Objective[WT5”BZ] To improve the surgical result of circumferential mixed hemorrhoids by using a new technique.[WT5”HZ]Method[WT5”BZ] 371 cases of circumferential mixed hemorrhoids were divided into two groups treated respectively by anal pad preserving(with intact dentate line) respective resection of the internal and external hemorrhoids (RR group) and those treated with routine approach of stripping off the varicose masses of the external hemorrhoids and ligating the internal (control group).[WT5”HZ]Results[WT5”BZ] (1)Cure rates were 84 7%(166/196) in RR group and 74 8%(131/175) in controls, P 0 05.(4) Postoperative complications: a) Postoperative anal pain:mild in 75,moderate in 53 and severe in 68 cases in RR compared with mild in 28,moderate in 47and severe in 100 cases in controls, P 0 05. c) Postoperative urinary dysfunction:26 5%(52/196) in RR and 44 6%(78/175) in controls respectively. d) Tenesmus:7 7%(15/196) in RR and 21 1%(37/175) in controls, P

Objective The amount of neuroglobin(Ngb) in cerebral cortex after different post-traumatic time intervals were studied in order to find out the value of Ngb in estimating the survival time after trauma.Methods Moderate brain contusions in rats were made using free-falling-body impact device,The area and gray values of Ngb immunoreactive products(Ngb-IR)in the core of injury in cerebral cortex and penumbra and the contra lateral cerebral cortex at different time points after trauma were studied by immunohistochemical method and image analysis.Results The expression of Ngb in the core of injured cerebral cortex declined quickly and reached the nadir by 24 hours and remained at low level for long time.On the contrary,it rose quickly and reached the peak value at 12 hours in the penumbra surrounding the core of injury,then declined gradually and reached normal level at 8d to 16d.Image analysis revealed that the expression of Ngb-IR in the penumbra of injured cortex were stronger than that in the opposite side.Conclusion The amount of Ngb in cerebral cortex at the core and penumbra of injury changed regularly according to different time intervals after trauma.Ngb may play an important role in neuroprotection during acute phase of injury.

Objective To investigate the efficacy of volume target pressure control(VTPC)and synchronized intermittent mandatory ventilation(SIMV)in treating severe neonatal respiratory distress syndrome(NRDS). Methods Fifty - six admitted cases with severe NRDS hospitalized in Jiangmen Central Hospital from October 2012 to March 2015 were randomly divided into 2 groups:28 cases in VTPC group were treated by VTPC and SIMV,and 28 cases in pressure control ventilation(PCV)group were treated by PCV and SIMV. There was no significant difference between 2 groups in terms of gender,gestational age,and birth weight(all P ﹥ 0. 05). Artery blood gas analysis was performed at 6 hours,12 hours,24 hours,and 48 hours respectively after ventilation. The following parameters were observed:the time of invasive mechanical ventilation,duration of oxygen therapy,mortality and the incidence rates of hypocapnia,pneumo-thorax,ventilator associated pneumonia( VAP),grade Ⅲ - Ⅳ periventricular intraventricular hemorrhage( PVH -IVH),periventricular leukomalacia(PVL)and bronchopulmonary dysplasia(BPD). Results No case in 2 groups withdrew from the test. There was no significant difference between 2 groups in terms of the first treatment time and total doses of poractant alfa injection(all P ﹥ 0. 05). The time of invasive mechanical ventilation in VTPC group[(71. 75 ± 9. 82)h]was shorter than that in PVC group[(97. 89 ± 16. 88)h](t = 7. 083,P = 0. 000). Hypocapnia incidence of four blood gas analysis in VTPC group[(19. 64 ± 14. 20)% ]was lower than that in PCV group[(47. 32 ± 18. 43)% ] (t = 6. 294,P = 0. 000). Incidence rates of VAP and PVL in VTPC group were lower than those in PCV group(χ2 =5. 197,P = 0. 023;χ2 = 4. 766,P = 0. 029). However,duration of oxygen therapy,mortality and the incidence rates of pneumothorax,Ⅲ - Ⅳ PVH - IVH and BPD were not significantly different between 2 groups( all P ﹥ 0. 05). Conclusion VTPC + SIMV has a better efficacy than PCV + SIMV in the treatment of NRDS.

Objective: To analyze the distribution and drug resistance characteristics of clinical separation germ in a hospital from 2013 to 2015 to provide reference and basis for the prevention and control of nosocomial infection and rational use of antibiotics.Methods: The microbial susceptibility of isolated strains was detected using the conventional methods, and the drug sensitivity was analyzed by BioMerieux ATB 1.22.The drug sensitivity was determined according to CLSI 2014 criteria.Results: A total of 18 421 specimens were isolated during 2013 and 2015, and a total of 3 744 strains were isolated with the total positive rate of 20.32%.The separation and identification of pathogenic bacteria at the top 5 were Escherichia coli (967 strains, 44.34%), Bauman Acinetobacter (323 strains, 14.81%), Klebsiella pneumoniae (312 strains, 14.31%), Staphylococcus aureus (297 strains 13.62%) and Pseudomonas aeruginosa (282 strains, 12.92%).Besides the natural resistance of Klebsiella pneumoniae to amoxicillin, the resistance rate of Escherichia coli to piperacillin was over 75%, while the sensitivity rate of Klebsiella pneumoniae to piperacillin and tazobactam was more than 90%.The sensitivity of Acinetobacter baumannii and Pseudomonas aeruginosa to clinical antibiotics was basically below 40%, and the overall resistance level was higher than that of Bauman.MRSA was sensitive to nitrofurantoin, minocycline, quinupristin-Dafoe and leptin glycopeptide antibiotics (such as teicoplanin and vancomycin).Conclusion: The hospital should strengthen the monitoring of bacterial resistance and track the results in a timely manner so as to provide reference for the rational drug use in clinical practice.

Objective To investigate the influence of high body mass index (BMI) on in vitro fertilization and embryo transfer (IVF-ET) pregnancy outcome in the patients with polycystic ovary syndrome (PCOS) .Methods A retrospective cohort study was conducted using existing data on 224 PCOS patients with IVF-ET by the standard long protocol in this hospital from Jan 2009 to Dec 2011 .All patients were divided into 2 groups according to BMI ,the high BMI group(BMI≥24 .0 ,64 cases) and the normal BMI group(18 .5≤BMI<24 .0 ,160 cases) .The differences of pregnaney outcomes between the high BMI and normal BMI PCOS pa-tients were compared .Results 1 .Basic testosterone(T) in the high BMI group was higher than that in the normal BMI group(P<0 .05) .2 .There were no statistical difference in the number of retrived oocytes ,dose of Gn ,Gn duration ,fertilization rate between the two groups(P>0 .05);the high BMI group demonstrated the higher endometrial thickness and lower good quality embryo rate than the normal BMI group(P<0 .05) .3 .There were no statistical difference in the clinical pregnancy rate and the abortion rate be-tween the two groups(P>0 .05) ,the high BMI group had the higher risk of developing gestational diabetes(GDM)than the normal BMI group(P<0 .05) .Conclusion PCOS patient with high BMI is liable to develop hyperandrogenism and increases the occurrence rate of pregnancy complication gestational diabetes mellitus (GDM ) ,but without affecting the clinical pregnancy rate .

Objective To investigate the effects of pregnancy complicated with diabetes on the insulin sensitivity of offspring during their early childhood. Methods Offspring of diabetic mothers(ODM) and of non-diabetic mothers(ONDM) aged 1 month to 24 months were recruited into this prospective cohort study and followed up for two years. Body weight and body length were measured at 2, 4, 6, 8, 10, 12, 18 and 24 months of age respectively, and body mass index (BMI) were calculated. Fasting plasma glucose and fasting serum insulin levels were measured on the following-up day at 6, 12 and 24 months of age and insulin sensitivity index (ISI) was calculated. Homeostasis model assessment was used to calculate the insulin resistance (HOMA-IR). Insulin sensitivity was evaluated by fasting serum insulin, ISI and HOMA-IR. The difference of insulin sensitivity between ODM and ONDM group were examined by analysis of covariance adjusted by gender, gestational age,birth weight and BMI. Results Six hundred and five babies including ninety ODM and five hundred and eleven ONDM met the inclusion criteria. There were no differences in gender, gestational age,birth-weight/height between the two groups(P＞0. 05). ODM were heavier and higher than ONDM at each measure point during early childhood, but there were statistical differences at the age of 2, 4 and 6 months only (P＜0. 05). And the BMI at age of 2 and 4 months of ODM were higher than those of ONDM(P＜0.05). The number of baby who accepted the measurement of fasting plasma glucose and fasting serum insulin levels at 6, 12 and 24 months of age was 276 cases, 273 cases and 56 cases respectively. The fasting serum insulin of ODM (logarithmically transformed) were 0. 95±0. 30,0. 89±0. 34 and 0. 90±0. 27, which were higher than those of ONDM (0. 70±0. 45, 0. 73±0. 35 and 0. 67±0. 30) (t=9. 58, 5.01 and 6. 11, P＜0.05); HOMA-IR (logarithmically transformed) were 0. 34±0. 33, 0. 27±0. 36 and 0. 27±0. 31, which were higher than those of ONDM also(0.08±0. 46,0. 10±0. 36 and 0. 03 ± 0.33) (t= 9. 55, 4. 79 and 5. 06, P＜0.05); ISI(natural logarithmically transformed) were -3.87±0. 75, -3.73±0. 81 and -3. 73±0. 71, which were lower than those of ONDM(-3.29±1.05, -3.35±0.84 and -3.18±0. 77) (t=9.20, 4. 90 and 5.06, P＜0.05).There were differences in feeding characteristics of ODM between insulin sensitive subgroup [40. 9%(9/22) breast-feeding] and insulin insensitive subgroup [16.67 % (12/72) breast-feeding] (x2 = 7.02,P=0. 03). Conclusions Pregnancy complicated with diabetes has adverse effects on the offspring insulin sensitivity during their early childhood, and affects the early growth and development of them.Breast-feeding might decrease insulin resistance in babies.

Objective:To explore the clinical significance of soluble interleukin 2 receptor(sIL-2R), interleukin-6(IL-6), interleukin-8(IL-8), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α), C-reactive protein(CRP) and procalcitonin(PCT) in the acute phase of severe Mycoplasma pneumoniae pneumonia(MPP).Methods:A total of 301 children with pneumonia admitted to the pediatric ward of the Second Affiliated Hospital of Dalian Medical University from September 2017 to December 2018 were selected and divided into severe MPP group(100 cases), mild MPP group(103 cases) and non MPP group(NMPP group, except for obvious bacterial infection, 98 cases were mainly mild viral infection). The serum levels of sIL-2R, IL-6, IL-8, IL-10, TNF-α, CRP and PCT were measured.Results:The serum levels of IL-6, PCT, CRP, IL-8, TNF-α and sIL-2R in severe MPP group were higher than those in mild MPP group and NMPP group( P<0.05). There was no significant difference in the serum level of IL-10 among the three groups( P>0.05). Receiver operating characteristic curve of inflammatory factors in severe MPP group indicated that IL-6 had the highest specificity(77.1%) and TNF-α had the highest sensitivity(85.0%). In severe MPP group, IL-6, PCT and CRP were the three inflammatory indexes with the largest area under receiver operating characteristic curve.IL-6 and PCT, IL-6 and CRP, PCT and CRP were positively correlated( r=0.277, 0.361, 0.538, respectively, P<0.05). Conclusion:The levels of IL-6, PCT, CRP, IL-8, TNF-α and sIL-2R in serum are important for the diagnosis, treatment and course evaluation of severe MPP.

OBJECTIVETo establish the liver-depression and spleen-deficiency syndrome model in rats to screen the optimal extraction method of small compound Yueanjian on the basis of pharmacodynamic and chemical indicators.

METHODThe PMS liver-depression and spleen-deficiency syndrome model were established by the chronic restraint stress method and treatment with Yueanjian extracted by three methods: water-extraction, steam-distillation and alcohol-extraction. Behavioral performances and the contents of estradiol and progestin in serum were determined before and after the administration of the three extracts. The contents of salvianolic acid B in these three extracts were detected by HPLC. The optimal extraction method of Yueanjian was selected according to pharmacodynamic results.

RESULTThe contents of estradiol and progestin in groups treated with steam distillations and alcoholic extraction were higher than the model group. In the open field test, the group treated with steam distillations showed much higher scores than the model group. HPLC showed that the content of salvianolic acid B extracted by steam-distillation was higher than the other two extracts.

CONCLUSIONOn the basis of pharmacodynamic and chemical results, the steam-distillation was proved to be best extraction method of Yueanjian.

Animals ; Benzofurans ; analysis ; Chromatography, High Pressure Liquid ; Distillation ; Drugs, Chinese Herbal ; isolation & purification ; pharmacokinetics ; therapeutic use ; Estradiol ; blood ; Female ; Premenstrual Syndrome ; blood ; drug therapy ; Progestins ; blood ; Rats ; Rats, Wistar

Background: Isolated systolic hypertension (ISH) is a common disease in elderly people, threatening their health. Traditional Chinese medicine (TCM) treatment or integrative treatment had advantages in improving quality of life and protecting target organs, but need to be proved by large evidence-based researches. Objective: To observe the effects of TCM treatment (Jiangya Capsule) or integrative treatment (combination of Jiangya Capsule and nimodipine) on blood pressure and vasoactive agents, and their safety in elderly ISH patients. Design, setting, participants and interventions: A multicenter, randomized, double-blind controlled trial was adopted. A total of 270 elderly ISH patients recruited from Xiyuan Hospital, and TCM Hospital and Community Health Service Centers of Yanqing County of Beijing were randomly divided into 3 groups: TCM group (Jiangya Capsule plus nimodipine simulation, 90 cases), integrative group (Jiangya Capsule plus nimodipine, 90 cases) and Western medicine (WM) group (nimodipine plus Jiangya Capsule simulation, 90 cases). They were all treated for 4 weeks. Main outcome measures: Before and after 4-week treatment, office blood pressure, 24-hour ambulatory blood pressure, serum nitric oxide (NO), and plasma endothelin-1 (ET-1), thromboxane B2 (TXB2) and 6-keto-prostaglandin 1alpha (6-keto-PGF1alpha) were detected, and safety evaluation was conducted. Results: After 4-week treatment, 5 patients in TCM group were lost to follow-up and another 5 patients were excluded, and 80 patients finished the trial; 7 patients in integrative group were lost to follow-up and another 7 patients were excluded, and 76 patients finished the trial; 2 patients in WM group were lost to follow-up and another 3 patients were excluded, and 85 patients finished the trial. After treatment, systolic blood pressure (SBP) decreased in each group (P<0.05), and integrative treatment was superior to TCM or WM treatment in decreasing SBP (P<0.05). Twenty-four hour average SBP and day average SBP decreased significantly in each group, and night average SBP decreased in integrative group, and integrative treatment was superior to TCM or WM treatment in decreasing day average SBP. Serum NO and plasma 6-keto-PGF1alpha levels were elevated and plasma ET-1 and TXB(2) levels were reduced after treatment, and integrative treatment was superior to TCM or WM treatment in reducing plasma TXB(2) level. Conclusion: TCM treatment or integrative treatment has affirmative effects and safety in treating elderly ISH patients, and integrative treatment has superiority in improving some indexes, and deserves further study.

The guanine-nucleotide exchange factor (GEF) RalGPS1a activates small GTPase Ral proteins such as RalA and RalB by stimulating the exchange of Ral bound GDP to GTP, thus regulating various downstream cellular processes. RalGPS1a is composed of an Nterminal Cdc25-like catalytic domain, followed by a PXXP motif and a C-terminal pleckstrin homology (PH) domain. The Cdc25 domain of RalGPS1a, which shares about 30% sequence identity with other Cdc25-domain proteins, is thought to be directly engaged in binding and activating the substrate Ral protein. Here we report the crystal structure of the Cdc25 domain of RalGPS1a. The bowl shaped structure is homologous to the Cdc25 domains of SOS and RasGRF1. The most remarkable difference between these three Cdc25 domains lies in their active sites, referred to as the helical hairpin region. Consistent with previous enzymological studies, the helical hairpin of RalGPS1a adopts a conformation favorable for substrate binding. A modeled RalGPS1a-RalA complex structure reveals an extensive binding surface similar to that of the SOS-Ras complex. However, analysis of the electrostatic surface potential suggests an interaction mode between the RalGPS1a active site helical hairpin and the switch 1 region of substrate RalA distinct from that of the SOS-Ras complex.
Amino Acid Sequence ; Binding Sites ; Catalytic Domain ; Cloning, Molecular ; Crystallography, X-Ray ; Escherichia coli ; Guanosine Diphosphate ; metabolism ; Guanosine Triphosphate ; metabolism ; Humans ; Models, Molecular ; Molecular Conformation ; Molecular Sequence Data ; Plasmids ; metabolism ; Protein Binding ; Protein Structure, Tertiary ; genetics ; Recombinant Proteins ; chemistry ; genetics ; metabolism ; ral GTP-Binding Proteins ; chemistry ; genetics ; metabolism ; ral Guanine Nucleotide Exchange Factor ; chemistry ; genetics ; metabolism