Objective To determine the risk factors for acute kidney injury following type Stanford A Aortic Dissection surgeryies.Methods It's a restrospective study.The clinical data of 176 patients undergoing type Stanford A Aortic Dissection surgery from Septerary 2009 to December 2011 were retrospectively analyzed.There were 115 males and 61 females with mean ages(43.20 ± 10.14)years old.The patients were divided into two groups according to whether AKI occurred after operation.Univariate and multivariate analyses were used to evaluate possible pre-,intra-,and post-operative parameters associated with AKI according to AKI Network.Results Among all the patients,AKI occurred in 78 (44.32％),21 (11.93％) of whom underwent continuous renal replacement therapy (CRRT).In hospital mortality was 3.41％ in all discharges while 6.45％ in AKI patients (P ＜ 0.01).Conclusion Multivariate Logistic regression analysis revealed that increased age,pre-operative left ventricular insufficiency,pre-operative renal insufficiency and long extracorpeal circulation (CPB) time ＞ 140 min were risk factors for the development of AKI.AKI is the most common complication of type Stanford A Aortic Dissection surgery,and is the risk factor of mortality after the surgery.It is important to enhance peri-operative protection of the renal function.

Objective:To observe the effects of Qingluotongbi granule(QLT) on the changes of cytokines in adjuvant induced arthritis(AIA) model of rats.Methods:The AIA model of rats were induced by complete Freunds adjuvant. Various doses of QLT were given by gavage once daily for 21 days.Results:QLT〔7.2,14.4 g/(kg?d).ig〕markedly decreased the levels of IL-1 and TNF-? in AIA rats.Conclusion:QLT has modulating effects on the alternations of cytokines of AIA model.

Objective To discuss the relationship between serum uric acid (SUA) and the metabolic components in metabolic syndrome(MS) .Methods 147 female cases of MS aged >60 year old were divided into MS Ⅰ group ,MSⅡ group and MS Ⅲgroup according to numbers of metabolic components ,and the levels of SUA were compared among the three groups .These patients were also subdivided into 4 groups according to the SUA levels by the quartile division ,and the differences of the metabolic compo-nents were compared among the 4 groups .The relationship between SUA and various metabolic components of MS was analyzed by Logistic regression analysis .Results The SUA level had statistical difference among the MS Ⅰ group ,MSⅡ group and MS Ⅲgroup(P<0 .05);the four SUA intervals of q25(< 44 .31 mg/L) ,q50(44 .31 -53 .24 mg/L) ,q75(>53 .24 -62 .68 mg/L) and q100(>62 .68 mg/L) showed significant differences in waistline ,SBP ,DBP ,TG ,HDL-C and FPG(P<0 .05) .Compared with the SUA interval of <44 .31 mg/L ,the occurrence risk of MS in the SUA intervals of (44 .31-53 .24) ,> (53 .24-62 .68) and >62 .68 mg/L were 1 .87(95% CI1 .35-2 .59) ,2 .71(95% CI 1 .88 -3 .91) and 4 .88(95% CI 3 .12 -7 .63) ,respectively .Waistline(OR=2 .56 ,95% CI 1 .52-4 .31) ,TG(OR=2 .21 ,95% CI 1 .63-3 .00) ,SBP(OR=1 .68 ,95% CI 1 .33-2 .12) ,DBP(OR=1 .84 ,95% CI 1 .41-2 .40) ,FPG(OR=2 .16 ,95% CI 1 .68-2 .78) and numbers of metabolic components (OR=2 .87 ,95% CI 1 .89-4 .36) were the risk factors for SUA ,and the HDL-C was the protective factor(OR=0 .48 ,95% CI 0 .29-0 .79) .Conclusion There may be in-teraction between SUA and the metabolic components of MS .

Objective To investigate serum total prostate special antigen(tPSA),complexed prostate special antigen(cPSA)and cPSA/tPSA ratio(C/T) in the differential diagnosis of benign prostate hyperplasia(BPH)and prostate cancer(PCa).Methods A total of 184 serum samples from hospital outpatient and inpatient were collected from May 2009 to December 2015,and which were divided into three groups including other diseases 68 patients,benign prostate hyperplasia(BPH group)80 patients,prostate cancer (PCa group)36 patients.Chemiluminescence immunoassay was used to detect the concentration of tPSA and cPSA,and the C/T ratio were calculated in the study.Results The tPSA,ePSA levels and C/T ratio were significant different from patients with PCa,BPH and other diseases group(P＜0.01).Compared with BPH group(r=0.661),the tPSA and cPSA levels have a higher relativity in PCa group(cPSA=0.708 × tPSA-0.219,r=0.956).While when tPSA level ranges 4.0-10.0 ng/mL),no significant difference of tPSA,cPSA levels and C/T ratio were found in these 3 groups(P＞0.05).Conclusion Combined detection of serum tPSA,cPSA and C/T,making importance in the differential diagnosis of BPH and PCa.

Objective To investigate the effect of Dectin-1 on the release of inflammatory factors interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in rat tracheal epithelial cells (RTECs) stimulated with heat-treated Candida glabrata (C.glabrata).Methods RTECs cultivated in vitro were randomly divided into three groups,including control group(RTECs + sterile normal saline),fungal stimulation group(RTECs + heat-treated C.glabrata),and inhibitor intervention group(RTECs + laminarin + heat-treated C.glabrata),cells were harvested after incubation for 0,2,4,6 hours respectively,cell survival rate was determined by MTT method,expression of Dectin-1 was analyzed by Western Blot,expression of IL-10 and TNF-α were detected by enzyme-linked immunosorbent assay (ELISA).Results Heat-treated C.glabrata destroyed cell structure and reduced cell survival rate.At the beginning of the culture (0 h),cell survival rate,expressions of Dectin-1,IL-10 and TNF-α among three groups were all not significantly different(all P＞0.05).After incubation for 2,4,6 hours,expressions of Dectin-1,IL-10 and TNF-α in fungal stimulation group and inhibitor intervention group were both significantly higher than control group;expressions of Dectin-1,IL-10,and TNF-α in inhibitor intervention group was lower than fungal stimulation group(all P＜0.05).The expressions of IL-10 in inhibitor intervention group at 0 h and 2 h was not significantly different,expressions of Dectin-1,IL-10,and TNF-α in fungal stimulation group and inhibitor intervention group at different incubation periods were significantly different(all P＜0.05).Conclusion Dectin-1 is an important receptor for RTECs to recognize the heat-treated C.glabrata,it induces the release of IL-10 and TNF-α,and mediate the occurrence of inflammation.

Objective To discuss the clinical epidemiology features and change trend of aortic dissection (AD) in Henan Province.Methods Retrospective analysis of consecutive 906 patients with AD over 10 years in Henan Provincial People' s Hospital,the First Affiliated Hospital of Zhengzhou University and Henan Provincial Chest Hospital.Hospital records and prognosis were compared between two five-year periods.Results 906 cases with AD were hospitalized during the past 10years.The mean age was (50.2 ± 9.8) years.The male/female ratio was 3.49 ∶ 1.Hypertension was present in 60.3 ％ of all patients.Heavy smoking history was elicited in 32.2％ of all patients.Type A dissection were identified in 57.8％ of all the cases,and type B in 42.2％.In-hospital mortality of acute type A dissection was 21.8％,acute type B dissection 6.8％.In two five-year periods,the total number of cases increased by 216％,among which type A was the fastest,increased by 294％,Changes of mean age and male/female ratio were not significant.For acute AD,changes of prognosis in one year improved,and reach statistical significance (P ＜ 0.05).Conclusion This study provides insight into current regional profiles of AD.The number of hospitalized patients with AD is increasing dramatically.The mean age of the first-attack is much younger and the male ration is much higher than that reported by other regional researchers.These data support the urgent need for further improvement in prevention and treatment of AD.

Objective To evaluate the feasibility and effectiveness of four closure techniques ,large incision with plastic distal at‐tachment and clip with suction ,1 .1 cm small incision with plastic distal attachment and clip with suction in natural orifice translu‐minal endoscopic surgery(NOTES) .Methods Forty‐one ex vivo porcine stomachs were involved in this research .According to the size of incision and different methods of incision closure ,all ex vivo porcine stomachs were divided into four groups .Group A in‐volved 8 ex vivo porcine stomachs ,their size of incision were 1 .2-2 .0 cm ,and their incisions were closured by a clip closure direct‐ly ;group B involved 10 ex vivo porcine stomachs ,their size of incision were 1 .2-2 .0 cm ,and their incisions were closed by plastic end attachment with suction and clip enclosure technique;group C involved 10 ex vivo porcine stomachs ,their size of incision were smaller than 1 .1 cm ,and their incisions were by a clip closure directly ;group D involved 13 ex vivo porcine stomachs ,their size of incision were smaller than 1 .1 cm ,and closured by plastic end attachment with suction and clip enclosure technique .Stomach leaks were evaluated by leaking studies after the procedure .Results In group A ,1 incision was closed successfully ,7 incisions were clo‐sured unsuccessfully ;in group B ,2 incisions were closed successfully ,8 incisions were closed unsuccessfully ;in group C ,2 incisions were closed successfully ,8 incisions were closured unsuccessfully ;in group D ,11 incisions were closed successfully ,2 incisions were Closured unsuccessfully .Fisher′s exact test showed that group D was significantly related to the success of incision closure .The were significant differences between group A and D ,group B and group D(P<0 .05) .Conclusion Small incision(smaller than 1 cm) and plastic end attachment with suction and clip enclosure technique are optimal in NOTES procedure in this ex vivo porcine stomachs study .

During September to October 2016 a cross-section survey on job satisfaction of general practitioners (GPs) was conducted among 619 GPs who were randomly selected from 15 community health service centers/stations in Xicheng District of Beijing. The questionnaire used in the survey included items related to the satisfaction for salary, working environment, performance, equipment, performance assessment, professional promotion, training and respect degree; as well as the aspects that need to be improved. The overall satisfaction rate was 80.0% (495/619). The satisfaction of salary was the lowest (43.5%, 269/619), while the satisfaction of training was the highest (94.3%, 584/619). 93.2% (577/619) and 80.0% (495/619) of the participants felt that they were respected by the patients. The most desired aspects need to be improved were to increase personal income (95.6%, 592/619) and work ability (44.3%, 274/619). The survey indicates that attention should be paid to increase the income of primary care GPs in the future heathcare reform.

OBJECTIVETo investigate the function of repair gene LIG4 in radiosensitivity enhancement of rectal cancer cells by curcumin.

METHODSHuman rectal cancer cells HT-29 were cultured in normal. LIG4-overexpression HT-29 cells and blank control plasmid HT-29 cells were established by gene transfection. Both kind of HF-29 cells were further randomly divided into curcumin group, radiotherapy group, curcumin plus radiotherapy group (combined group) and control group. The growth inhibition and apoptosis of cells were detected by MTT and Annexin V/PI respectively. Change of tumor volume was observed in nude mouse xenograft model, and the apoptosis of tumor cells was analyzed by TUNEL.

RESULTSRegarding blank control plasmid HT-29 cells, the growth inhibition rate and apoptosis rate in combined group were significantly higher than those in radiotherapy group(all P<0.05); tumor volume of nude mouse in combined group was significantly smaller than that in radiotherapy group, and the apoptotic index in combined group was significantly higher than that in radiotherapy group (all P<0.05). However, regarding LIG4-overexpression HT-29 cells, the growth inhibition rate and apoptosis rate were not significantly different between combined group and radiotherapy group(all P>0.05); the tumor volume of nude mouse and the apoptotic index were also not significantly different between combined group and radiotherapy group (all P>0.05).

CONCLUSIONDown-regulation of LIG4 is an important mechanism of radiosensitivity enhancement of rectal cancer cells by curcumin.

Objective The optimal access for natural orifice transluminal endoscopic surgery is still uncertain .This study was designed to compare the practicability and maneuverability of transgastric ,transunmbilical ,and transrectal approach in abdominal surgery in a canine model .Methods Three dogs were used in this research .Three approach :trangastric ,transunmbilical and tran-srectal approach were carried out for abdominal exploration ,liver biopsy ,bladder biopsy and an attempted cholecystectomy .The ma-neuverability ,endoscopic image ,performer′s perception ,and spatial orientation were evaluated .Results The maneuverability of trangastric ,and transrectal approach NOTES were better than transunmbilical NOTES .Abdominal exploration ,live biopsy ,and bladder biopsy were completed successfully .The cholecystectomy was failed because of poor exposure and difficulty of separating the around tissure .Conclusion The optimal approach for upper abdomen NOTES is transrectal route .For lower abdomen NOTES , the trangastric approach is superior to other accesses .Further study is needed to develop more flexible and precise equipment for NOTES and to evaluate more feasible access approach .