Objective To investigate the effect and safety of thoracic drainage by central venous catheter in critical patients with pleural effusion. Methods A prospective study was carried out,in which 46 critical patients with pleural effusion admitted to department of critical care medicine were included,and according to the types of their primary diseases to make matched pairs,and they were divided into two groups:conventional drainage control group and central venous catheter drainage observation group(each 23 cases). The drainage effect and complications were compared between the two groups,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score, quantitative pleural effusion and the counts of white blood cells(WBC)and of platelets(PLT),the levels of prothrombin time(PT),procalcitonin(PCT)and C-reactive protein(CRP),etc. were measured on the baseline and 24 hours after the operation. Results There were no significant differences in the APACHEⅡ score,quantitative pleural effusion,amount and duration of drainage,as well as the levels of WBC,PLT,PT and PCT between group control and observation(all P>0.05). The post-drainage CRP(μg/L)level in group observation was much lower than that in group control(77.26±67.20 vs. 106.13±66.23,P<0.01). There was a trend that the incidence of complication in group control was higher than that in group observation(26.1%vs. 4.3%),but the difference was not statistically significant(P>0.05). Conclusions In the comparison between the conventional drainage and thoracic drainage with central venous catheter,the therapeutic effects for treatment of critical patients with pleural effusion were similar, but the stress was milder and the incidence of complications was lower in the latter group. Therefore,the thoracic drainage with central venous catheter is a safe,effective and alternative method to substitute the conventional drainage for critical patients with pleural effusion.

Objective To investigate the Influence of FOXC1 downregulating on biological behavior of nasopharyngeal carcinoma (NPC) 5-8F cell lines. Methods Western blotting was used to detect the protein levels of FOXC1 in human immortalized nasopharyngeal cell lines NP69, nasopharyngeal carcinoma cell lines 6-10B with lower metastasis potential and nasopharyngeal carcinoma cell lines 5-8F with higher metastasis potential. siRNA was used to downregulate the expression of FOXC1 in 5-8F cell lines, and then ability of migration and invasion were observed. Results FOXC1 protein expression level in NP69 cell lines, 6-10B cell lines and 5-8F cell lines were (0.27 ± 0.04), (0.7 ± 20.06), (1.08 ± 0.05) respectively, and the difference was statistically significant (P < 0.05). Also ability of cell migration and invasion significantly weakened after FOXC1 depletion in 5-8F cell lines (P < 0.05). Conclusion FOXC1 might regulate invasion and metastasis of nasopharyngeal carcinoma through changing expression of Fibronectin and Vimentin, and FOXC1 may be an available target for molecular target therapy of nasopharyngeal carcinoma.

Objective To explore the differential expression of low molecular weight proteins in serum of ischemic stroke patients.Methods Serum samples obtained from ischemic stroke patients (n=33) and normal controls (n=39) were analyzed by Matrix Assisted Laser Desorption/ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS). The severity of stroke was assessed with the National Institutes of Health Stroke Scale (NIHSS) and functional outcome was assessed with modified Rankin Scale (mRS). Results 55 peaks were significantly different between ischemic stroke patients and the controls (P<0.05). There were 7 peaks between 1000~2000 Da, 4 increased peaks and 3 induced peaks in serum of ischemic stroke patients. One induced peak at 1864(m/z) had highest peak intensity in controls and induced significantly in ischemic stroke patients. While induce degree of this peak didn't correlate with the NIHSS, mRS, stroke risk factors and laboratory data. Conclusion The application of this potential biomarker is not restricted to certain subgroups of ischemic stroke patients,so it may serve as one reverse direction biomarker and provide support for early diagnosis and treatment of ischemic stroke.

Objective To investigate the percentage of CD5-positive B cells in peripheral blood mononuclear cells(PBMC) of patients with chronic HCV infection and its clinical significance.Methods The expression of CD5 molecule on B cell surface was detected by flow cytometry and HCV RNA copies were detected by real-time PCR.Results The percentage of CD5+-B cells significantly increased in the patients with chronic HCV infection(58.4%?9.8%) compared with healthy controls(22.5%?5.9%)(P

Objective To compare clinical Pseudomonas aeruginosa different sources of β-lactamase-resistant phenotype differences,as to provide theoretical basis for guiding clinical rational use of antibiotics.Methods Isolation of 478 strains of Pseudomonas aeruginosa were collected from clinical specimens in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2015,by VITEK 2 Compact bacteria identification and drug sensitivity analysis of advanced expert system for β-lactamase-resistant phenotype,statistical analysis of drug resistance phenotype and antibiotic resistance.Results 478 strains of Pseudomonas aeruginosa were mainly composed of phenotype 5 and phenotype 3.Sputum,drainage fluid and bile duct bile specimens of Pseudomonas aeruginosa were based on phenotype 5,accounted for 31.08％,34.71％ and 38.46％.Multiple comparison x2 were 3.893,4.071 and 5.595,There was no statistical difference between groups compare significance (P＞0.05).Urine,secretions and whole blood samples of Pseudomonas aeruginosa were phenotype 3,accounted for 34.88 ％,27.78 ％,45.45 ％;Multiple comparison x2 were 6.654,9.956 and 9.852.There was no statistical difference between groups compare significance (P＞0.05).Sputum,drainage of liquid,bile duct bile and urine,secretion,whole blood specimens respectively source of Pseudomonas aeruginosa resistant phenotype distribution of two comparative difference was statistically significant (x2 =15.056～22.050,P＜0.05).Comparing the resistance of different β-lactamase-resistant phenotypes in Pseudomonas aeruginosa isolates from different sources:the sputum specimen source in imipenem,meropenem,piperacillin and piperacillin/tazobactam had significant difference (x2 =22.225～39.025,P＜0.05).There was statistical significance in department of hepatobiliary surgery only ceftazidime and meropenem differences (x2 =21.890～22.872,P＜0.05).Conclusion The phenotypic analysis of β-lactamase-resistant phenotypes of Pseudomonas aeruginosa from different specimens was different,which provided a theoretical basis for guiding the clinical application of antibiotics and the control of nosocomial infection of Pseudomonas aeruginosa.

Objective To describe the clinical features of convulsive status epileptieus (CSE) in our hospital and to provide a basis for future CSE prevention and treatment. Methods Patients with CSE hospitalized from January 1996 to October 2007 were prospectively observed. Logistic regression was used to identify predictors of prognosis. Results All 220 eases of CSE were prospeetively analyzed, a hundred and two patients(46.4%) originated from rural areas. The primary cause of CSE was central nervous system(CNS)infectian (72cases, 32.7%), followed by discontinuation or reduction of antiepileptie drugs (AEDs, 35 cases,15.5%). The median duration of CSE was 5 hours and median duration of seizures before treatment was 2 hours; both were longer in rural patients (7.0 and3.5 hours respectively) than in urban patients (3.0 and 2.0 hours, Z=-3.433,-1.558,both P<0.05). The fatality rate by the time of discharge was 15.9%. Logistic regression analysis showed that the duration of CSE (χ2=20.941), a history of epilepsy (χ2=4.910), and respiratory depression (χ2=16.086) were independent predictors of CSE prognosis (allP<0.05) . Comparisons between these data of USA and Europe were made. Conclusions CSE occurs mostly in rural population and epilepsy patients. CNS infection and withdrawal or reduction of AEDs in patients with epilepsy were important triggers of CSE. Antiepileptic therapy for status epilepticus in China falls behind that in the European countries.

Objective To assess the value of magnetic resonance imaging for acute pancreatitis.Methods 77 patients of acute pancreatitis were examined with holding breath MRI sequence.Transverse scan:2D Flash T 1WI/T 1W+FS,TSE T 2WI+FS or HASTE+FS,Trufisp.Coronals scan:2D Flash T 1W+FS.MRCP was used in 34 patients.2D Flash dynamic contrast enhanced were used in 77 patients.Results 59 cases of acute edematous pancreatitis showed swelling and low signal intensity on T 1WI and higher signal intensity on T 2WI.Excepted the above findings,18 cases of hemorrhagic necrosis pancreatitis alos showed the higher signal intensity on T 1WI and peripancreatic exudative hydrops.Conclusion MRI is a reliable method for demonstrating acute pancreatitis.

Objective To determine the relationship between the delayed enhanced area on contrast enhanced MRI to the infarct area on pathologic examination in order to offer the groundwork for clinic in the assessment of myocardial viability by MRI Methods Application of short axial view of delayed contrast enhanced MRI was assessed in a pig model of nonreperfused and reperfused myocardial infarction After excision, the hearts were sectioned into short axial slices, and all slices were stained with TTC The signal intensity on the delayed contrast enhanced MRI of the infarct area was compared with that of the normal area The extent of delayed enhanced area on contrast enhanced MRI was also compared with the extent of the infarct area on TTC stained sections Results On delayed contrast enhanced MRI, the signal intensity of the 7-10 day-old infarct area was much higher than that of normal area In nonreperfusion group, the signal intensity of infarct area(20 81?6 49)was 7 76 times than that of normal area(2 68?1 10)( t =11 68, P 0 05)in nonreperfusion 7-10 day-old myocardial infarction, and the extent of delayed enhanced area (12 52?5 93)% was larger than the extent of infarct area(11 13?5 81)% ( t =-14 48, P

Objective To evaluate the role of comprehensive cardiac MRI (CMRI) in diagnosis of patients with coronary artery disease (CAD) Methods 55 patients with acute coronary syndrome underwent MR imaging 3-6 months after the reperfusion therapy Short axis images acquired by cine FIESTA sequence were used to analyze the motion of the different anatomy regions Used the FGRE ET sequence to detect the patterns of the first pass perfusion after injection of 0 2 mmol?kg 1 Gd DTPA at a flow of 3 ml?s 1 7-12 min later, MDE pulse sequence used to recognize the high signal in the myocardium Results At study entry, 38 subjects had the defect in the first pass perfusion The signal in the defect was significantly lower than that in the normal regions, which always in the subendocardium 51 subjects had delayed enhancement regions in the myocardium at different degree and different range The mean intensity of hyperenhanced regions was 4 36 times higher compared with that of the regions without hyperenhancement The difference between the 2 regions had statistical significance The extent of hyperenhancement was significantly related to the abnormality of wall motion The range of delayed enhancement was bigger than that of the first perfusion defect Conclusion Comprehensive evidence of delayed hyperenhancement, dysfunction of myocardium, and the defect of first pass perfusion can be used to predict myocardial infarction

Objective To study and evaluate the MRI findings and their diagnostic value for breast carcinoma.Methods Preoperative contrast-enhanced MR imaging and mammography were performed in 12 patients who underwent surgery and were histopathologically proved with breast carcinoma.MR imaging findings were compared with clearly mammography.Results Twenty-one breast lesions in 12 cases were detected with MR imaging.Seventeen of the twenty-one lesions were detected with mammography.Contrast-enhanced MR imaging was superior to mammography to demonstrate lesions in these dense breasts.It could clearly indicate the extension of posterior breast carcinoma into the pectoralis major muscle and the metastases of parasternal lymphatic node,while it was difficult to evaluate with mammography.The "rim enhancement sign" might be valuable to diagnose breast carcinoma.Conclusion The sensitivity and accuracy of MR imaging is superior to that of mammography.Contrast-enhanced imaging of the breast is helpful not only in early diagnosis of breast carcinoma but also in staging breast carcinoma and planning therapy.