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 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 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 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 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 investigate the effect of ulinastatin on acute lung injury in rats with severe heatstroke.Methods Fourty-eight rats were randomly (random number) assigned into control group (HS group,n =12),low dose Ulinastatin group (LUTI group,n =12),high dose Ulinastatin group (HUTI group,n =12) and non-thermal group (Sham group,n =12).Rats were prepared with pre-warm chamber to initiate heatstroke.The change of rectum temperature (Tc),heat-rate (HR) and mean arterial pressure (MAP) under heat-stress were recorded.The time-point of heatstroke onset and Tc ＞42 ℃ was observed.Arterial blood samples were draw at 0 min,20 min,40 min and 60 min for testing partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2).Bronchoalveolar lavage fluid (BALF) were collected at 60 min,and the concentrations of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-l β) and interleukin-6 (IL-6) in BALF were measured with enzyme linked immunosorbent assay kit.Lung tissues were harvested for observing pathological change and measuring the expression of iNOS with Western blot test.Results Compared with HS group,the time-point of Tc ＞ 42℃ (P =0.00),severe heat-stroke (P =0.00) and the median of survival time (P =0.00) in LUTI and HUTI groups were significantly increased.At 60min after heat-stress,the level of PaO2 in HS group was much lower than those in other groups (P =0.00).But there were no differences between LUTI and HUTI groups (P =0.91).The value of PaCO2 in HS group was much higher than those in other groups (P =0.00).And the differences between LUTI and HUTI groups were no significant (P =0.79).The concentrations of TNF-α,IL-1β and IL-6 in HS group was the highest in four groups (P =0.00,P =0.04 and P =0.04),followed by LUTI,HUTI and Sham group.The concentrations of proinflammatory cytokine in LUTI were higher than those in HUTI group (P =0.02,P =0.00,P =0.00).Compared with HS group,the pathological injuries were alleviated in LUTI and HUTI group (P =0.00).The expression of iNOS in lung tissue of HS group was strengthened than LUTI and HUTI group (P =0.00),and there was a significant difference between LUTI and HUTI group (P =0.03).Conclusion Ulinastatin improves respiratory dysfunction and the prognosis of severe heatstroke rats through reducing the inflammatory and oxidative injury in lung tissue.

Objective To study the clinical characteristics of tracheotomy in patients with critical diseases and obesity aged 80 years and over. Methods A total of 120 patients with critical diseases and obesity undergoing tracheotomy from July 2006 to August 2011 were retrospectively reviewed,and divided into advanced age group(aged 80-99 years,n=60) and control group(aged 60-79 years,n=60).Surgery time,operation preparation,surgery skill and complication after surgery were compared between the two groups. Results A total of 60 patients undergoing tracheotomy were successfully performed by relative surgery skills according to characteristics of critical obesity in advanced age group.There was 1 case (1.7％) and 0 case with trachea cannula exodus,3 cases (5.0％) and 4 cases(6.7％) with cuff leak,4 cases (6.6％) and 3 cases(5.0％) with stoma bleeding,5 cases (8.3％) and 7 cases (11.4％) with subcutaneous emphysema in advanced age and control groups,respectively.Total complication rate was similar between the two groups of patients [13 cases (21.7％) vs.14 cases (23.3％),x2 =1.00,P＞0.05]. Conclusions Individualized procedure of tracheotomy may reduce complication of patients with critical diseases and obesity aged 80 years and over.

Objective To observe the clinical efficacy of warm needling in treating chronic prostatitis due to kidney-yang deficiency.Method Seventy-eight patients with chronic prostatitis due to kidney-yang deficiency were randomized into a treatment group of 40 cases and a control group of 38 cases. The treatment group was intervened by warm needling, while the control group was by oral administration of Terazosin hydrochloride tablets. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and white blood cell (WBC) count in prostatic fluid were observed before and after treatment, and the clinical efficacies were compared.Result The total effective rate was 92.5% in the treatment group versus 76.3% in the control group, and the difference was statistically significant (P<0.05). The NIH-CPSI scores and WBC counts were significantly changed in both groups after treatment (P<0.05). After treatment, the NIH-CPSI score of the treatment group was significantly different from that of the control group (P<0.05). There was no significant difference in comparing the WBC count between the two groups after treatment (P>0.05).Conclusion Warm needling is an effective approach in treating chronic prostatitis due to kidney-yang deficiency.