Objective To review the clinical features and early management of combined thorcoabdominal injury(CTI),to decrease the mortality rate.Methods A retrospective study was carried out in 63 cases of CTI treated surgically from May 1990 to May 2007.There were 34 cases with blunt injuries and 29 cases with penetrating injuries.Forty-seven patients had rapture of left diaphragm,9 cases had rupthure of right diaphragm,7 cases had rupture of both diaphragms,24 cases were combined with traumatic diaphragmatic hernia,63 cases were combined with hemopneumothorax,and 60 cases were combined with shock.Forty-one cases were diagnosed correctly before surgery.Sixty-three cases were treated by surgery,among them,surgery was performed through left thoracotomy in 18 cases,through a right thoracotomy in 2 cases,through bilateral thoracotomy in 5 cases,through thoraco-abdominal incision in 2 cases,and through the abdominal route in 32 cases.Results Fifty-six cases were cured,and 7 cases(11.1 %) died.The main cause of death was hemorrhagic shock.Conclusions CTI has high mortality rate,and the most frequent cause of mortality is hemorrhagic shock.The operative approach is based on the individual injury condition.Early diagnosis and timely surgical intervention is the key to improving the cure rate and reducing mortality in severe CTI.

Objective To determine the risk factors for imipenem-resistant Pseudomonas aeruginosa (IRPA) infections in neonatal intensive care unit (NICU).Methods One hundred and eighty-eight Pseudomonas aeruginosa infected children (confirmed by pathogenic examination) in the NICU of Maternal and Child Health Hospital of Guangdong from January 1,2008 to December 31,2011,were chosen as the objects of study,and were divided into two groups.The first group included 73 children that had been isolated with IRPA strains(IRPA group),and the second group included 115 children that only had imipenem-sensitive Pseudo monas aeruginosa (ISPA) strains (ISPA group).Chi-square test or t-test was applied.The risk factors were investigated by univariate or multivariate Logistic regression analysis.Results Data from univariate analysis showed that the gestational age and birth weight of neonates were lower than those in ISPA group [(34.0±3.5) weeks vs (35.6±2.8)weeks,t=3.413,P＜0.01; (1848.1±276.4) g vs (2110.7±345.6) g,t=5.472,P＜0.01].There were more neonates with gestational age ≤ 32 weeks [67.1％ (49/73) vs 45.2 ％ (52/115)],birth weight ＜1500 g [73.9％ (54/73) vs 33.0％(38/115)],small for gestational age [68.5％ (50/73) vs 29.6％ (34/115)],receiving imipenem [72.6％ (53/73) vs 27.0％ (31/115)] or the third generation cephalosporins [65.8％ (48/73) vs 33.0％ (38/115)] two weeks before the isolation of Pseudomonas aeruginosa,and mechanical ventilation [78.1％ (57/73) vs 61.7 ％ (71/115)],deep vein catheterization [83.6％(61/73) vs 65.2％(75/115)] in the IRPA group than in the ISPA group (all P＜0.05 or 0.01).The multivariate Logistic regression analysis revealed that imipenem treatment within two weeks before the isolation of Pseudomonas aeruginosa (OR=6.409; 95％ CI:1.926-21.333,P =0.002) was an independent risk factor.Conclusions IRPA infection in NICU hospitalized infants is strongly related to their gestational age and birth weight.History of imipenem administration could be an independent risk factor.

AIM:This study was performed to investigate the feasibility and efficiency of exogenous mesenchymal stem cells(MSCs) transplantation on post-infarction ventricular remodeling and heart function in rats and compare the effects between adult rat MSCs and neonate rat MSCs transplantation.METHODS:1-2 hours after left coronary artery ligation,MSCs cultured in ex vivo,marked with BrdU,were injected directly into the border of infarcts in exogenous rats.6 weeks after transplantation,rat' heart function,ventricular remodeling and pathological results were measured.RESULTS:MSCs transplantation decreased LV end-diastolic diameter and end-systolic diameter,limited LV chamber dilatation and reduced collagen content significantly.The numbers of blood vessels and cardiomyocytes were increased.BrdU-labelled MSCs with oval nucleus were widely distributed.There were no significant difference between adult rat MSCs and neonate rat MSCs transplanted groups.CONCLUSION:MSCs can survive and home in exogenous host infarct hearts without addition of any immunosuppressant.MSCs transplantation has benificial effects on remodeling processes and contributes to improvement of cardiac function,which may be related with the reduction of the amount of the collagen,promotion of myogenesis and angiogenesis.

Objective To understand the changes of NKT cells in the livers and spleens of mice infected with Schistosoma japonicum.Methods Twenty-four female BALB/c mice aged 6-8 weeks were randomly divided into 4 groups.Three groups of mice were infected with(14?2)cercariae of S.japonicum.In 3,6 and 12 weeks post-infection,the mice were randomly chosen from each group and sacrificed resectively and the lymphocytes were harvested from the livers and spleens.The cells were stained with fluorescein-isothiocyanate(FITC)-conjugated anti-mouse pan-NK cells(CD49b)and phycoerythrin(PE)anti-mouse CD3e monoclonal antibodies,respectively.The proportion of NKT cells was analyzed by flow cytometry.In the experiment in vitro,the lymphocytes from spleens of normal mice were harvested and stimulated with SEA,the protein constituents of eggs and lipid constituents of eggs,respectively.The proportion of NKT cells was also analyzed by flow cytometry.Results The proprotion of splenic NKT cells in lymphocytes in 12 weeks post-infection was(4.73?0.41)%,which was significantly higher than that of the control(2.07?0.12)%(P

AIM:To investigate the effects of myeloid-related protein 8/14 ( MRP8/14 ) on the survival and apoptosis of human alveolar epithelial cell line A549, and to explore the role of nuclear factor-κB (NF-κB) in this process. METHODS:A549 cells were treated with different doses of MRP8/14 or stimulated with MRP8/14 for different time.The effect of MRP8/14 on the viability of A549 cells was determined by CCK-8 assay.The apoptotic rates were tested by flow cytometry.The nuclear translocation of NF-κB p65 was detected by Western blot and indirect immunofluorescence.Be-sides, the phosphorylation level of NF-κB p65 was determined by Western blot.NF-κB-specific inhibitor Bay 11-7082 was used to further analyze the role of NF-κB in the apoptosis induced by MRP8/14.RESULTS:The viability of the A549 cells was affected by MRP8/14 in a dose-and time-dependent manner.Flow cytometric analysis showed that the apoptotic rates were increased in the cells treated with MRP8/14 (P<0.01).In A549 cells administered with MRP8/14, NF-κB p65 was significantly phosphorylated and translocated into the nuclei, suggesting the activation of NF-κB signaling pathway. However, NF-κB-specific inhibitor Bay 11-7082 significantly attenuated the cell apoptosis induced by MRP8/14 ( P <0.01).CONCLUSION:NF-κB plays an important role in regulating the apoptosis of human alveolar epithelial cells in-duced by MRP8/14.

Objective To investigate awareness of definition, diagnostic criteria, severity classification and standard diagnosis and treatment for chronic obstructive pulmonary disease (COPD) among primary-care physicians at the grassroots in urban and suburban Shanghai.Methods In total, 298 physicians were surveyed by unified questionnaire for COPD-related knowledge in two secondary-care general hospitals (one in urban and suburban areas each ) and 12 community primary-care centers (four in urban and eight in suburban areas) in Shanghai.One hundred and fifteen physicians in two urban hospitals and one suburban hospital were trained professionally and then evaluated for its effectiveness.Results Awareness of diagnostic criteria of COPD was only 22.4% (35/156), 25.6% ( 10/39), 4.3 % (3/69)and 26.5% (9/34) among physicians in urban primary-care hospitals, urban secondary-care hospitals,suburban primary-care hospitals and suburban secondary-care hospitals, respectively.Their awareness of knowledge about use of anti-cholinergic agents was 13.5 % (21/156), 35.9 % ( 14/39), naught (0/69),and 14.7 % ( 5/34 ), respectively.Only 0.67 % of them ( 2/298 ) knew about severity classification of COPD.Awareness of definition and diagnostic criteria for COPD in the physicians increased to 72.2 % ( 83/115) after training from 18.2% (21/115) before it, and their awareness of severity classification for COPD increased to 45.2% (52/115) after training from 0.8 % (1/115) before it.Conclusions Awareness of COPD-related knowledge, especially of standard diagnosis and treatment for COPD, was poor in primary-care physicians at the grassroots in Shanghai, so it is necessary to strengthen training for them in COPD-related knowledge, including pulmonary function tests.

OBJECTIVETo evaluate the safety and tolerability of long-term (6 months) administration with Shexiang Baoxin Pill (SBP) in patients with coronary heart disease (CHD) of stable angina pectoris.

METHODSAdopting randomized non-blinded and parallel controlled trial, 200 patients with CHD were randomly and equally assigned to the SBP group and the control group. Both received basic therapy for CHD, including anti-platelet, lipid regulating and anti-ischemia with additional SBP 2 pills, taken orally three times per day in the SBP group. They were followed up for 6 months. The drug tolerability and adverse drug reactions occurred in the observation period were recorded, and the laboratory indexes involving blood routine, liver function, renal function, blood glucose and blood lipids were detected before and after treatment.

RESULTSThe trial was completed in 92% of the patients, 5 patients withdrew in the SBP group and 11 patients in the control group; but none for the intolerable therapy. There were 1 case of adverse reaction related to SBP. No obvious change was found in blood glucose and blood lipids in the two groups before and after treatment. No serious adverse reaction and injury of liver and renal function or others happened.

CONCLUSIONLong-term administration of SBP has favorable clinical tolerability and safety for CHD patients.

Angina Pectoris ; drug therapy ; Coronary Disease ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Tablets

Objective To explore the characteristic manifestations of breast malignant isodense masses using mammography. Methods 121 breast isodense masses with pathological confirmations were collected.Compared indicators with pathological findings were the tumor size,shape,edge,structure changes around the mass,axillary lymph nodes,skin changes,nipple changes,suspi-cious malignant calcification.χ2 test and Logistic regression analysis were used to evaluate the diagnostic values of each indicator.Re-sults In the 121 isodense masses,73 were benign,48 were malignant tumors.According to χ2 test analysis,factors impacted the nature of mass including:tumor morphology (χ2 =14.376,P =0.002),tumor edge (χ2 = 21.555,P =0.000),structure twisted surrounding the mass (χ2 =26.939,P =0.000),axillary lymph nodes (χ2 =1 6.285,P =0.000),skin thickening (χ2 =4.698,P =0.030).According to multivariate binary Logistic regression analysis,risk factors of the Logistic regression model included:edge infiltrating of mass (P =0.014),structure twisted surrounding the mass (P =0.003),axillary lymph nodes (P =0.026).Conclusion The characteristic manifestations of breast malignant isodense masses include edge infiltrating,structure twisted surrounding the mass,axillary lymph nodes.These manifestations are of great significance in differential diagnosis of breast isodense masses.

Objective To investigate the effects of disulfiram (DS) combined with Cu on the human Burkitt lymphoma cell xenografts in nude mice.Methods Burkitt lymphoma xenograft was established by subcutaneous injection of Raji cell into nude mice after 2 Gy whole body X-irradiation (1×107 Raji cells were resuspended in 200 μl saline).18 bearing tumor mice were randomly divided into control group,DS group and DS/Cu group.During the experiment,the effects of DS/Cu on the nude mice with tumors were examined,including the tumor volumes,weights and the growth curves of xenograft tumor.Histopathological examination of tumor tissue was observed with optical microscape.The protein expression levels of p-JNK and c-jun were also detected by Western blot.Results Subsequent tumor size and weight in DS or DS/Cu-treated animals were (67.71±2.15) mm3,(33.35±7.74) mm3 and (43.35±4.22) mg,(18.05±2.88) mg.One-way ANOVA analysis indicated that the tumor size and weight in DS or DS/Cu-treated animals were reduced significantly relative to tumors in vehicle-treated animals (F =27.579,P =0.000;F =16.369,P =0.000).Furthermore,multiple comparisons revealed that the DS or DS/Cu-treated animals had significantly reduced tumor size and weight compared with control animals (all P ＜ 0.05).There were significant differences in tumor size and weight between DS or DS/Cu-treated animals (both P ＜ 0.05).Tumor inhibition rates in DS or DS/Cu group were 63.48 ％ and 80.24 ％,respectively.An increase of apoptosis changes in the xenograft tumor cells in DS or DS/Cu treated mice were more significant.Westem blot showed that the p-JNK and c-jun protein expressions in the tumors were improved after the DS or DS/Cu treatment,more obvious in DS/Cu treatment.Conclusion DS/Cu can inhibit the growth of xenografts,and one possible mechanism may involve the regulation of JNK signal pathway.

Reverse transcriptase-PCR experiments suggest that the two clusters of genes potentially involved in the oxidation of reduced sulfur compounds are organized as operons in strain of the acidophilic, chemolithoautotrophic bacterium Acidithiobacillus ferrooxidans ATCC 23270, the two clusters of genes including such the ORF of putative sulfate-thiosulfate-molybdate binding proteins, the ORF of putative thiosulfate: quinone oxidoreductase and the ORF of the rhodanese-like protein (P21). Bioinformatic analyses have predicted the possible promoters sequences and the possible +1 start site of transcription for the doxDA operons.