Abstract: Superior mesenteric veinous thrombosis (SMVT) is a rare complication that often occurs in conjunction with intra-abdominal diseases such as diverticulitis, appendicitis, inflammatory bowel disease, etc. Its clinical symptoms are non-specific and include fevers, abdominal pain; it has no specific symptoms, and the diagnosis depends on clinical laboratory tests and imaging studies. The occurrence of superior mesenteric veinous thrombophlebitis is related to septic phlebitis caused by the sloughing of the embolus containing bacteria into the portal vein with blood flow. Due to the nonspecific clinical features of this disease, diagnosing it based on clinical characteristics and microbiological aspects is a challenge. A case of superior mesenteric veinous septic thrombophlebitis caused by Bacteroides fragilis infection is reported and to provide a reference for the diagnosis and treatment of such diseases. The patient was a 34-year-old man who was admitted the hospital with intermittent abdominal pain and fever. Computed tomography (CT) showed partial thrombosis of the superior mesenteric vein, colonoscopy revealed diverticulitis in the ileoceca, and the blood culture grew Bacteroides fragilis. The patient was treated with anti-infection (ceftazidime 2.0 g q12h intravenous infusion for 11 days; metronidazole 0.5 g, q8h intravenous infusion for 3 days) and anticoagulation (rivaroxaban 20 mg qd orally for 8 days. On the 11th day of hospitalization, the patient's condition improved, and he was discharged. In this case, for patients with fever and abdominal pain, superior mesenteric venous thrombophlebitis should be included in the differential diagnosis. Through auxiliary examination, blood sample culture and other technologies, clear diagnosis should be made in time to improve patient outcomes.

Child ; Humans ; Hyperplasia ; Male ; Panniculitis ; diagnosis ; Skin Diseases ; diagnosis ; T-Lymphocytes ; pathology

Objective To explore the application effect of de-escalation thinking shift mode in emergency condition of morning shift meeting. Methods Guided by the de-escalation thinking, critical ill patients transfer tables were established in the emergency department, patients admitted into the emergency resuscitation room were selected from January 2015 to December 2015, and divided into the observation group (329 cases) and the control group ( 310 cases) . Patients in the control group applied the traditional oral shift meeting mode by the bed to check the patient; patients in the observation group applied the de-escalation thinking shift mode of morning shift meeting, followed by the specification of morning shift process and content; additionally, the cooperation of nursing staff, the transfer of nursing adverse events, nurses awareness of the patient′s condition, the patient satisfaction survey were counted before and after the implementation, respectively. Results Chinese version of Nursing Assessment Shift Report (NASR) was used to evaluate the cooperation status between the two sides of nursing staffs, and the mean scores of nursing staffs were 60.50±1.80 and 78.20±2.50 in the control group and the observation group, respectively, showing statistical significance (t=14.23, P<0.01);before application, corresponding statistical results regarding the shift meeting related nursing adverse events showed that there were 5 cases of infusion prolapse/leakage, 2 cases of pressure ulcer, 3 cases of pipe extrusion, and 2 cases of delayed drug delivery;after application, there were 2 cases of infusion prolapse/leakage, 0 case of pressure ulcer, 1 case of pipe extrusion, and 1 case of delayed drug delivery;comparison results showed significantly statistical difference (χ2=1.76-6.74, P<0.05). Before application, assessment results regarding the mean scores of nurses awareness of the patient's condition showed that mean scores of patients′ state of illness, test results, current treatment, potential risk, and nursing focus were 3.83 ± 0.62, 3.16 ± 0.64, 4.17 ± 0.36, 3.47 ± 1.26, and 3.64 ± 1.10, respectively;and after application, mean scores of patients′state of illness, test results, current treatment, potential risk, and nursing focus were 4.71 ± 0.27, 4.53±0.66, 4.89 ± 0.10, 4.50 ± 0.61, and 4.72 ± 0.43, respectively;the differences were statistically significant (t=-8.86--3.35, P<0.05). Furthermore, patient satisfaction with nursing staff in emergency department was improved from 91.6%(284/310) to 96.0%(316/329)(χ2 =25.74,P<0.05). Conclusions The application of de-escalation thinking shift mode in emergency condition of morning shift meeting may contribute to the specification of the transfer process, improvement of nursing work efficiency, and finally result in the promotion of patients′safety and teamwork.

Objective To analyse the clinical characteristics,therapeutic modalities and prognosis of pulmonary large cell neuroendocrine carcinoma(LCNEC). Methods The clinical data of 14 patients with pulmonary LCNEC confirmed by surgery were retrospectively reviewed. Results No case was correctely diagnosed before surgery.The immunohistochemical amalysis of the specimens revealed the characters of endocrine carcinoma.Twelve cases received adjuvant chemotherapy of platinum agents,but recurrence or metastasis was found in 8 of them several months after surgery.The median survival time was 19 months.The 1-year,2-year and 3-year survival rate were 85.7%(12/14),21.4%(3/14) and not more than 14.3%(2/14),respectively.The statistical analysis showed that the stage,lymph node metastasis and postoperative adjuvant chemotherapy may have impacts on the prognosis of pulmonary LCNEC. Conclusion Pulmonary LCNEC is a carcinoma with poor prognosis,high tendency of invasion and metastasis.The stage of disease,lymph node metastasis,and adjuvant chemotherapy may be related to the prognosis.

Angioplasty, Balloon ; methods ; Aortic Valve Stenosis ; therapy ; Cardiac Pacing, Artificial ; methods ; Child, Preschool ; Heart Ventricles ; Humans ; Infant ; Male

Angioplasty, Balloon ; methods ; Aortic Coarctation ; diagnostic imaging ; pathology ; therapy ; Aortography ; Cardiac Catheterization ; methods ; Child ; Humans ; Male ; Platinum ; Prosthesis Design ; Stents ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo review the bioactivity of angiotensin II and the effects of Chinese herbs on it.

METHODThe correlative documents published in recent years were summarized.

RESULTAngiotensin II plays an important role in the development of many diseases, such as hypertension, arteriosclerosis, myocardial lesion due to ischemia and reperfusion, cardiac hypertrophy and fibrosis, dysfunction of fibrinolytic system, thrombosis, renal failure etc. Some Chinese herbs inhibit the actions of angiotensin II.

CONCLUSIONFurther researches must be done to investigate the bioactivity of angiotensin II and the effects of Chinese herbs on preventing the body tissue from being impaired by it.

Angiotensin II ; metabolism ; physiology ; Angiotensin-Converting Enzyme Inhibitors ; pharmacology ; Animals ; Blood Pressure ; drug effects ; Cardiomegaly ; physiopathology ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Heart Failure ; physiopathology ; Humans ; Hypertension ; physiopathology ; Myocardial Reperfusion Injury ; physiopathology ; Plants, Medicinal ; chemistry ; Receptor, Angiotensin, Type 2 ; physiology

Objective To investigate the effects of emulsified isoflurane preconditioning on myocardial NF-κB activity during ischemia-reperfusion(I/R)in rats.Methods Forty-eight healthy male SD rats weighing 230-280 g were randomly divided into 4 groups with 12 animals in each group: sham operation group(group S),I/R group,lipid emulsion + I/R group(group L)and emulsified isoflurane + I/R group(group EI).In group I/R,EI and L,myocardial I/R was produced by occlusion of left coronary anterior descending artery(LAD)for 30 min followed by 120 min reperfusion.In group L,30% lipid emulsion 4 ml·kg-1 ·h-1 was infused intravenously for 30 min before myocardial I/R.In group EI,emulsified isoflurane 4 ml· kg- 1 · h- 1 was infused intravenously for 30 min followed by 15 min washout before myocardial I/R.In group S and I/R,normal saline was given instead.Blood samples were taken from femoral artery at the end of 120 min reperfusion for determination of serum cTnI and IL-6 concentrations and CK-MB activity by ELISA.The rats were then killed and the myocardial tissues were taken for determination of NF-κB activity by Western blot and observation of the ultrastructure by electron microscopy.Results The NF-κB activity,serum cTnI and IL-6 concentrations and CK-MB activity were significantly higher in group I/R,EI and L than in group S(P ＜ 0.05 or 0.01),while lower in group EI than in group I/R(P ＜ 0.05).Microscopic examination showed that emulsified isoflurane significantly attenuated the histopathological changes in group EI.Conclusion Emulsified isoflurane pretreatment can attenuate myocardial I/R injury through decreasing the NF-κB activity and inhibiting inflammatory response in rats.

Objective To study the expression and prognostic significance of neuroendocrine differentiation markers chromogranin A(CgA)and synaptophysin(SYN) in patients with resectable non-small cell lung cancer(NSCLC).Methods From January 2000 to January 2003,123 patients with NSCLC who received operations were investigated.The resected specimens and clinical data were collected.Immunohistochemical Elivison method was used to detecte the expression of CgA and SYN.Kaplan-Meier survival curve and Cox proportional hazard model multivariate analysis were applied for the prognostic factors. Results The positive expression rates of CgA and SYN were 22%,17.9%,respectively.The expression of SYN was associated with histological differentiation(P=0.001).No significant association was found between NSCLC with neuroendocrine differentiation(NSCLC-ND) and sex,age,smoke index,TNM Stage and pathology classification.No evidence showed the patients with positive expression of CgA or SYN could be tolerant with more cycles of chemotherapy(P=0.406).Kaplan-Meier survival curve indicated the survival had a relation with the expression of CgA and SYN.It was revealed by Cox analysis that SYN(P=0.001),TNM stage(P=0.02)and the maximal diameter of tumor(P=0.049) were independent prognostic factors. Conclusion The patients with NSCLC-ND had a poorer prognosis.SYN may be one of the prognostic factors in patients with NSCLC.

Objective To investigate the p53,Bax,bcl-2 gene in NaAsO2-induced human embryonic lung fibroblasts(HELF)apoptosis.Methods HELF was divided into HELF cells transfected with p53 plasmid(p53 group),HELF cells transfected with PC plasmid(PC group)and normal cultured HELF cells(normal group).The mRNA expression of p53,Bax and bcl-2 gene was detected by real-time PCR,the protein expression of p53,Bax and bcl-2 was assessed by immunohistochemical SABC and the cell apoptosis of HELF was detected by flow cytometry(FCM),in a 6-well plate and cultured for 48 hours,which was exposed to different doses(0,3,9,15mmol/L)NaAsO2 for 24 hours.Results The p53 gene mRNA expression level of p53 group(0.51±0.29)was lower than that of the normal group and PC group [ (1.00 ± 0.20), (1.32 ± 0.26), all P < 0.05 ]. The p53 protein expression level of p53 group(4.10 ± 1.20) was lower than the PC group and normal group[ (8.00 ± 1.63), (7.90 ± 1.79), allP < 0.05]. In p53 group, PC group, normal group exposed to 0,3,9,15 mmol/L NaAsO2 doses, the apoptotic rate [(0.57 ± 0.28)%, (22.91 ± 4.86)%, (40.05 ± 3.93)%, (44.87 ± 3.58)%; (0.65 ± 0.24)%, (14.09 ± 3.49)%,(20.31 ± 3.66)%, (32.42 ± 3.63)%; (0.56 ± 0.25)%, (12.14 ± 3.70)%, (19.61 ± 3.63)%, (30.43 ± 2.83)%], Bax mRNA expression level[(12.73 ± 3.96), (25.12 ± 6.42), (104.96 ± 26.77), (154.04 ± 30.52); (14.63 ± 3.57),(36.75 ± 3.67), (272.26 ± 66.11), (846.12 ± 243.36); (14.75 ± 5.65), (37.22 ± 11.27), (278.51 ± 37.42),(861.67 ± 369.29) ], Bax protein expression level [ ( 15.07 ± 0.83 ) %, ( 23.79 ± 3.99 ) %, (38.51 ± 1.58 ) %, (53.86 ±1.74)%;(15.43 ± 1.45)%,(36.11 ± 1.37)%, (56.86 ± 1.97)%, (76.09 ± 2.01)%; (15.20 ± 1.03)%,(35.25 ±1.09)%, (55.56 ± 2.17)%, (74.48 ± 2.85)% ] was respectively increased in a dose-dependent manner with the increased concentration of NaAsO2(all P < 0.05). The bel-2 mRNA expression level [ (443.00 ± 244.47), (156.79 ±53.18), (62.13 ± 13.66), (23.10 ± 6.44); (420.55 ± 110.77), (48.15 ± 10.02), (14.91 ± 6.53), (7.54 ± 2.62);(577.75 ± 123.22), (49.68 ± 10.11), (12.41 ± 1.28), (7.22 ± 1.89)], bcl-2 protein expression level[(47.20 ±3.77)%, (41.80 ± 2.94)%, (36.00 ± 2.36)%, (29.00 ± 2.91)%; (45.90 ± 4.15)%, (35.70 ± 2.77)%, (29.80 ±2.78)%, (24.80 ± 2.66)% ; (46.70 ± 3.47)%, (36.20 ± 2.90)%, (30.10 ± 3.21)%, (25.10 ± 2.28)% ] wasdecreased in a dose-dependent manner with the increased concentration of NaAsO2(all P < 0.05 ). In 3,9,15 mmol/L NaAsO2, apoptotic rate of p53 group, mRNA expression of bcl-2, protein expression of bcl-2 was higher than that ofnormal group and PC group, respectively (all P < 0.05), but mRNA expression of Bax, protein expression of Bax was respeetivelylower than that normal group and the PC group(P < 0.05 ). Conclusion p53 gene reduced the apoptosis induced by NaAsO2 in HELF, possibly by changing the apoptosis pathway.