeably be used for large-scale preparation of huma islets for clinical use.