Objective To compare the efficacy of internal fixation with non-operative treatment of traumatic flail chest combined with sternal fracture.Methods A retrospective review was made on 102 patients with traumatic flail chest combined with sternal fracture treated from January 2007 to January 2014.There were 71 patients in operation group and 31 patients in non-operation group.Operation group was allocated to pure titanium rib plating (Group Ⅰ,22 cases),porous titanium screw fixation (Group Ⅱ,20 cases),and nickel-titanium memory alloy sternal rib plating (Group Ⅲ,29 cases).Rib traction was performed in non-operation group.Clinical results and incidence of complications were compared between the two groups.Results At 24 and 72 hours,operation group was superior over non-operation group with regard to HR [(100.4 ± 9.5) times/min vs (105.2 ± 10.1) times/min,(92.1 ± 9.9) times/min vs (102.1 ± 9.2) times/min],MAP [(97.7 ± 14.5) mmHg vs (91.0 ± 13.3) mmHg,(112.5 ± 15.2) mmHg vs (93.1 ± 13.8)mmHg] and CVP [(7.8 ±3.7)cmH2O vs (9.4 ±3.8)cmH2O,(6.2 ±2.9)cmH2O vs (9.1 ±3.2) cmH2 O] (P ＜ 0.05).Duration in ICU [(5.1 ± 0.8) days vs (9.3 ± 1.1) days],ventilation time [(4.5 ±1.0)days vs (8.2 ± 1.4)days],hospitalization time [(14.6 ±3.5)days vs (23.3 ±4.4)days] and incidence of complications were significantly lower in operation group than in non-operation group (P ＜ 0.05).Two months after discharge,tidal volume (VT) [(0.52 ±0.04)L vs (0.40 ±0.03)L],inspiratory capacity (IC)[(1.99 ±0.45)L vs (1.22 ±±0.33)L],forced vital capacity (FVC) [(3.52 ±0.51)L vs (2.44 ±0.42)L],total lung capacity (TLC) [(5.41 ±0.82)L vs (3.72 ±0.56)L] and forced expiratory volume in one second (FEV1) [(2.80 ± 0.43) L vs (1.95 ± 0.50) L] showed significantly better results in operation group than in non-operation group (P ＜ 0.05).Operation time,intraoperative bleeding and daily drainage volume were (38.8 ±9.2)min,(43.5 ±7.6)ml and (10.9 ± 1.1)ml in Group Ⅱ versus (62.5 ± 10.1)min,(100.0 ± 10.5) ml and (26.8 ±3.1)ml in Group Ⅰ and (49.3 ±9.6)min,(61.4 ±8.3)min and (19.8 ±1.6)ml in Group Ⅲ (P ＜ 0.01).Conclusion For traumatic flail chest combined with sternal fracture,the internal fixation should be done as early as possible so as to reduce incidence of complications.Relatively,porous titanium screw fixation has better clinical outcome.

The diagnosis and treatment of prostate cancer are being improved due to the popularized screening of prostate specific antigen. Advanced prostate cancer, in spite of its response to androgen deprivation therapy, may finally develop into castration-resistant prostate cancer (CRPC) and shorten the overall survival of the patients. Many efforts have been made by worldwide researchers for new approaches to the management of CRPC, including new hormonal therapy, cytotoxic chemotherapy, immunotherapy, and bone metastasis-targeted therapy. This paper reviews the emerging agents undergoing clinical evaluation and drugs that have received approval for the treatment of CRPC in order to provide doctors and patients with more treatment options for CRPC and improve the overall survival rate and quality of life of the patients.
Androgen Antagonists ; Bone Neoplasms ; prevention & control ; Humans ; Immunotherapy ; Male ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms, Castration-Resistant ; therapy ; Quality of Life

Adult ; Foot Diseases ; diagnostic imaging ; Humans ; Male ; Melorheostosis ; diagnostic imaging ; Radiography ; X-Rays

Thirty SHRs were obtained randomly to hypertension, model group, captopril group and Qingre jiangya capsule group. Ten Wistar rats were used as control group. The hippocampus tissue was removed to explore the damage of spontaneously hypertensive rats (SHR) and the protective effect of Qingre jiangya capsule after continuously administered for 14 days. And then the data were processed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). The research results revealed captopril group was significantly different from the other three groups. The classification of other three groups is also very clear after captopril group removed. This suggested that Qingre jiangya capsule could improve the overall metabolism compared with captopril. Four metabolites were identified: dimethylglycine, glycerophosphocholine, aldosterone and noradrenaline. Hypertension hippocampus damage may mainly be expressed in tyrosine metabolism, aldosterone-regulated sodium, vascular smooth muscle contraction reabsorption, and Qingre jiangya capsule could reverse the hippocampus tissue damage of SHR.
Animals ; Capsules ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Hippocampus ; drug effects ; Hypertension ; drug therapy ; Male ; Rats ; Rats, Inbred SHR ; Rats, Wistar

OBJECTIVE:To provide reference for rational use of antibiotics to treat Pseudomonas aeruginosa (PA) infection in the clinic. METHODS:Resistant rate of PA in our hospital during 2011-2015 were analyzed retrospectively. Antibiotics use densi-ty(AUD)of 10 commonly used antibiotics were analyzed statistically,and the correlation of resistant rate with AUD was investi-gated by Spearman correlation analysis. RESULTS:One thousaud and eleven strains of PA were isolated in our hospital during 2011-2014,detection rate of PA always occupied the top 5 place. Top 3 antibiotics in the list of AUD were levofloxacin,ceftazi-dime,cefoperazone sodium and tazobactam sodium. AUD of piperacillin sodium and tazobactam sodium,levofloxacin,ciprofloxa-cin and meropenem were positively correlated with resistant rate of PA(r were 1.000,0.900,1.000,1.000,P<0.05). AUD of ce-foperazone sodium and tazobactam sodium were negatively correlated with resistant rate of PA(r=-0.900,P<0.05). AUD of imi-penem and cilastatin sodium,ceftazidime,gentamicin,aztreonam and amikacin had no correlation with resistant rate of PA(P>0.05). CONCLUSIONS:There is correlation between AUD of antibiotics and resistant rate of PA. It is of important significance to detect resistant rate of PA and the use of antibiotics regularly. Antibiotics should be selected cautiously in accordance with bacterial monitoring data,results of drug sensitivity tests,the amount and resistant rate of antibiotics,etc,in order to reduce resistant PA.

AIM: To investigate the expression of EMMPRIN, MMP1, MMP9 and TIMP2 in retinoblastoma (RB) and normal retinal tissues and their clinicopathological significance and interrelationship.METHODS: Envision immunohistochemistry stainings of EMMPRIN, MMP1, MMP9 and TIMP2 were performed in 30 enucleated eyeballs with retinoblastoma and 15 specimens of normal retina tissue, which had been routinely imbedded with paraffin.RESULTS: Positive rate of EMMPRIN, MMP1, MMP9 expression was higher in RB tissue than in normal control (P<0.01), while TIMP2 expression was lower in RB than in normal retinal tissue (P<0.01). Samples from RB cases of clinical stage Ⅰ, differentiated type, and life span≥2 years had lower positive rate in expression of EMMPRIN, MMP1, MMP9 than those from RB cases of clinical stage Ⅲ, undifferentiated type, and life span<2 years (P<0.05 or P<0.01), while samples from RB cases of differentiated type, optic nerve unaffected, and life span≥2 years had markedly higher positive rate in expression of TIMP2 than those from RB cases of undifferentiated type, optic nerve involved and life span<2 years (P<0.05 or P<0.01). In RB tissues, EMMPRIN, MMP1, MMP9 expressions were highly consistent (P<0.05), whereas TIMP2 expression is highly inconsistent with EMMPRIN, MMP1, MMP9 expression levels (P<0.05).CONCLUSION: The expression level of EMMPRIN, MMP1, MMP9 and TIMP2 may be an important marker of RB progression, invasion and prognosis. There exist internally mutual regulation relations among them.

Objective To study the changes of behavior and depression-like classic indicators after hippocampal microinjection of K252a,and to establish a new animal model of depression.Methods SD rats were randomly divided into five groups,namely the control group,sham group,chronic stress depression model group,hippocampal of K252a microinjection group,and hippocampal microinjection K252a plus chronic stress group.Open field experiments,sucrose consumption test,and Morris water maze behavioral assay were used to assess the behavioral changes in the rats.ELISA was used to detect the plasma monoamine neurotransmitter,radioimmunoassay was used to determine the plasma CRH,ACTH,CORT contents,and western-blotting was performed to observe the protein expression of BDNF,CREB,ERK1/2,and BCL-2 in the hippocampus.Results Compared with the control group,the amount of activity,sugar consumption,learning and memory abilities were decreased(P<0.05 or P<0.01),also the serum monoamine neurotransmitters were decreased (P<0.01),HPA axis function was improved (P<0.01),and the expression of BDNF,CREB,ERK1/2,BCL-2 decreased in the CUMS group(P<0.05 or P<0.01),but there was no significant difference in the DMSO group.Compared with the DMSO group,the activity,consumption of sucrose,learning and memory ability were significantly decreased(P<0.05 or P<0.01),while the HPA axis function was increased (P<0.05 or P<0.01),the serum monoamine neurotransmitters decreased(P<0.05 or P<0.01),and the BDNF,CREB,ERK1/2,BCL-2 expressions in the hypocampus were significantly decreased(P<0.05 or P<0.01) in the K252a group and K252a + CUMS group.Compared with the CUMS group,the K252a group and K252a + CUMS group did not show significant changes in these parameters.Compared with the K252a group,these indicators were not significantly changed in the K252a + CUMS group.Conclusions The results of behavior,hematology,and molecular biology analysis show that this model has a great similarity to the classical model of CUMS in surface validity,construct validity,and functional validity.It may provide an alternative investigative technology platform for basic research and antidepressant drug screening.

Adenocarcinoma ; pathology ; Adenocarcinoma, Papillary ; pathology ; Aged, 80 and over ; Carcinoma, Renal Cell ; pathology ; Duodenal Neoplasms ; pathology ; Humans ; Kidney Neoplasms ; pathology ; Lung Neoplasms ; pathology ; Male ; Neoplasms, Multiple Primary ; pathology ; Sarcoma ; pathology ; Stomach Neoplasms ; pathology

ObjectiveTo evaluate the clinical effect of integrated traditional and western medicine in the treatment of post stroke depressive disorder (PSDD). MethodsThe data of 52 patients of PSDD evaluated on self rating depression scale(SDS) before and after treatment were analyzed statistically. ResultsThe curing rate of PSDD is about 78.85%.There was an apparent decrease in the level of SDS before and after treatment(P<0.001). ConclusionsThe treatment of integrated traditional Chinese and western medicine can produce a good effect on PSDD.

Abstract: Objective　To investigate the diagnostic efficacy of rifampin-resistant real-time fluorescent quantitative nucleic acid amplification detection technology (GeneXpert MTB/RIF) in bronchoalveolar lavage fluid (BALF) combined with peripheral blood tuberculosis infection T cell spot test (T-SPOT) and tuberculosis antibody (TB-Ab) in smear-negative pulmonary tuberculosis. Methods　The clinical data of 114 cases of clinically diagnosed smear-negative pulmonary tuberculosis, 80 cases of non-tuberculous pulmonary diseases and 22 cases of smear-positive pulmonary tuberculosis in our hospital from January 2019 to January 2021 were retrospectively analyzed. The detection results of peripheral blood T-SPOT, TB-Ab and BALF GeneXpert in the three groups were analyzed. The sensitivity, specificity, negative predictive value, positive predictive value, false negative rate, false positive rate and Youden index of the three detection methods were compared. The differences in the positive detection rate of smear-negative pulmonary tuberculosis between the separate detection and the combined detection of the three methods were compared. The receiver operating characteristic curve (ROC) was performed to calculate the area under the curve (AUC). Results　The sensitivity of BALF GeneXpert and peripheral blood T-SPOT and TB-Ab was 66.91%, 80.88% and 90.44%, respectively. The specificity was 98.75%, 73.75% and 41.25%, respectively; the diagnostic coincidence rates were 78.70%, 78.24% and 72.22%, respectively, which were higher than 70.00%. In the smear-negative pulmonary tuberculosis group, the positive detection rates of these three methods in the smear-negative pulmonary tuberculosis group were 63.15%, 79.82% and 90.35%, respectively, and the differences were statistically significant compared with those in the non-tuberculosis pulmonary disease group (all P<0.01). The positive detection rate of the three combined methods in the smear-negative pulmonary tuberculosis group was 96.49 %, which was significantly higher than that of TB-GeneXpert method and T-SPOT, and the differences were statistically significant (χ2=37.283, P<0.01; χ2=13.612, P<0.01); the Youden index of combined detection was significantly higher than that of single detection, and the AUC of combined detection was 0.977, which was significantly higher than that of single detection. Conclusion　BALF GeneXpert combined with peripheral blood T-SPOT and TB-Ab can significantly improve the diagnostic rate of bacterial-negative pulmonary tuberculosis, providing a strong basis for guiding clinical treatment.