Objective To evaluate the feasibility and safety of ultrasound-localized percutaneous thrombin injection (ULTI) for the treatment of iatrogenic femoral pseudoaneurysm. Methods From January 2000 through October 2001, 5 patients (3 males, 2 females, age range 38～72 years) were found to have a pseudoaneurysm confirmed by ultrasound between 1 and 3 days following femoral arterial puncture. Two patients were associated with diagnostic arteriography and 3 with stent implantation. ULTI was our first choice for the treatment of ablating femoral pseudoaneurysm. All patients following ULTI were restudied within 24 hours. Results All 5 patients were initially treated with ULTI. Thrombin was injected directly into the pseudoaneurysm with a dose of 500 units over several seconds, successful ablation was visualized immediately in 4 patients, the remaining 1 patient needed ultrasound-guided compression treatment of five minutes. Follow-up at the 24th hour showed no recurrent pseudoaneurysm after initial successful ablation in any case. No distal embolization or allergic reaction occurred. Conclusion ULTI is a safe, rapid, well-tolerated, inexpensive and effective noninvasive method for the treatment of iatrogenic femoral pseudoaneurysm and should be considered as first-line therapy.

Objective To realize unifying gas source adapter's standards for different medical gas use equipment while the one be connected to different terminal units of central gas source, and terminal's pressure control of the medical gas pipe network, and medical gas uninterrupted supply for partial department in hospital. Methods A general fast adapter for terminal units of medical gas use equipment and central gas source was designed and developed, and its operation methods were explained. It was used and connected into different terminal units for unified format and universality. Results It was convenient and effective in the clinical application in clinical test. Conclusion The general fast adapter is simply manufactured, and achieves the resources shared of the medical gas use equipment. It has good perspective for clinical surgery applying.

Objective To investigate the potential suppression role of Pingchuan-Guben Decoction in airway chronic inflammation and remodeling by observing the expression of vascular endothelial growth factor (VEGF) and NF-κB on the mice asthma model Methods Forty Kunming mice were randomly divided into three groups.Those were negative control group(A),asthma model group(B),Pingchuan-Guben Decoction group (C),and every group was 8 mice.Total and differential cells were counted from bronchoalveolar lavage fluid (BALF).Histological examination(HE) was performed to observe the general pathologic alteration and analyze the thickness of airway wall.The protein expression of VEGF and NF-κB were detected by immunohistochemistry.Results (1)HE staining showed that compared with the Pingchuan-Guben Decoction group,there were a large number of inflammatory cells infiltration,heavier smooth muscle hypertrophy and mucous membrane hyperemia in mice of the asthma group,(2) The Eosinophil cell counting in BALF,airway wall thickness NF-κB,VEGF expression levels in rats asthma model group were (2.15 ± 0.44) × 108/L,(16.66 ± 1.52) μm2/μm,(36.01 ± 4.78),(35.87 ± 4.92) respectively,significantly higher than that in control group ((0.03 ±0.03) × 108/L,(6.61 ± 1.14) μm2/μm,(12.78 ± 1.47),(11.57 ± 1.64) ;P ＜ 0.01).The Eosinophil cell counting in BALF,airway wall thickness NF-κB,VEGF expression levels in Pingchuan-Guben Decoction group were (0.35 ± 0.12) × 108/L,(11.57 ± 1.26) μm2/μm,(29.13 ± 1.92),(28.28 ± 2.02) respectively,significantly higher than that in rats asthma model group (P ＜ 0.01).Conclusion PingchuanGuben Decoction can decrease NF-κB and VEGF expression of asthma mice,and then inhibits airway chronic inflammation and remodeling.

Objective To investigate the efficacy of relaparoscopic common bile duct exploration in choledocholithiasis.Methods 50 patients who underwent LC/OC/LCBDE/OCBDE for biliary surgery with choledocholithiasis were randomized into two groups:Group A (n ＝25) laparoscopic approach and Group B (n =25) open approach.The operation time,hospital stay,cost of hospitalization and postoperative complications were compared.Results There was no significant difference in the operation time,liver functional index,postoperative bile leakage rate and cost of hospitalization between the two groups.The postoperative hospital stay in group A was shorter than that in group B (7.1 ± 1.5 vs 12.4 ±4.3 days,P ＜0.05),as was the volume of intraoperative blood loss (58.3 ± 24.2 ml vs 108.6 ± 35.7 ml,P ＜ 0.05),recovery of gastrointestinal function (26.3 ±3.6 vs 58.2 ±6.3 hours,P ＜0.05),postoperative analgesia (7/25 vs 17/25,P＜0.05) and wound infection rate (1/25 vs 6/25,P＜0.05).Conclusions Relaparoscopic commonbile duct exploration for recurrent choledocholithiasis appeared to be a safe,feasible,and efficacious procedure when carried out by expert laparoscopic surgeons.The procedure is worth promoting.

Through stating the current situation of the doctor -patient relationship , and combining with its characteristics in emergency ICU (EICU), to analyze the application basements and skills of progressive doctor -patient communication in EICU , in order to explore the present stage to build a harmonious doctor -patient rela-tionship , a feasible way to safeguard the rights and interests of both doctors to provide the reference .

Objective To investigate the correlation among fractional exhaled nitric oxide (FeNO), child asthma control test(C-ACT) and lung function in asthmatic children and its clinical significance. Methods A total of 108 cases of asthmatic children in the Affiliated Hospital of Qingdao University from June 2016 to September 2018 were recruited. Forty-seven cases (47.44%) were in acute onset, 40 cases(40.37%) were in chronic persistent, and 21 cases (21.19%) were in paracmasis. FeNO, lung function and C-ACT score were measured, and the correlation among them was analyzed. Results The level of FeNO in acute onset patients and chronic persistent patients had no significant difference:(44.18 ± 25.47)×10-9 vs. (46.98 ± 27.50)×10-9, P>0.05, but the level of FeNO in paracmasis patients was lower [(24.43 ± 10.71) × 10-9], compared with that of acute onset patients and chronic persistent patients, there were significant differences (P < 0.01). The scores of C-ACT in three groups had significant difference (P < 0.01), and there were significant differences between any two groups (P <0.01). The levels of forced expiratory peak flow rate measured value as a percentage of predicted value (FEV1%) and forced expiratory volume and forced vital capacity ratio in the first second (FEV1/FVC) in acute onset patients were significantly lower than those in chronic persistent patients and paracmasis patients (P <0.01), and there were no significant differences between chronic persistent patients and paracmasis patients (P＞0.05). Conclusions Compared with lung functions and C-ACT, FeNO is a good biomarker to evaluate the airway inflammation of asthmatic children.

Objective To investigate the protective effect and mechanism of environmental enrichment(EE)on radiation induced cognitive dysfunction in mice.Methods A total of 45 female Kunming mice(2-month old)were randomly divided into control group,irradiation group and irradiation plus EE group with 15 in each group.Irradiation group and irradiation plus EE group were treated with a single dose of 4 Gy whole body irradiation,irradiation plus EE group were housed in EE condition for 35 d after irradiation.The object recognition task was used to evaluate the cognitive function of mice.The expression of microglial marker IBA-1 in hippocampus was determined by immunohistochemical staining.The expressions of CD68 and synaptophysin(SYP)proteins in hippocampus were assayed by Western blot.Results Compared with control group,the irradiation group had a low discrimination ratio in object recognition task and had a remarkable low level of SYP expression in hippocampus(t＝3.66,6.84,P＜0.05).In addition,radiation activated microglia in hippocampus by increasing the number of IBA-1-positive cells and enhancing the expression of CD 68(t ＝6.83,5.79,P ＜0.05).Compared with irradiation group,irradiation plus EE group increased the discrimination ratio and the expression of SYP in hippocampus(t＝3.56,4.06,P＜0.05),while the number of IBA-1-positive cells and the expression of CD68 were significantly reduced(t＝7.69,4.59,P＜0.05).Conclusions A single dose of 4 Gy whole body irradiation leads to cognitive dysfunction in mice,while EE could effectively improve the animals′cognitive behavior possibly by inhibiting microglial activation and preventing synapse loss in hippocampus.

Rationale: Trichosporon, an anamorphic fungus, proliferates under high humidity, causing serious opportunistic infections collectively called trichosporonosis. Among the Trichosporon species causing trichosporonosis are Trichosporon (T.) asahii, T. asteroides, T. cutaneum etc. Patient concerns: A 38-year-old Chinese male with severe aplastic anemia was admitted due to multiple joints pain, poor appetite, and right ankle swelling. One year earlier he had undergone allogeneic hematopoietic stem cell transplantation. Diagnosis: T. asahii infection and severe aplastic anemia. Interventions: Combined treatment of amphotericin B liposomes (55 mg/24 h) and voriconazole (200 mg/12 h) for 8 days. Outcomes: The symptoms of the patient's ankle were relieved and effusion cultures showed no T. asahii. Lessons: To the best of our knowledge, T. asahii ankle cavity effusion infections are rare. Trichosporon infections may be attributed to risk factors such as improper long-term use of antimicrobials for an underlying disease (e.g., anemia, hypoalbuminemia). Attention should be paid to prevent and control Trichosporon infections in order to avoid comorbidities.

Objective:To investigate the effect of MCC950 (a NLRP3 inflammasome inhibitor) on cognitive impairment in mice with radiation-induced inflammatory brain injury.Methods:Mice were divided into normal (NS) group, whole body irradiation (IR) group and MCC950 intervention post irradiation (IR+ MCC950) group according to the random number table method, with 15 mice in each group. The mice in IR group and IR+ MCC950 group were irradiated with a single dose of 4.0 Gy. The radiation source was 137Cs and the dose rate was 1.118 Gy/min. The mice in NS group were not irradiated. Mice in IR+ MCC950 group were injected intraperitoneally with MCC950 once a day (10 mg/kg each time) from 3 weeks after irradiation. Behavioral tests such as new and old things recognition experiment and social cognition experiment were used to detect the cognitive function of mice. Immunohistochemistry was used to detect the expression of NeuN protein in CA3 area of mouse hippocampus. PCR and Western blot were used to detect the expression of NLRP3 inflammatory body related protein. Results:Compared with NS group, the short-term and long-term recognition index of new and old things in the IR group decreased significantly ( t=4.321, 5.473, P<0.01), and the social cognitive recognition index of the IR group also decreased significantly ( t=2.097, P<0.05). MCC950 treatment reversed the above changes (short-term and long-term new and old thing recognition test: t=5.860, 4.598, P<0.05; new and old position recognition test: t=3.040, P<0.05; social cognition test: t=4.021, P<0.01). The expression of NLRP3, Caspase-1, IL-1 β and IL-18 in mice hippocampus of the IR group was significantly higher than that of the control group ( t=2.699, 8.515, 3.340, 3.950, P<0.05). Compared with NS mice, radiation significantly increased the expressions of Bax, Caspase-3 and PARP1 in hippocampus ( t=3.887, 2.742, 3.287, P<0.05), while MCC950 significantly decreased the expressions of Bax, Caspase-3 and PARP1( t=2.852, 4.090, 9.614, P<0.05). Conclusions:NLRP3 inflammasome inhibitor MCC950 could alleviate radiation-induced cognitive impairment, which may be due to the inhibition of hippocampal inflammatory and neuronal death.

Objective:To investigate the protective effect of intermittent fasting on radiation-induced cognitive impairment and the possible underlying mechanism.Methods:A total of 36 male 7-week old c57BL/6J mice were divided into Sham-irradiation and ad libitum (Sham-AL) group, irradiation and ad libitum (IR-AL) group, and irradiation add intermittent fasting (IR-IF) group according to the random number table method, with 12 mice in each group. The cognitive function of mice was assessed by novel object recognition task. The expressions of autophagy gene 5 (ATG5), microtubulesas sociated protein light chain II (LC3II), voltage dependent anion channel protein 1 (VDAC1), interleukin-1β (IL-1β), synaptophysin (SYP), synapsin I (SYN-1), and postsynaptic density 95 (PSD95) were tested by Western blot. The location of VDAC1 in mice hippocampus was detected by immunofluorescence.Results:The discrimination index (-22.45 ± 16.76) of IR-AL group was significantly ( t=3.032, P<0.05) lower than that of Sham-AL group (30.02 ± 9.05). Compared to Sham-AL group, IR-AL group had a decreased expressions of autophagy-related proteins (ATG5 and LC3II), mitochondrial marker (VDAC1), inflammatory factors (IL-1β) as well as synapse-associated proteins SYP, SYN-1 and PSD95 ( t=2.49, 2.19, 2.40, 3.47, 2.87, 2.25, 2.17, 2.31, P<0.05). Compared to IR-AL group, IR-IF group had an increased discrimination index (21.22 ± 5.62) and the increased expressions of ATG5, LC3II, VDAC1, IL-1β, SYP, SYN-1, and PSD95 ( t=2.70, 2.88, 2.71, 3.18, 3.18, 3.11, 3.30, 3.35, 2.53, P<0.05). The immunofluorescence assay revealed that VDAC1 was co-expressed with the markers of astrocytes (GFAP) and microglia (IBA-1), but not with neurons (NEUN). Conclusions:Intermittent fasting could greatly improve the cognitive function of irradiated mice possibly by upregulating VDAC1 expression, induce autophagy, and inhibit the release of inflammatory factors and protecting the synapticplasticity in the hippocampus.