Humans ; Lung ; pathology ; Physical Examination ; Pneumoconiosis ; diagnosis ; Thoracotomy

2cm~2.Conclusions The auto-cranial pedicle flap via endonasal repairing blow-out fractures of or- bital inferior wails is an effective technique.The results are good for improving eye movement especially for fracture ranged≤2cm~2. (Ophthalmol CHN,2007,16:388-390)

The clinical values of acetoacetate ( AcAA ) and β hydroxybutyrate ( βHBA ) determination in classification of type 1 and2 diabetes were explored. 102 normal control subjects,33 cases of type 1 diabetes, and 104cases of type 2 diabetes were enrolled. Serum AcAA, βHBA, fasting plasma glucose ( FPG), C-peptide, and insulin levels were measured. The results showed that serum AcAA, βHBA, total ketone tody (TKB) levels in the diabetic groups were significantly higher than those of the normal group( P＜0. 01 ). AcAA, βHBA, TKB levels in type 1diabetes were higher as compared with those of type 2 diabetes( P＜0.01 ). The AcAA, βHBA, and TKB levels were negatively related with C-peptide and insulin in diabetic patients( P＜0. 01 ). All the type 1 diabetic patient were found to have TKB and lower C-peptide levels. TKB positive and lower C-peptide in type 2 diabetes were found in 47% and 26% respectively. Receiver operating characteristic (ROC) curve suggested that the area under the ROC curve of type 1 and type 2 diabetes was 0.926. The optimal operating point of the total ketone body was 0. 532 mmol/L with higher sensitivity and specificity. Enzymatic determination of acetoacetate and β hydroxybutyrate seems to have important clinical values for classification of type 1 and 2 diabetes.

Objective: To explore the relationship between expression of tumor necrosis factor-α( TNF-α) and electrophysiological heterogeneity in isolated heart tissues and isolated rat ventricular myocytes.The arrhythmogenic mechanisms of TNF-αwere further studied.Methods:Langendorff perfused heart tissues models were used to verify the arrhythmogenic effects of TNF-α.The monophasic action potentials( MAPs) of the endocardium and epicardium from the isolated heart tissues were recorded by elec-trophysiological experiments.The isolated rat ventricular myocytes were obtained by enzymatic dissociation.K+currents(Ito,IK1)were recorded by using whole cell patch clamp technique.Results: Compared to the control group, the difference in MAPD between endocardium and epicardium dramatically increased with TNF-α( P<0.05 ) .TNF-αcould cause MAP duration ( MAPD ) prolongation, and a single dose of TNF-αdifferentially affected the MAPs of endocardium and epicardium of isolated heart tissues.Compared to the control group,the K+currents(Ito,IK1)were dose-dependently decreased with TNF-αin rat ventricular myocytes(P<0.05).However, etanercept had no effects on the MAPD in the absence of TNF-α.Conclusion:TNF-α-induced heterogeneity of MAPD between the endo-cardium and epicardium may provide the substrate for the onset of ventricular arrhythmias during acute myocardial infarction.The effect might be associated with TNF-αcontribute to re-entrant ventricular arrhythmias which resulted from decreased K+currents(Ito,IK1).

Objective To establish an animal model of severe blast lung injury in baby rabbits,and to provide a way to study the char-acteristic and treatment of blast lung injury in minors.Methods Randomly selected sixteen 4-weeks old New Zealand white rabbits,and the blast lung injuries were made by BST-Ⅰ biological shock tube with different drive pressure (4.0 MPa and 4.5 MPa)respectively.Then compared the injury severity of the 4.0 Mpa group and the 4.5 MPa group.Selected forty-eight 4-weeks old New Zealand white rabbits and di-vided them into the control group (8 rabbits)and the blast lung injury group (40 rabbits)Rabbits in the blast lung injury group were injured with 4.5 MPa drive pressure.Observed the vital signs,physiological index,gross anatomy of the lung,pathology,and pulmonary water content at the time of injury immediately (0 hour),2 hours,4 hours,6 hours,12 hours,24 hours,48 hours and 72 hours after the injury.Results Rabbits inthe 4.0 Mpa group and the 4.5 MPa group were all alive.The overpressure of blast wave of the 4.0Mpa group was (328.16 ± 4.78)kPa,rate of severe pulmonary defense was 12.5%,and the AIS score was (3.38 ±0.52)points.In the 4.5 MPa group,the overpressure of blast wave was (395.04 ±11.74)kPa,rate of severe pulmonary defense was 87.5%,and the AIS score was (4.13 ±0.64) points.Rabbits in the control group and the blast lung injury group were all alive.The spirits of rabbits were drooping immediately after inju-ry,and it last about 0.5 hour.Then the breathing and heart rate was accelerated,pulmonary water content was increased significantly,and there were extensive hemorrhage and edema in the lung.Most of the rabbits suffered severe lung injury,and the AIS score was (3.98 ±0.55) points.Lung tissue rupture,hemorrhage,edema,and inflammatory cells infiltration were the main pathological manifestations under light microscopy. Conclusion The model of severe blast lung injury in baby rabbits could be established with BST-Ⅰbiological shock tube and drive pressure of 4.5 MPa.It is relatively simple,easily controllable and highly repeatable,which can be used as a feasible model for the study of blast lung injury.

Objective To evaluate the feasibility and outcome of laparoscopic cholecystectomy as a overnight procedure in China.Methods The data of 59 consecutive patients who had undergone outpatient laparoscopic cholecystectomy between Januaiy 2013 and January 2015.All the patients were operated in the morning hours and discharged during 24 hours after operation.They were contacted by telephone 3 days subsequent to surgery and were seen in the outpatient unit 7 days after.Results Fifty-nine laparoscopic cholecystectomies were performed.No Conversion to open surgery case.The average operation time was 25 minutes,and restore semi-liquid diet 6 hours after the operation All the 59 patients were discharged during 24 hours after operations.None of the patients had an emergency readmission.None of the patients had complications 7 days after discharged.The average payment was 8 240 yuan.Conclusion These results suggest that laparoscopic cholecystectomy can be routinely performed as a overnight procedure.

Salmonella enterica serovar Cerro 87, which was isolated from a commercial egg-producing farm, has a phosphorothioated DNA backbone resulting DNA degradation(Dnd) during the pulsed field gel electrophoresis (PFGE) process. In this research, a gene deletion mutant XTG103 was engineered with the entire dnd gene cluster knocked out by double crossover using vector pKOV-kan, and lost Dnd phenotype corre- spondingly. We regulated the DNA phosphorothioation by heterogenous expression of dnd gene cluster with an isopropyl ?-D-1-thiogalactopyranoside (IPTG) inducible promoter PlacZ.

Objective To investigate the effects of magnesium isoglycyrrhizinate on liver function of patients with gastrointestinal cancer following chemotherapy.Methods From Apr.2012 to Dec.2015,a total of 168 cases of patients with gastrointestinal cancer following chemotherapy were enrolled,and were randomly divided into observation group(84 cases) and control group(84 cases).Each of the two groups was divided into A group(42 cases) and B group(42 cases) according to the treatment methods.Patients of observation group(including observation A group and observation B group) were treated with magnesium isoglycyrrhizinate,while patients of control group(including control A group and control B group) were treated with glutathione.Patients of A group(including observation A group and control A group) were treated with FOLFOX4 regimen,while patients of B group(including observation B group and control B group) were treated with XELOX regimen.The incidence of abnormal liver function and changes of the levels of liver function of each group were analyzed and compared.Results After the appropriate treatment,the abnormal rate of liver function of observation group were significantly lower than control group(P<0.05).After treatment,levels of liver function parameters in observation group and control group were all significantly increased(P<0.05),and those in control group were higher than observation group(P<0.05).After treatment,levels of liver function parameters in observation A group and control A group were all significantly increased(P<0.05),and those in control A group were higher than observation A group(P<0.05).After treatment,levels of liver function parameters in observation B group and control B group were all significantly increased(P<0.05),and those in control B group were higher than observation B group(P<0.05).Conclusion Magnesium isoglycyrrhizinate could be with protection effects on liver function of patients with gastrointestinal cancer following chemotherapy,which might be worthy of promotion.

Objective To explore the clinical efficacy of laparoscopic transabdominal preperitoneal (TAPP) hernia repair and risk factors affecting postoperative complications.Methods The retrospective casecontrol study was conducted.The clinical data of 595 patients who received laparoscopic TAPP hernia repair in the First Affiliated Hospital of Soochow University from February 2008 to August 2016 was collected.Operations were performed by the same doctors' team.Observation indicators:(1) surgical situations;(2) postoperative situations;(3) follow-up situations;(4) risk factors affecting complications after laparoscopic TAPP hernia repair.Follow-up using outpatient examination and telephone interview was performed to detect the recovery time of non-restricted activity,postoperative complications and hernia recurrence up to February 2017.Measurement data with normal distribution were represented as (x)±s.The univariate analysis and multivariate analysis were done using the chi-square test and Logistic regression model.Results (1) Surgical situations:595 patients underwent laparoscopic TAPP hernia repair using the heavy meshes.Overall operation time and overall volume of blood loss were (55±25) minutes and (7±5)mL,including operation time of (50±20)minutes in 502 unilateral hernias and operation time of (81 ± 29)minutes in 93 bilateral hernias.Of 595 patients,34 had incarcerated hernia,the contents of hernia:greater omentum,small intestine and sigmoid colon were detected in 21,11 and 2 patients,respectively,with an incarcerated time of 2-21 hours;4 with incarcerated hernia induced small intestinal necrosis received laparoscopy-assisted small intestinal resection ± anastomosis,1 with sigmoid colon necrosis received necrotic sigmoid canal resection ± sigmoidostomy and 29 received repair after the contents restoration of hernia.Operation time and volume of intraoperative blood loss in 34 patients with incarcerated hernia were (84 ± 39)minutes and (12±6) mL.Thirteen of 595 patients (10 with indirect hernia and 3 with direct hernia) had recurrent hernia,and operation time and volume of intraoperative blood loss were (75±-26)minutes and (10± 5)mL.(2) Postoperative situations:time to initial exsufflation of 595 patients was (19± 12)hours.Of 595 patients,590 took fluid diet at 6 hours postoperatively and 5 undergoing enterectomy took fluid diet at 24 hours postoperatively.The pain score at 1 day postoperatively and duration of hospital stay were respectively 2.5± 1.4 and (2.1± 1.9)days.(3) Follow-up situations:of 595 patients,593 recovered non-restricted activity at 2 weeks postoperatively and 2 didn't recover non-restricted activity at 2 weeks postoperatively.Of 595 patients,542 were followed up for 6-60 months,with a median time of 31 months.Fifty-seven,25,13 and 1 patients were respectively complicated with seroma,surgical pain,urinary retention and enteroparalysis,they were improved by symptomatic treatment,and the same patient can have multiple complications.There were no severe complications which needed surgical intervention,such as vascular injury,damnify of intestinal canal and poke hole hernia.Of 2 patients with recurrence of hernia,1 with right indirect hernia had recurrence of direct hernia and then received Lichtenstein tension-free hernia repair,and 1 received treatment in other hospital.(4) Risk factors affecting complications after laparoscopic TAPP hernia repair:results of univariate analysis showed that age,diameter of hernia sac,incarcerated hernia,recurrent hernia,operation time and volume of intraoperative blood loss were related factors affecting complications after laparoscopic TAPP hernia repair (x2 =6.657,55.296,44.305,5.253,117.461,100.722,P＜0.05).Results of multivariate analysis showed that diameter of hernia sac ≥ 4 cm,incarcerated hernia,operation time ≥ 100 minutes and volume of intraoperative blood loss ≥ 10 mL were independent risk factors affecting complications after laparoscopic TAPP hernia repair (OR =3.610,11.315,12.401,7.346,95％ confidence interval:2.009-6.486,3.579-35.772,5.408-28.437,3.739-14.434,P＜ 0.05).Conclusion Laparoscopic TAPP approach for inguinal hernia is safe and effective,and diameter of hernia sac ≥4 cm,incarcerated hernia,operation time ≥ 100 minutes and volume of intraoperative blood loss ≥ 10 mL are independent risk factors affecting complications after laparoscopic TAPP hernia repair.

The main treatment strategies for chronic pancreatitis in young patients include therapeutic endoscopic retrograde cholangio-pancreatography (ERCP) intervention and surgical intervention. Therapeutic ERCP intervention is performed much more extensively for its minimally invasive nature, but a part of patients are referred to surgery at last. Historical and follow-up data of 21 young patients with chronic pancreatitis undergoing duodenum-preserving total pancreatic head resection were analyzed to evaluate the outcomes of therapeutic ERCP intervention and surgical intervention in this study. The surgical complications of repeated therapeutic ERCP intervention and surgical intervention were 38% and 19% respectively. During the first therapeutic ERCP intervention to surgical intervention, 2 patients developed diabetes, 5 patients developed steatorrhea, and 5 patients developed pancreatic type B pain. During the follow-up of surgical intervention, 1 new case of diabetes occurred, 1 case of steatorrhea recovered, and 4 cases of pancreatic type B pain were completely relieved. In a part of young patients with chronic pancreatitis, surgical intervention was more effective than therapeutic ERCP intervention on delaying the progression of the disease and relieving the symptoms.