OBJECTIVE To investigate the surgical management and its result of the cervical esophageal cancer.METHODS Forty six patients with cervical esophageal carcinoma who received surgical treatment in our hospital were included in this retrospective study.The removed hypopharynx and cervical esophagus were repaired with laryngotracheal flap in 5 cases,free myocutaneous flap in 4 patients and free jejunum in 2 patients.The inversion stripping esophagectomy without thoracotomy were performed in 35 patients.RESULTS During the early postoperative period,complications included recurrent laryngeal nerve paralysis in 2 cases,anastomotic fistula in 3 cases,anastomotic stenosis in 5 cases,Long-term postoperative gastro-esophageal reflux occurred in 19 cases.The 5-year survival rate was 28.7%. CONCLUSION The surgical treatment for cervical esophageal carcinoma should be decided by the location of the tumor,the extent of the cancer involved and lymph node metastasis.

Objective To study the quality of life and its influential factors among HIV positive population. Methods Quality of life was evaluated among 2608 HIV positive population by WHOQOL (Chinese Version) to calculate the total and four domains' scores of quality of life. Multiple linear regression model was used to analyze the relationship between the factors and the scores of the four domains and the total score of quality of life. Results Physical,psychological,social,environmental and the total scores of the HIV positive population were 12.96±1.94,11.79± 1.19,13.79±2.44,12.40±1.93 and 51.02±6.03,respectively. Females had a higher scores than males in the four domains and the total score of quality of life. Through a multiple linear regression model,we found that the influential factors would include gender,age,occupation,family conflict and appetite etc. Conclusion People living with HIV had higher scores in social domain,but lower scores in psychological domain,suggesting that psychological intervention should he strengthened.

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in the general adult population in the Hulunbeir Prefecture, Inner Mongolia Autonomous Region where many minorities of north China live. Methods Sampling surveywas performed in the residents aged 20 years and older in the Hulunbeir Prefecture. All the investigated subjects were tested for urinary albumin to creatinine ratio (ACR); hematuria by microscopy of urinary sediment; and GFR estimated by modified MDRD equation for Chinese adults (eGFR). The related risk factors of CKD were also investigated. Results A total of 4522 subjects were enrolled in the study. The prevalence of albuminuria was 7.11％, hematuria was 2.64％ and reduced eGFR [60 ml-min-1·(1.73 m2)-1] was 2.75％. The prevalence of hypertension was 38.90％; hyperglycemia 6.61％; hyperlipidemia 2.72％; increased waist 24.79％ and metabolic syndrome 15.02％. After the subjects with combined microalbuminuria, hematuria and reduced eGFR were excluded, the prevalence of CKD was 12.95％. Logistic regression analysis and stratified analysis showed increased age, increased waist, elevated systolic pressure, hyperglycemia,hypertriglyceridemia and metabolic syndrome were independently associated with albuminuria;increased age, elevated systolic pressure and hyperglycemia were independently associated with reduced eGFR; increased age was independently associated with hematuria. Conclusions The prevalence of adult CKD is 12.95％ in the Hulunbeir Prefecture, Inner Mongolia Autonomous Region. Independent risk factors of CKD include increased age, increased waist, hypertension,abnormal blood glucose or lipid, and metabolic syndrome.

Objective To investigate the impacts on inpatient costs of a hospital in Beijing as incurred by the reform of clinic-pharmacy-separation by means of DRGs. Methods As required by BJ-DRGs, we selected DRGs grouping information and medical record homepage information of the inpatients discharged from a tertiary hospital in Beijing from January to March in 2017 ( pre-reform group ) and that from May to July in 2017 ( the post-reform group ) . Then we compared the differences of inpatient costs before and after the reform, and the inpatient cost changes of the DRGs groups. Results The median of inpatient costs before the reform was 8751. 21 yuan, and that after the reform was 8522. 07 yuan, a difference without statistical significance (P>0. 05). Of the 104 DRGs studied, cost changes were found in 28 DRGs (P<0. 05), with increases in 19 DRGs and drops in 9 DRGs groups. Conclusions The reform, though without impact on the inpatient costs, changed the makeup of costs on the other hand, especially on HJ13 and BB25 DRGs groups, worthy of attention. A dynamic tuning mechanism is thus suggested for pricing of medical services, and a fine management suggested for the hospitals to curb unreasonable growth of costs.

Subolesin (4D8), the ortholog of insect akirins, is a highly conserved protective antigen and thus has the potential for development of a broad-spectrum vaccine against ticks and mosquitoes. To date, no protective antigens have been characterized nor tested as candidate vaccines against Dermacentor silvarum bites and transmission of associated pathogens. In this study, we cloned the open reading frame (ORF) of D. silvarum 4D8 cDNA (Ds4D8), which consisted of 498 bp encoding 165 amino acid residues. The results of sequence alignments and phylogenetic analysis demonstrated that D. silvarum 4D8 (Ds4D8) is highly conserved showing more than 81% identity of amino acid sequences with those of other hard ticks. Additionally, Ds4D8 containing restriction sites was ligated into the pET-32(a+) expression vector and the recombinant plasmid was transformed into Escherichia coli rosetta. The recombinant Ds4D8 (rDs4D8) was induced by isopropyl beta-D-thiogalactopyranoside (IPTG) and purified using Ni affinity chromatography. The SDS-PAGE results showed that the molecular weight of rDs4D8 was 40 kDa, which was consistent with the expected molecular mass considering 22 kDa histidine-tagged thioredoxin (TRX) protein from the expression vector. Western blot results showed that rabbit anti-D. silvarum serum recognized the expressed rDs4D8, suggesting an immune response against rDs4D8. These results provided the basis for developing a candidate vaccine against D. silvarum ticks and transmission of associated pathogens.
Animals ; Antigens/chemistry/genetics/*immunology/isolation & purification ; Arthropod Proteins/chemistry/genetics/*immunology/isolation & purification ; Chromatography, Affinity ; Cloning, Molecular ; Cluster Analysis ; Conserved Sequence ; Dermacentor/*genetics ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli/genetics ; Gene Expression ; Humans ; Molecular Sequence Data ; Molecular Weight ; Phylogeny ; Recombinant Proteins/chemistry/genetics/immunology/isolation & purification ; Sequence Analysis, DNA ; Sequence Homology, Amino Acid

OBJECTIVEAbnormalities in dopamine production and receptor function have been described in human essential hypertension and rodent models of genetic hypertension. We investigated the role of G protein kinase (GRK) 4gamma in essential hypertension in GRK4gamma mutant A142V transgenic mice.

METHODSBlood pressure, renal sodium excretion, D(1) receptor protein expression and phosphorylation were measured in GRK4gammaA142V transgenic mice and control mice. Moreover, the effects of GRK4 inhibition by antisense oligonucleotides on D(1) receptor expressions were determined in HK-2 cells.

RESULTSAs compared with their control mice, GRK4gammaA142V transgenic mice had higher blood pressure, lower D(1) receptor expression (0.6 +/- 0.2 vs. 1.5 +/- 0.2, P < 0.05), higher D(1) receptor phosphorylation [(65 +/- 7) DU vs. (35 +/- 7) DU, P < 0.05] in renal cortical membranes and the diuretic and natriuretic effects after stimulation of renal D(1) receptor were impaired in GRK4gammaA142V transgenic mice. Inhibition of GRK4 expression (0.60 +/- 0.10 vs. 1.30 +/- 0.09, P < 0.05) by GRK4 antisense oligonucleotides upregulated D(1) receptor expression (1.5 +/- 0.2 vs. 0.8 +/- 0.1, P < 0.05) in HK-2 cells.

CONCLUSIONSOur results show that GRK4gammaA142V overexpression induced hypertension is mediated by dowregulated renal D(1) receptor expressions in GRK4gammaA142V transgenic mice.

Animals ; Blood Pressure ; Down-Regulation ; Female ; G-Protein-Coupled Receptor Kinase 4 ; genetics ; metabolism ; Gene Expression Regulation ; Hypertension ; genetics ; metabolism ; physiopathology ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Oligonucleotides, Antisense ; Phosphorylation ; Receptors, Dopamine D1 ; metabolism

OBJECTIVETo investigate the regulatory effects of Shenfu Injection (SFI, ) on hemodynamic parameters and serum proteins in rats with post-infarction chronic heart failure (CHF).

METHODSForty-five healthy Wistar rats were randomized into three groups: sham, heart failure (model) and SFI group. The CHF was induced by left coronary artery ligation. Seven days after the surgical operation, animals in the sham group and the model group received saline (6.2 mL/kg/d), while animals in the SFI group received SFI (6.2 mL/kg d) intraperitoneally. Four weeks later, cardiac hemodynamic parameters were measured via the carotid route. The expression of serum proteins was analyzed by two-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometer (MALDI-TOF MS).

RESULTSRecording of hemodynamic parameters showed that left ventricular systolic pressure (LVSP), maximum rate of left ventricular pressure (+dp/dtmax) rise, and maximum rate of left ventricular pressure (-dp/dtmax) decrease, while the left ventricular end diastolic pressure (LVEDP) rose in the model group compared to those in the sham group (P <0.05). The results of the MALDI-TOF MS indicated that haptoglobin (HP), pentraxin 3 (PTX3) and alpha-1-antitrypsin were up-regulated, while serum albumin and 40S ribosomal protein were down-regulated in the model group (P <0.05). Compared with the model group, LVSP, +dp/dtmax and -dp/dtmax were higher, while LVEDP was lower in the SFI group (P<0.05). Expression levels of HP and PTX3 were lower than in the model group (P<0.05).

CONCLUSIONSFI could improve hemodynamic function and decrease inflammatory reactions in the pathophysiology of CHF. The serum proteins HP and PTX3 could be potential biomarkers for chronic ischemic heart failure, and they could also be the serum protein targets of SFI.

Animals ; Blood Proteins ; metabolism ; C-Reactive Protein ; metabolism ; Chronic Disease ; Drugs, Chinese Herbal ; therapeutic use ; Electrophoresis, Gel, Two-Dimensional ; Haptoglobins ; metabolism ; Heart Failure ; blood ; complications ; drug therapy ; physiopathology ; Heart Function Tests ; Hemodynamics ; Hydrogen-Ion Concentration ; Imaging, Three-Dimensional ; Inflammation ; complications ; drug therapy ; Male ; Myocardial Ischemia ; blood ; complications ; drug therapy ; physiopathology ; Phytotherapy ; Proteome ; metabolism ; Rats, Wistar ; Serum Amyloid P-Component ; metabolism ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Objective To explore the current prevalence of human echinococcosis in Qinghai Province and to lay the basis for establishing the preventing and controlling strategies.Methods Clustered random sampling was performed in selected survey spots.The enzyme-linked immunosorbent assay(ELISA)and ultrasound techniques were used for detecting human echinococcosis.Results 95 out of 5274 hydatid cases were found from 6 counties of Qinghai Province,with a prevalence of 1.80%.The immunological postitive rates examined by ELISA were 12.01%(198/1649)and 16.37%(383/2340)in male and female,respectively.The positive rate in female was significantly higher than that in male(χ2=14.78,P＜0.01).The infection and prevalence 1evels were generally increased among Tibetan[18.54%(446/2405),2.54%(78/3070)],herders[24.97%(239/957),4.78%(50/1046)]and people aged 60～＜70 years old[15.8l%(34/215),6.52%(18/276)],and were higher in Gonghe County[24.44%(240/982),3.95%(41/1037)]and Yushu County[20.59%(161/782),2.99%(32/1070)].Conclusions Echinococcosis was found in any surveyed area in Qinghai Province.The echinococcosis was severe in the pastoral areas such as the south plateau of Qinghai and places around Qinghai-lake. It is suggested that a strengthened control program should be conducted in the pastoral areas in Qinghai Province,targeting at females,Tibetan and herders people.

To understand the pathogenicity,virulence genes,drug resistance genes,and drug resistance of Staphylococcus aureus isolated from yaks in some areas of Lhasa and Nagqu City,55 yak nasal swab samples were analyzed for S.aureus in this study.The cocci were isolated and identified,and the carriage of virulence genes and drug resistance genes,as well as the pathogenicity and drug sensitivity of the isolated S.aureus strains,were detected with PCR,artificially infected mice,and the K-B drug susceptibility disk method.Seven strains of S.aureus were isolated from the 55 yak nasal swab samples,with an iso-lation rate of 12.73％.The isolated strains were all pathogenic to mice,with a fatality rate exceeding 60％.These seven strains of S.aureus carried three drug resistance genes(tetM,tet,and mecA)and six virulence genes(seb,sec,clfA,hla,hlb,and nuc).The detection rate of the three drug resistance genes was 100％,whereas the detection rate of the six virulence genes in the isolates ranged from 83.33％to 100％.The resistance rates of the isolated strains to penicillin,ampicillin,and cotrimox-azole reached 85.71％-100％,whereas the resistance rates to tetracycline and ceftazidime were both 28.57％.Thus,yaks in Lhasa and Nagqu cities were found to be infected by S.aureus strains carrying various drug-resistance genes and virulence genes.These strains were highly pathogenic and showed sensi-tivity to most antibacterial drugs.These findings may serve as a reference for treating S.aureus infection in yaks in the cities of Lhasa and Nagqu.

Toxic epidermal necrolysis (TEN) is a rare acute life-threatening mucocutaneous disorder that is mostly drug-related (80%-95%). It is clinically characterized as a widespread sloughing of the skin and mucosa. AP regimen (pemetrexed plus cisplatin) has been the preferred first-line chemotherapy for metastatic non-squamous non-small cell lung cancer (NSCLC). Gefitinib, a small-molecule epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), has already been recommended as a first-line treatment in EGFR-mutant metastatic NSCLC. We report rare presentation of TEN involving adverse effects of AP and gefitinib combination treatment in a 42-year-old woman diagnosed with metastatic NSCLC harboring an EGFR mutation. On the 21st day after administration of the first cycle of AP regimen and the 8th day after the initiation of gefitinib treatment, she developed an acne-like rash, oral ulcer, and conjunctivitis, which later became blisters and ultimately denuded. The characteristic clinical courses were decisive for the diagnosis of TEN. Treatment with systemic steroids and immunoglobulin as well as supportive treatment led to an improvement of her general condition and a remarkable recovery.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Cisplatin ; administration & dosage ; Female ; Glutamates ; administration & dosage ; Guanine ; administration & dosage ; analogs & derivatives ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Neoplasm Metastasis ; Pemetrexed ; Quinazolines ; administration & dosage ; Stevens-Johnson Syndrome ; etiology