Objective To investigate the effects of angiotensin1-7 (Ang1-7) on renal tubulointerstitial fibrosis of diabetic rats.Methods Thirty-two male Wistar rats were randomly divided into four groups: normal control group,diabetic group,telmisartan group,Ang1-7-treated group.For 9 weeks after diabetes mellitus model established,24 h proteinuria,urine NAG/Cr,glucose,insulin,TG,TC,BUN,Scr,Na+ and K+ were assessed.Renal pathological changes were evaluated by PAS staining; Expression of TGF-β1,PPARγ and α-SMA mRNA was deteeted by real-time PCR; Protein levels of PPARγ,α-SMA and TGF-β1 were detected by Western blotting.Results (1)At the end of the ninth week,the blood pressure,proteinuria,renal weight/body weight in group DM were significantly higher than those in group NC (P＜0.05).(2)Renal interstitial fibrosis in group DM was obviously severe as compared to group NC (P＜0.05),but was improved in group TM and group T(P＜0.05).(3)TGF-β1 and α-SMA mRNA in group DM were significantly increased,and PPARγ mRNA was significantly decreased.Compared with group DM,TGF-β1 and α-SMA mRNA were significantly decreased,and PPARγ mRNA was significantly increased in group TM and group T,especially in group T.(4)TGF-β1 and α-SMA in group DM were significantly increased,and PPARγ decreased significantly.Compared with group DM,TGF-β1 and α-SMA decreased significantly,PPARγ increased significantly in group TM and group T,especially in group T.Conclusion Ang1-7 inhibits high glucose-induced α-SMA expression in vivo through up-regulating the PPAR expression and may inhibit renal tubulointerstitial fibrosis of diabetic rats.

Objective To investigate the distribution and antibiotic resistance of pathogens isolated from inpatients with urinary tract infections.Methods A retrospective analysis was carried out on 1033 strains of pathogens isolated from urine culture in patients with urinary tract infections in Zhejiang Xiaoshan Hospital during January 2009 and December 2011.Urine specimens were cultured with Uricult,and K-B method was used for drug susceptibility test,WHONET 5.6 software was used to analyse drug susceptibility test.Results Among 1033 strains of pathogens,681 (65.9％) were gram-negative bacteria,197 (19.1％) were gram-positive bacteria,and 155 (15.0％) were fungi.The three most prevalent bacteria were Escherichia coli (402 strains,38.9％),Klebsiella pneumoniae (74 strains,7.2％) and Candida albicans (64 strains,6.2％).60.7％ (244/402) of Escherichia coli and 45.9％ (34/74) of Klebsiella pneumoniae were extended-spectrum β-lactamases (ESBLs) positive.Escherichia coli and Klebsiella pneumoniae were susceptible to imipenem,meropenem,cefoperazone/sulbactam,piperacillin/tazobactam and amikacin.Enterococcus and staphylococcus were susceptible to vancomycin,linezolid and furadantin.Candida was sensitive to flucytosine,voriconazole and amphotericin B.Conclusion Gram-negative bacteria mainly E.coli is the predominant pathogen to urinary tract infections in this group of patients.Regular analysis and monitoring of pathogen species and drug resistance is important for rational use of antibiotics.

BACKGROUND:Many studies concern the comparison of posterior laminectomy and instrumented fusion and posterior laminoplasty for multilevel cervical spondylotic myelopathy, but the sample size of many studies has limitations. There is lack of objective evaluation on advantages and disadvantages of two surgical methods. OBJECTIVE:To compare the efficacy and safety of posterior laminectomy and instrumented fusion and laminoplasty in the treatment of multilevel cervical spondylotic myelopathy. METHODS:A systematic search of al the studies published was conducted on the PubMed, Cochrane Central, EMbase, the ISI Web of Knowledge Database, CMB, CNKI, VIP and Wanfang databases. Randomized and non-randomized control ed trials that compared between posterior laminectomy and instrumented fusion and laminoplasty for multilevel cervical spondylotic myelopathy were identified. Meta-analyses were performed in postoperative Japanese Orthopaedic Association scores, cervical range of motion, cervical curvature index, incidence of C5 nerve root paralysis and incidence of axial symptoms. RESULTS AND CONCLUSION:(1) Fourteen studies involving 1 024 patients were included. Among the patients, 519 underwent laminectomy and instrumented fusion and 505 underwent laminoplasty. (2) The results of the meta-analysis indicated that, compared with laminectomy and instrumented fusion group, laminoplasty group had advantages of a lower incidence of C5 palsy [RR=2.24, 95%CI(1.33,3.75), Z=3.05, P<0.05] and smal degree of cervical rotation injury [SMD=-0.71, 95%CI(-2.21,-1.2), Z=6.63, P<0.05]. However, the two groups had no statistical difference in postoperative Japanese Orthopaedic Association score, cervical curvature index and the incidence of axial symptoms. (3) These results suggested that both laminectomy and instrumented fusion and laminoplasty were demonstrated to be effective for multilevel cervical spondylotic myelopathy. Laminoplasty had obvious advantages of decreasing the degree of cervical rotation injury and lowering incidence of C5 palsy. However, in the process of clinical diagnosis and treatment, the patient’s condition should be combined. The long-term clinical efficacy of the technology needs more clinical work to confirm.

OBJECTIVE To investigate the bacterial distribution and sensitivity to antibiotics isolated from infected patients in emergency department. METHODS The antimicrobial susceptibility tests to commonly used antibiotics were performed to the specimen send by the emergency and respiratory departments in our hospital in 2007.The data were analyzed respectively. RESULTS Totally 340 strains were isolated in emergency department and 366 strains were isolated in respiratory department.The main bacteria isolated were similar in the two departments such as Acinetobacter baumannii,Pseudomonas aeruginosa,Staphylococcus aureus and Escherichia coli,but their sensitivities to antibiotics were different. CONCLUSIONS Bacterial distribution of the infected patients in emergency department is similar to respiratory departments,but their sensitivities to antibiotics are different.

Vascular dementia(VD)is caused by cerebrovascular diseases,either hemorrhage or ischemic damage in the brain,with ischemia being the most common.In recent years,increasing efforts have been made to study the etiology,pathogenesis,and prevention of VD.The establishment of appropriate animal models to study the mechanism of VD and explore the efficacy of VD treatments has become an important issue in this research field.On the basis of conventional method,such as bilateral occlusion of common carotid arteries(2VO)and four-vessel occlusion,researchers have modified these method to improve stability with better reflection of the clinical manifestations of VD.This review summarizes these modified method and discusses possible cellular and molecular mechanisms and their advantages and disadvantages.

Objective:To investigate the changes of neuron-specific enolase (NSE) in serum and cerebrospinal fluid of patients with subacute 1, 2-dichloroethane (DCE) poisoning.Methods:Ten patients with subacute 1, 2-DCE poisoning hospitalized in Guangzhou 12th Municipal People's Hospital from December 2014 to March 2019 were taken as the subacute 1, 2-DCE poisoning group, 34 typical acute toxic encephalopathy patients hospitalized at the same time as typical acute toxic encephalopathy group, 40 healthy physical examinees as normal control group. The levels of serum NSE in patients of subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy group during onset and improvement were detected by chemiluminescence method, and the results were analyzed statistically. The level of NSE in cerebrospinal fluid of subacute 1, 2-DCE poisoning group was detected and analyzed its correlation with the level of NSE in serum. Using receiver operator characteristic (ROC) curve to analyze the diagnostic efficacy of NSE in subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy (area under curve, AUC) .Results:There was no significant difference between the serum NSE level of the patients with subacute 1, 2-DCE poisoning in the onset group and the normal control group and the improvement group ( P>0.05) . The serum NSE level of subacute 1, 2-DCE poisoning in the improvement group was lower than those in the normal control group ( P<0.01) . The serum NSE level of the subacute 1, 2-DCE poisoning in the onset group was lower than those in the typical acute toxic encephalopathy in the onset group ( P<0.01) . There was no linear correlation between cerebrospinal fluid NSE and serum NSE in patients with subacute 1, 2-DCE poisoning ( r=-0.183, P=0.52) . ROC curve showed that the AUC of serum NSE in diagnosing subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy were 0.661 and 0.726, respectively. Conclusion:There is no significant change in serum NSE in patients with subacute 1, 2-DCE poisoning.

Objective:To investigate the changes of neuron-specific enolase (NSE) in serum and cerebrospinal fluid of patients with subacute 1, 2-dichloroethane (DCE) poisoning.Methods:Ten patients with subacute 1, 2-DCE poisoning hospitalized in Guangzhou 12th Municipal People's Hospital from December 2014 to March 2019 were taken as the subacute 1, 2-DCE poisoning group, 34 typical acute toxic encephalopathy patients hospitalized at the same time as typical acute toxic encephalopathy group, 40 healthy physical examinees as normal control group. The levels of serum NSE in patients of subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy group during onset and improvement were detected by chemiluminescence method, and the results were analyzed statistically. The level of NSE in cerebrospinal fluid of subacute 1, 2-DCE poisoning group was detected and analyzed its correlation with the level of NSE in serum. Using receiver operator characteristic (ROC) curve to analyze the diagnostic efficacy of NSE in subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy (area under curve, AUC) .Results:There was no significant difference between the serum NSE level of the patients with subacute 1, 2-DCE poisoning in the onset group and the normal control group and the improvement group ( P>0.05) . The serum NSE level of subacute 1, 2-DCE poisoning in the improvement group was lower than those in the normal control group ( P<0.01) . The serum NSE level of the subacute 1, 2-DCE poisoning in the onset group was lower than those in the typical acute toxic encephalopathy in the onset group ( P<0.01) . There was no linear correlation between cerebrospinal fluid NSE and serum NSE in patients with subacute 1, 2-DCE poisoning ( r=-0.183, P=0.52) . ROC curve showed that the AUC of serum NSE in diagnosing subacute 1, 2-DCE poisoning and typical acute toxic encephalopathy were 0.661 and 0.726, respectively. Conclusion:There is no significant change in serum NSE in patients with subacute 1, 2-DCE poisoning.

Objective To develop a self-care scale for patients with lymphedema after breast cancer surgery and verify its reliability and validity.Methods Based on the model of knowledge,belief and practice,a questionnaire item pool was constructed after literature reviews and qualitative interviews.A questionnaire-based scale was drafted based on the established item pool by carrying out two rounds of consultation with 15 clinical nursing specialists,nursing administrators and nursing educators from 8 provinces or cities in China.Reliability and validity of the scale were tested using convenience sampling,involving 444 patients with breast cancer surgery related lymphedema from 7 general hospitals in Hubei and Henan provinces,China,between May and July 2023.Results The response rates for the two rounds of expert consultation were 93.75%and 93.33%,respectively.The authority coefficients of the two rounds were 0.86 and 0.89,respectively,and the coordination coefficients for the 2 rounds were 0.130 and 0.379,respectively.In the first round,the average importance rating was from 4.33 to 4.93 with the coefficient of variation from 0.05 to 0.19,and the full score ratio from 53.33%to 93.33%.In the second round,the average importance rating ranged from 2.86 to 4.93 with the coefficient of variation from 0.05 to 0.36,and the full score ratios from 7.14%to 92.86%.A total of 421 patients completed the survey.The overall Cronbach's α coefficient of the scale was 0.943,the overall split-half reliability was 0.824,the scale-level content validity index(S-CVI)was 0.912,and the item-level content validity index(I-CVI)of the total scale ranged from 0.857 to 1.000.The KMO value of exploratory factor analysis was 0.919,the Bartrett spherical test value was 4671.724(P<0.001),and the cumulative variance contribution rate was 64.155%.Confirmatory factor analysis showed a good model fit.After the reliability and validity tests,the scale was finalised and determined to consist of three dimensions with 33 items:knowledge(9 items),attitude(6 items)and behaviour(18 items).Conclusion The self-care scale for the patients with lymphedema after breast cancer surgery has demonstrated good reliability and validity,and makes it an effective assessment tool for the patients with lymphedema after breast cancer surgery.

Objective:To summarize the experience of robot-assisted enucleation of tumors located in uncinate process of pancreas.Methods:This is a retrospective case series study. The clinical data of patients with robot-assisted enucleation of tumors located in the uncinate process of pancreas at the Department of Gastroenterology and Pancreatic Surgery,Zhejiang Provincial People′s Hospital from June 2019 to December 2023 were retrospectively analyzed. A total of 16 cases were enrolled,including 10 males and 6 females,with an age( M(IQR)) of 56(21)years (range: 28 to 77 years),and body mass index of 22.4(2.3)kg/m 2 (range:19.8 to 25.6 kg/m 2). Follow-up was asked every 6 to 12 months after the first 3-month postoperative follow-up through out-patient service or via telephone. Results:In total 16 cases,there were 11 cases with pancreatic enucleation,and 5 cases with resection of the uninate process. The operation time was 70(60) minutes (range: 40 to 165 minutes),and the blood loss was 30(13)ml (range: 10 to 80 ml). The rate of pancreatic fistula was 5/16. The length of stay was 8(6)days (range: 5 to 33 days). The pathological finding included non-functional neuroendocrine tumor( n=3),insulinoma( n=2),introductal papillary mucinous neoplasm ( n=5),solid pseudopapillary neoplasm ( n=2),mucinous cystadenoma ( n=1),serous cystadenoma ( n=2),pseudocyst ( n=1). Follow-up as of March 12, 2024, the follow-up time was 16(12)months (range: 3 to 41 months). All patients had no new onset diabetes and no dyspepsia. Conclusion:Robot-assisted surgical system can be used for local resection of uncinate process tumors of pancreas,and the quality of life of patients can be improved.

Objective:To summarize the experience of robot-assisted enucleation of tumors located in uncinate process of pancreas.Methods:This is a retrospective case series study. The clinical data of patients with robot-assisted enucleation of tumors located in the uncinate process of pancreas at the Department of Gastroenterology and Pancreatic Surgery,Zhejiang Provincial People′s Hospital from June 2019 to December 2023 were retrospectively analyzed. A total of 16 cases were enrolled,including 10 males and 6 females,with an age( M(IQR)) of 56(21)years (range: 28 to 77 years),and body mass index of 22.4(2.3)kg/m 2 (range:19.8 to 25.6 kg/m 2). Follow-up was asked every 6 to 12 months after the first 3-month postoperative follow-up through out-patient service or via telephone. Results:In total 16 cases,there were 11 cases with pancreatic enucleation,and 5 cases with resection of the uninate process. The operation time was 70(60) minutes (range: 40 to 165 minutes),and the blood loss was 30(13)ml (range: 10 to 80 ml). The rate of pancreatic fistula was 5/16. The length of stay was 8(6)days (range: 5 to 33 days). The pathological finding included non-functional neuroendocrine tumor( n=3),insulinoma( n=2),introductal papillary mucinous neoplasm ( n=5),solid pseudopapillary neoplasm ( n=2),mucinous cystadenoma ( n=1),serous cystadenoma ( n=2),pseudocyst ( n=1). Follow-up as of March 12, 2024, the follow-up time was 16(12)months (range: 3 to 41 months). All patients had no new onset diabetes and no dyspepsia. Conclusion:Robot-assisted surgical system can be used for local resection of uncinate process tumors of pancreas,and the quality of life of patients can be improved.