Objective To investigate the clinical value of combining early urine paraquat early clearance rate (UPCR) with severity index of paraquat poisoning (SIPP) in predicting the prognosis for paraquat poisoning patients.Methods In this retrospective research,a total of 425 cases diagnosed with acute paraquat poisoning from March 2014 to March 2016 in Emergency Intensive Care Unit,First Affiliated Hospital of China Medical University were enrolled.The general data of patients,the results of rapid qualitative test of paraquat in blood and urine,the concentration of paraquat in blood / urine,the poisoning time,the concentration of blood lactic acid and the APACHE Ⅱ score were collected.The early UPCR and SIPP were measured at different time intervals,and the ratio of 6-SIPP and 12 h-UPCR were calculated.These patients were divided into death groups and survival groups according to the 28-day mortality.The relationship between these factors and the mortality were analyzed.Results Of all the 425 patients,268 cases (63.1％) died,157 cases (36.9％) survived;the blood concentration of paraquat,the lactate concentration,SIPP values and the APACHE Ⅱ scores were significant difference between the two groups (P ＜ 0.05).The mortality of 2-6 hour paraquat rapid qualitative test result positive patients was higher (96.4％) than that of the negative patients (3.6％) (P ＜ 0.05);the mortality of 12-24 hour paraquat rapid qualitative test result negative patients was lower (11.5％) than that of the positive patients (88.5％) (P＜0.05).The 2-6 hour SIPP value was 19.8 ±6.7 in death group,which was higher than that in survival group (4.9±3.1) (P＜0.05);the 2-6 hour UPCR value was (41.7±9.3) indeath group,which was lower than that in survival group (86.3 ± 15.8) (P ＜ 0.05).There was no significant difference in the 2-6 hour UPCR value and 12-24 hour UPCR value between two groups (P ＞0.05).The 6 h-SIPP/12 h-UPCR value was (41.94 ±5.9) in death group,which was higher than that in survival group (5.27 ± 3.6) (P ＜ 0.05).Conclusion The combined use of early UPCR and SIPP values is an effective indicator of the prognosis of patients with acute paraquat poisoning and is helpful for the early stratification.We should pay more attention to the patients whose rapid qualitative blood test is positive because of their high mortality risk;for the patients whose 12 h urinequalitative test was negative,the hemoperfusion therapy might be stopped because the toxin was completely excluded,and the medical resources can be saved reasonably.The UPCR might indicate the excretion of toxins,and SIPP might indicate the severity of poising.

Objective To investigate the joint value of early peak temperature and 48 h-△sequential organ failure assessment (SOFA) score in predicting the prognosis for patients with sepsis in emergency department.Methods Two hundred and thirty-one patients with sepsis admitted from January 2013 to January 2015 in Emergency Intensive Care Unit of the First Affiliated Hospital of China Medical University were enrolled.Clinical features,early peak temperature,SOFA scores,the length of stay in EICU and the mortality in 28 days were studied.The patients were divided into two groups according to the 48 h-△SOFA.Each group were divided into three subgroups according to the early peak temperature.For example,hypothermia subgroup had temperature below 36 ℃,normothermia subgroup had temperature between 36 ℃ and 38 ℃,and hyperthermia subgroup had temperature above 38 ℃.The relationship between peak temperature plus 48 h-△SOFA and the length of stay in EICU as well as mortality were analyzed.Results Of 231 patients,in 48 h-△SOFA＞0 group (n =142) 27 (19.0％) patients died,and in 48 h-△SOFA≤0 group (n =89) 33 (37.1％) patients died (P ＜ 0.05).Hypothermia subgroup had a higher odds ratio value in predicting nonsurvival in 48 h-△SOFA≤0 group (OR =4.51,95％CI:1.33-2.17,P =0.01).Hyperthermia subgroup had a longer stay in EICU than hypothermia subgroup and normothermia subgroup (P ＜ 0.05).Conclusion The combination of the early peak temperature and 48h-△SOFA score is an effective indicator to evaluate the prognosis and to stratify patients with sepsis in emergency department.More attention should be paid to the patients with an early peak temperature ＜ 36 ℃ and 48 h-△SOFA ≤0 because of higher mortality.The condition of patients should be reassessed and try to make a more rational treatment for the patients with an early peak temperature ＞38 ℃ and 48 h-△SOFA ＞0 because of its longer stay in EICU.

Objective To compare the efficacy of video-assisted thoracoscopy plus minithoracotomy(VAMT) and limited axillary thoracotomy(LAT) for the treatment of lung cancer.Methods 85 consecutive lung cancer patients were treated by either VAMT or LAT.The operative time,blood loss during operation,postoperative chest drainage time,and hospital stay time and postoperative complication were compared between the two groups.Results There was no death in two groups.The operative time and blood loss during operation were significant less in VAMT than inLAT(t =6.514,2.413,all P ＜0.05).But postoperative chest drainage time,and hospital stay time and postoperative complication were no significant difference between the two groups (t =0.490,0.338,all P ＞ 0.05).Conclusion VAMT is a safe and less traumatic procedure in the treatment of lung cancer,which is worthy of promotion and application.

Medicine, Chinese Traditional ; methods ; trends

Coronary Disease ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods

BACKGROUND: Liuwei Dihuang Pills (LWPs), a famous Chinese prescription for replenishing the liver and kidney, have achieved good effect in the treatment of backache. However, the mechanism underlying LWPs treating backache with kidney deficiency is unclear. OBJECTIVE: To observe the effect of LWPs on extracellular matrix components of rabbit intervertebral disc degeneration models in vitro, and to explore the effect of LWPs in the prevention and treatment of intervertebral disc degeneration.METHODS: Totally 100 L1-6 intervertebral discs with endplate removed from 20 New Zealand rabbits were randomly divided into control, tumor necrosis factor α (TNF-α), p38-JNK/SAPK blocked, LWPs, and combination groups (n=20 per group). 2 μL of 10 mg/L TNF-α, 10 μL of 20 μmol/L SB203580 (specific inhibitor of p38MAPK) and SP600125 (inhibitor of JNK), 10% LWPs serum, 10% LWPs combined with 2 μL of 10 mg/L TNF-α were added into the medium of the corresponding group. Samples were collected at 2, 4, 6 and 14 days of culture. RESULTS AND CONCLUSION: The addition of TNF-α significantly upregulated the mRNA and protein expression levels of collagen type I, while significantly downregulated the levels of glycosaminoglycan and hyaluronic acid, chondroitin sulfate/keratan sulfate ratio, as well as the protein and mRNA expression levels of proteoglycan and collagen type Ⅱ (P < 0.05). LWPs could partly reverse the changes caused by TNF-α, indicating that LWPs can alleviate intervertebral disc degeneration to a certain extent.

During the last decade a lot of new learning about asthma was arisen along with the development of modern immunology and molecular biology,and asthma had been one hotspot in the studies of molecular biological and administer medical field.One of the new viewpoints was that airway neurogenic inflammation took important role in asthma development.For years scholars had suspected that airborne pollutants had an synergistic effect on the attack of asthma and could cause asthma attack,but they did not know the molecular mechanism.In 1991 Denish scholar Nielsen GD advanced a new hypothesis that airway irritation was mediated by capsaicin receptor.The pathological process included a molecular chain of message transfer as air pollutants_capsaicin receptor_Ca2+_substance P_neurokinin receptor.Airway neurogenic inflammation was the result of activation of the receptors.In 1997 American scholar Caterina MJ and his colleagues successfully obtained the cloned capsaicin receptor in expressing cells,this will make Nielsen GD's hypothesis living.

A registration form for orthopedics in-plant metal materials is designed to improve their management.The standardized operation process resulting from the registration form makes medical disputes due to quality problems of in-plant metal materials decreased greatly.Applied in 637 cases of orthopedics operations,the registration form is satisfactory.

Objective To investigate the effectsof quercetin on human umbilical vein endothelial cell (HUVEC)-12 undergoing endothelial-to-mesenchymal transition (EndMT) induced by TGF-β1; To discuss its mechanism of action. Methods Cell activity of intervening by quercetin with different concentrations and TGF-β1 for 72 h was detected by CCK-8 method;RT-PCR and immunofluorescence staining were used to detect the transition of endothelial and stromal markers; Western blot was used to detect the signal transduction pathway; RT-PCR was performed to detect the transcription factors that play crucial roles in the process of transformation. Results The results of RT-PCR and immunofluorescence double staining showed that TGF-β1 (10 ng/mL) stimulated HUVEC-12 cells for 72 h to induce fibroblast phenotype, showing more interstitial markers and less endothelial markers;Western blot and RT-PCR results showed that quercetin inhibited the phosphorylation of smad2/3 in a concentration-dependent manner;After TGF-β1 stimulation, the downstream transcription factors EndMT of snail1, twist1, twist2, ZEB1, and ZEB2 significantly increased, while 100 μmol/L quercetin could down-regulate the five downstream transcription factors. Conclusion Quercetin has anti-fibrosis effects through inhibiting HUVEC-12 cells undergoing EndMT.

Objective To evaluate the therapeutic efficacy of peritoneal dialysis(PD) for acute renal failure(ARF) subsequent to cardiac surgical procedures in adults.Method Clinical data of 125 consecutive adult patients,admitted from Feb.1997 to Nov.2007,with ARF subsequent to cardiac surgery and undergone PD,were analyzed retrospectively.The levels of creatinine(Cr),blood urea nitrogen(BUN),albumin and kalium ion([K+]) were compared before and after PD.Results Of 8451 consecutive adult patients undergone operations on heart,358 cases(4.2%) experienced ARF,and 125 cases(1.5%) required PD.In 117 patients performed PD,[K+] declined to normal level within one day,BUN and Cr were 10.5?3.6mmol/L and 129.3?41.6?mol/L at the third day after PD respectively,significantly lower than those before PD(P