Objective To explore the curative effect of the single pore video-assisted thoracoscopic surgery and thoracic closed drainage for patients with acute pyothorax by comparing the advantage and disadvantage of two methods.Methods The clinical data of 65 patients with acute pyothorax in our hospital from January 2012 to June 2015 were retrospectively analyzed.Of which 30 patients underwent single pore video-assisted thoracoscopic surgery were as observation group,35 cases received thoracic closed drainage were as the control group.The cura-tive effect of two methods for acute pyothorax was compared by analyzing the result data of two groups.Results The postoperative chest tube indwelling time,length of hospital stay,postoperative antibiotics of observation group were significantly less than those of the control group,the difference was statistically significant(P<0.05).And the incidence of postoperative complications,the proportion of the chronic pyothorax and secondary tube rate of observation group were lower than those of the control group,the difference was statistically significant(P<0.05). Conclusion The single pore video-assisted thoracoscopic surgery is safe and effective for treatment of acute pyothorax, which is worth promoting.

OBJECTIVE: To explore the relationship between pedestrian traffic accidents and the type of vehicles and summarize the characteristics. METHODS: Ninety cases of pedestrian traffic accidents were reviewed, and the relationship between the types of vehicles and the injuries (site, feature and severity) were analyzed. RESULTS: Different impact injuries were caused by different types of vehicles. The primary sites of the impact injuries depended on the body posture and the height of protruding parts of the front when the accident happened. The injury characteristics were related to the size, direction of acting force and contact surface. CONCLUSION The analysis of position, feature, and severity of pedestrian injury can determine the type of injury vehicle.
Accidents, Traffic/statistics & numerical data* ; Female ; Humans ; Injury Severity Score ; Male ; Motor Vehicles ; Posture ; Sickness Impact Profile ; Walking ; Wounds and Injuries/mortality*

This paper is to report the development of a rapid and sensitive method for the determination of s-oleylpropanolamide (OPA) in various tissues of rat (brain, heart, lung, liver, spleen, small intestine, kidney, adipose tissue and muscle), and to assess the applicability of the assay to tissue distribution. OPA was extracted by liquid-liquid extraction method with undecylenoylethanolamide as an internal standard. The concentrations of OPA were determined by LC-MS/MS after a single intragastric dose of 50 mg x kg(-1) at 4 time points (5 rats per group). With multiple reactions monitoring mode (MRM) the limit of quantification (LLOQ) was determined at 1 microg x L(-1). The calibration curve was linear from 1 to 2 x 104 microg x L(-1) (r > or = 0.999 0) for tissue homogenates. Validation parameters such as accuracy, precision and recovery were found to be within the acceptance criteria of the assay validation guidelines. The highest concentration was found in small intestine (the highest time point is 15 min) and heart (the highest time point is 90 min). The assay is rapid, sensitive and applicable to studying tissue distribution of OPA in rats.

Objective To determine the correlation between Smad4 mRNA,protein expression,abnormal methylation of CpG islands of Smad4 and colorectal cancer.Methods The expression of Smad4 in 43 cases of colorectal cancer and its adjacent tissue.30 cases of colorectal adenoma and 12 normal colon mucosa were analyzed by RT-PCR,sequencing,semi-quantitative RT-PCR,methylation-specific PCR(MSP)and immunohistochemistry.Results The mRNA expression of Smad4 was detected in 25 cases of colorectal cancer(58.14%),with expression levels at 0.73±0.25,which was significantly lower than those in corresponding adjacent tissues(88.37%,0.95±0.29),eolorectal adenoma(90.63%,1.01±0.37)and normal mucosa(100.00%,1.18 ±0.33)(P＜0.05).The positive rates of Smad4 gone promoter methylation in colorectal caner(60.53%)was significantly higher than that in other tissues(27.03%,25.00%and 16.67%,respectively,P＜0.05).The expression of Smad4 protein was significantly lower in colorectal cancer(44.19%)than that in other tissues(81.40%,87.50%,91.67%,respectively,P＜0.05),which was correlated with tumor invasion and lymph node metastasis.Conclusion Down-regulation of Smad4 expression may be associated with the development,the biological behavior and prognosis of colorectal cancer,and it can be an important biological marker in evaluation of disease progression.

Objective To evaluate the accuracy of auditory evoked potential index (AAI) in monitoring the anesthetic depth during isoflurane anesthesia.Methods Thirty ASA Ⅰ or Ⅱ patients aged 18-55 years and undergoing elective surgery under general anesthesia were enrolled in this study. The patients were unpremedicated. Anesthesia was induced with midazolam 0.05 mg/kg, fentanyl 3 μg/kg and propofol 1 mg/kg. Tracheal intubation was facilitated with recuronium 0.1 mg/kg. The patients were mechanically ventilated (VT:40 mm Hg. Anesthesia was maintained with isoflurane inhalation and intermittent intravenous boluses of vecuronium. Isoflurane was started with high-flow (FGF, 3 L/min) for 12 min followed by low-flow (LGF, 0.5 L/min). The inspired isoflurane concentration was set at 3%. The electrocardiogram (ECG), mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2), end-tidal isoflurane concentration and AAI were continuously monitored during anesthesia and recorded before induction of anesthesia (baseline, To ), immediately after induction (T1), immediately before isoflurane inhalation (T2), at 3 min(T3), 6 min (T4), 9 min (T5) and 12 min (T6) during high-flow wash-in and at the end-tidal isoflurane concentrations of 0.8 MAC (T7), 1.0 MAC (T8) and 1.3 MAC (T9) during low-flow inhalation of isoflurane, respectively.Results AAI decreased gradually while the end-tidal isoflurane concentration increased during high-flow wash-in. And AAI was negatively correlated with the end-tidal isoflurane concentrations ( r = -0.896, P ＜ 0.01 ) during low-flow inhalation of isoflurane anesthesia.

Objective To compare the blood-saving effect when acute hypervolemic hemodilution (AHH) was performed with hydroxyethyl starch (HES) 130/0.4 dissolved in electrolyte injection (HES-E) and HES 130/0.4 in sodium chloride injection (HES-NaCl).Methods Thirty patients of both sexes,aged 18-60 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 18-25 kg/m2,hemoglobin (Hb) ＞100 g/L,hematocrit (Hct) ＞ 35％,scheduled for elective abdominal operations under general anesthesia,were randomly divided into HES-E group and HES-NaCl group using a random number table,with 15 patients in each group.AHH was performed after induction of anesthesia.In HES-E and HES-NaCl groups,HES-E and HES-NaCl 15 ml/kg were intravenously infused over 30 min,respectively,and the infusion was conpleted before skin incision.Immediately after onset of AHH (T1),at 2 h after the end of AHH (T2),and at the end of operation (T3),arterial blood samples were collected for blood gas analysis and blood routine test,and pH value,base excess,HCO3-,K+,Na+,Cl-,Ca2+,Hb and Hct were recorded.Venous blood samples were collected at T1 and T2 for measurement of blood coagulation parameters including prothrombin time,activated partial thromboplastin time and fibrinogen and thrombelastography parameters.The volume of liquid intake and output and requirement for allogeneic blood transfusion were recorded,and the blood volume expansion rate was calculated.Results Compared with group HES-NaCl,no significant changes were found in the total volume of liquid infused,requirement for allogeneic blood transfusion,blood volume expansion rate,blood coagulation parameters at each time point,Hb and Hct (P＞0.05),pH value,base excess,HCO3 and K+ were significantly increased,and Na+ and Cl-were significantly decreased in group HES-E (P＜0.01).Conclusion There is no significant difference in the blood-saving effect between AHH with HES-E and HES-NaCl clinically,but HES-E can maintain homeostasis better.

Objective To understand the occurrence of healthcare-associated infection(HAI) in intensive care units (ICUs) in secondary and above hospitals in a province, and provide basis for HAI management.Methods HAI management quality control center in a province performed targeted monitoring on HAI in ICUs in secondary and above hospitals in a province from July 1, 2010 to June 30, 2015.Results ICUs in 176 hospitals were monitored, the incidence of HAI in ICUs for 6 consecutive years was 7.23％, case incidence of HAI was 9.72％;incidence of HAI showed a decreased trend in 6 years(P<0.001).The adjusted rate of HAI per 1 000 patient days in the general hospital ICUs was higher than that of special hospital ICUs (4.30‰ vs 3.53‰).Incidence of HAI in surgical ICUs and general ICUs were both relatively higher, adjusted rates of HAI per 1 000 patient days were 4.79‰ and 4.21‰ respectively.Respiratory tract, urinary tract, and bloodstream infection were major HAI in ICUs, accounting for 68.64％, 14.45％, and 10.09％ respectively, the utilization rates of central venous catheter, ventilator, and urinary catheter were 49.86％, 39.16％, and 81.95％ respectively, incidence of three catheter-associated infection were 1.74‰, 13.77‰, and 2.08‰ respectively, incidence of three catheter-associated infection decreased year by year (P<0.001).The utilization rates of ventilator, central venous catheter, and urinary catheter in different ICUs were not correlated with the incidence of infection(all P>0.05).A total of 36 223 strains of pathogens were isolated, the top 6 isolated pathogens were Acinetobacter baumannii(22.77％), Klebsiella pneumoniae (11.96％), Pseudomonas aeruginosa(11.94％), Staphylococcus aureus (8.08％), Candida albicans (5.63％), and Escherichia coli(5.55％).The isolation rates of carbapenem-resistant Klebsiella pneumoniae showed a increased tendency for 6 years(P<0.05).Conclusion Continuous targeted monitoring on HAI in ICUs, regular analysis on risk factors for HAI, and timely implementation of intervention measures can effectively decrease the incidence of HAI.

Objective To study the relationship between efflux pump MexAB‐OprM and carbapenem resistance of Pseudomonas aerginosa strains .Methods The minimum inhibitory concentrations of imipenem and meropenem were determined by agar dilution method for 75 strains of P .aerginosa in the absence or presence of MC207110 to screen the phenotypes of active efflux pump .Reverse transcriptase‐polymerase chain reaction (RT‐PCR) method was used to determine the mRNA expression level of mexA which encodes the membrane fusion protein in active efflux pump MexAB‐OprM and the reference (housekeeping) gene rpoD .PCR method was used to amplify the regulatory genes mexR ,nalC ,and nalD of active efflux pump MexAB‐OprM in the strains overexpressing the efflux pump . The PCR products were subject to DNA sequencing and BLAST analysis . Results Of the 75 P .aeruginosa strains ,13 (17 .3% ) were positive for efflux pump MexAB‐OprM .Overexpression of the efflux pump was identified in 10 of the 13 strains and associated with positive regulatory genes mexR ,nalC and nalD .A Gly71→Glu mutation in nalC was found in 9 strains ,and a Ser209→Arg mutation in nalC was identified in 8 strains .Only one strain had a Thr158→Ile mutation in nalD .Eight strains had mutation in mexR .Conclusions Overexpression of multidrug efflux pump MexAB‐OprM plays an important role in carbapenem resistance of P .aeruginosa .High level expression of MexAB‐OprM is related to the mutations of its regulatory genes .

Objective To investigate the effects of different doses of rosuvastatin on expression of liver X receptor(LXR) and caveolin-1 in cultured human monocyte-macrophage cells which induced by oxidized low density lipoprotein (ox-LDL).Methods The human monocyte-macrophage cells were divided into six groups:control group,ox-LDL group,different doses of rosuvastatin group (0.01 μmol/L,0.1 μmol/L,1 μmol/L,5 μmol/L).The expression of LXR mRNA and caveolin-1 mRNA were assayed by RT-PCR.Results LXR mRNA expression induced by ox-LDL in the control group and ox-LDL group were 1.00 ± 0.02,0.26 ± 0.02,and the difference was significant (t =56.39,P ＜ 0.001).Meanwhile,caveolin-1 mRNA expression in ox-LDL is (0.27 ± 0.01) fold than that in control (t =31.27,P ＜ 0.001).Meanwhile,There were significant differences among ox-LDL group and the different doses of rosuvastatin group in terms of LXR mRNA and caveolin-1 mRNA expressions (F =72.154,66.007,P ＜ 0.001).Along with the increase the doses of rosuvastatin,there was an increased trends of LXR mRNA and caveolin-1 mRNA expressions (P ＜ 0.05).Conclusion Rosuvastatin and upregulated the LXR mRNA and caveolin-1 mRNA expressions in a dose dependent manner.

Objective To investigate the effects,mechanisms,and the optimum doses of Rosuvastatin and Losartan on expression of caveolin-1 in cultured human monocyte-macrophage cells which were induced by oxidized low density lipoprotein(ox-LDL).Methods Human-monocyte cells were separated and changed into the human monocyte-macrophage cells.The model of amerosclerosis was set up.These cells were incubated in different doses of Rosuvastatin(0.1,1.0,5.0 μmol/L) and Losartan (10,50,100 μmol/L),and then cultured in combination of two drags (5.0 μmol/L + 100 μmol/L).Expression of caveolin-1 mRNA was determined with real-time fluorescent quantitative polymerase chain reaction (RT-PCR).Results In ox-LDL group,caveolin-1 mRNA was decreased sharply relative to control group [(0.2533 ±0.00973) vs (0.9410 ±0.03677)] in a concentration-dependent manner (P ＜0.01).Compared to ox-LDL group,expressions of Caveolin-1 mRNA were increased gradually in different doses of Rosuvastatin alone and Losartan alone group [(0.5198 ± 0.04840),(0.6183 ± 0.06740),(0.7257 ± 0.03052) vs (0.2533 ± 0.00973) ; (0.3350 ± 0.04177),(0.4428 ± 0.03804),(0.6049 ± 0.02627) vs (0.2533 ± 0.00973)] in a concentration-dependent manner (P ＜ 0.01) ; the summit expressions of caveolin-1 mRNA were emerged in using Rosuvastatin and Losartan together (F =59.119,P ＜ 0.01).Conclusions Rosuvastatin and Losartan may be responsible for the expression of caveolin-1 in human monocyte-macrophage cells that were induced by ox-LDL.The expressions were up-regulated with dose dependent manner of these drugs,and got the crest stage when using optimum doses of Rosuvastatin and Losartan together.