BACKGROUND: Resent studies demonstrate that sciatica is caused by inflammatory reaction of nucleus pulposus, and dorsal root ganglion (DRG) is in involved in this process; however, its pathophysiological changes remain poorly understood. OBJECTIVE: To explore pathogenesis of sciatica related to nucleus pulposus protrusion without mechanical compression. METHODS: Totally 24 male SD rats were randomly divided into the experimental group and control group, with 12 rats in each group, The coccygeal intarvartebral discs of rats were opened to obtain 5 coccygeal nucleus pulposus, mixed with 50 μL physiological saline to prepare suspension. Rats in the experimental group were prepared non-compressive models by injecting suspension to the epidural cavum of rats. Meantime, the same volumes of physiological saline were injected into rats in the control group. The rat hind paw mechanical withdrawal thresholds were measured, pain-related behavior and dorsal root ganglion morphology were observed. RESULTS AND CONCLUSION: In the absence of mechanical pressure, disappearance of the nucleolus, degeneration of the nuclear membrane and significant hyperalgesia derived by auto-transplantation of nucleus pulposus to the epidural cavum of rats were observed. Dorsal root ganglion cells often had hyperemia, edema and intracytoplasmic vacuoles, with large and irregular nuclei. Prominent Nissl bodies were not seen. The Inflammatory reaction derived by autograft nucleus pulpcsus is an important factor in DRG injury and sciatica.

Objective · To design an immuno-affinity chromatography device for the separation and detection of syphilis specific antibody, then verify its performance of detection and clinical application. Methods · Affinity filler packed by Treponema pallidum (TP) antigen in affinity chromatography can specifically adsorb TP specific antibody (including IgG and IgM) in samples. After balance, elution and desalination, IgG or IgM gold labeled chromatography strip detects the possibly present syphilis specific IgG or IgM antibody. Twenty cases of syphilis antibodynegative samples and 230 cases of syphilis antibody positive clinical specimens were detected by this chromatography device, and 40 cases were also detected by Western blotting.Results ·The standard operation procedure of the affinity chromatography device was optimized, which could effectively detect the specific IgG and IgM antibody of syphilis. The results of 20 syphilis antibody negative samples were all negative. In 230 syphilis antibody positive cases, the detection results were 2 cases with TP-IgG(-) and TP-IgM(-), 210 cases with TP-IgG(+) and TP-IgM(-),10 cases with TP-IgG(-) and TP-IgM(+), and 2 cases with TPIgG(+)and TP-IgM(+). The detection results of 40 cases were compared with the results detected by Western blotting, among which 2 cases detected by affinity chromatography device were TP-IgG(-) and TP-IgM(-), while the results detected by Western blotting were TP-IgG(+) and TP-IgM(-). But the results of the two methods showed no statistically significant difference (P>0.05). Conclusion · The application of the device in separation and detection of IgG and IgM antibodies against TP pathogens is feasible, and it has important value for further application in clinical diagnosis.

OBJECTIVE:To prepare Weikang capsule and establish its quality standard METHODS:Weikang capsule was prepared with gentamycin sulfate,vitamin B1,vitamin B2,vitamin B6 and vitamin B12 A polarimetry was established for determining the content of gentamycin sulfate in Weikang capsule RESULTS:There was a good linearity between optical rotations and concentrations of gentamycin sulfate from 2 000IU/ml to 12 000IU/ml with a regression equation of ?=0 00 767+1 77 003C,r=0 9 999 The average recovery rate of gentamycin sulfate in Weikang capsule was 100 1%,RSD was 0 79%(n=6) The results of polarimetry and microbioassay were nearly equivalent CONCLUSION:The preparation process of Weikang capsule is simple,and polarimetry for determination of the content of gentamycin sulfate in Weikang capsule wes rapid and reliable

Objective To obtain conversion formulae of cyclosporine test results between TDX and AXSYM system and evaluate the influence of different sample diluents in over-range samples on AXSYM system.Methods One hundred samples with different concentration were analyzed by TDX and AXSYM system, respectively. The results were compared. Fifty over-range samples were diluted with prepared diluents such as whole blood, phosphate buffer, self-prepared diluents and zero point calibrator and then analyzed on AXSYM system.Results There was a significant difference in the results between TDX and AXSYM system. Reasonable formulae were concluded based on different concentration ranges. Results obtained by using whole blood and phosphate buffer as diluents differed from that got by using zero point calibrator. In contrast, there was no significant difference between self-prepared diluents and zero point calibrator.Conclusion The conversion formulae are helpful to evaluate the variation of the results while the analysis system was changed. Self-prepared diluents could be used to replace zero point calibrator as sample diluents.

BACKGROUND: Hepatic myelopathy results from liver disease, which lacks of effective cure method. Liver transplantation has attempted to cure this disease; however, the long-term therapeutic effect is rarely reported. OBJECTIVE: To explore the long-term therapeutic effect of liver transplantation in patients with hepatic myelopathy. METHODS: The clinical data of 2 patients with hepatic myelopathy, who underwent orthotopic liver transplantation, in August 2002 and November 2004, at the 309 Hospital of Chinese PLA, were analyzed retrospectively. The time of follow-up was 18 and 43 months, respectively. The muscle strength of double lower limbs in 2 patients was assessed prior to and after operation. RESULTS AND CONCLUSION: Two patients recovered well at 4 weeks after transplantation, the clinical symptom and physical signs of patients were improved obviously, the blood routine examination and other biochemical index were normal,and the function of transplanted kidney was normal. Two patients discharged at 6 weeks after transplantation. Patient 1 could stand for a long time at months 6 after transplantation, walked slowly with the supporter after 12 months and without the supporter at 43 months. The muscular strength of two lower limbs was grade 4. And the liver function was normal. Patients 2 could move his lower limbs in bed at months 6 after transplantation, walked with the supporter at 18 months. The muscular strength of two lower limbs was grade 3. The liver function was normal. It demonstrated that liver transplantation is beneficial to control hepatic myelopathy and recover muscular strength of two lower limbs. It is a newly developed, effective curing method for treating hepatic myelopathy. However, the numbers were small with short time observation, thus, the long-term therapeutic effect still need to be explored.

Predicting the termination of paroxysmal atrial fibrillation (AF) may provide a signal to decide whether there is a need to intervene the AF timely. We proposed a novel RdR RR intervals scatter plot in our study. The abscissa of the RdR scatter plot was set to RR intervals and the ordinate was set as the difference between successive RR intervals. The RdR scatter plot includes information of RR intervals and difference between successive RR intervals, which captures more heart rate variability (HRV) information. By RdR scatter plot analysis of one minute RR intervals for 50 segments with non-terminating AF and immediately terminating AF, it was found that the points in RdR scatter plot of non-terminating AF were more decentralized than the ones of immediately terminating AF. By dividing the RdR scatter plot into uniform grids and counting the number of non-empty grids, non-terminating AF and immediately terminating AF segments were differentiated. By utilizing 49 RR intervals, for 20 segments of learning set, 17 segments were correctly detected, and for 30 segments of test set, 20 segments were detected. While utilizing 66 RR intervals, for 18 segments of learning set, 16 segments were correctly detected, and for 28 segments of test set, 20 segments were detected. The results demonstrated that during the last one minute before the termination of paroxysmal AF, the variance of the RR intervals and the difference of the neighboring two RR intervals became smaller. The termination of paroxysmal AF could be successfully predicted by utilizing the RdR scatter plot, while the predicting accuracy should be further improved.
Atrial Fibrillation ; diagnosis ; Computer Systems ; Heart Rate ; Humans ; Machine Learning

Objective To investigate the antibiotic resistance of Acinetobacter baumannii,and to identify the risk factors for fatality of Acinetobacter baumannii bloodstream infection.Methods A retrospective review was conducted on 80 patients with Acinetobacter baumannii bloodstream infections admitted in Tianjin General Hospital during January 2011 to May 2014.Clinical data including demographic information,the ward of stay,underlying diseases,treatment,invasive procedures,antibiotic resistance,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at admission were collected.Multivariate Logistic regression analysis was performed to identify the risk factors for fatality.Results There were ≥90％ strains resistant to ceftazidime,ceftriaxone and cefoxitin,and 66.3％ strains were resistant to imipenem.While most strains were sensitive to cefoperazone/shubatan and tigecycline,and the resistance rates were 7.5％ and 2.5％,respectively.ICU admission (OR =6.67,95％ CI:2.01-22.07,P ＜0.01),multi-drug resistance (OR =3.55,95％ CI:1.30-9.69,P ＜ 0.05),APACHE Ⅱ score ≥ 19 (OR =39.00,95％ CI:9.87-154.09,P ＜ 0.01),artery catheterization (OR =3.24,95％ CI:1.16-9.04,P ＜ 0.05),central venous catheterization (OR =3.33,95％ CI:1.22-9.12,P ＜ 0.05),tracheal catheterization (OR=3.60,95％CI:1.31-9.88,P＜0.05),tracheostomy (OR=3.21,95％CI:1.19-8.66,P＜0.05),and other invasive procedures (OR =3.00,95％ CI:1.11-8.08,P ＜ 0.05) were the risk factors for fatality.Conclusion Invasive procedures and multi-drug resistance are associated with increased fatality of patients with Acinetobacter baumannii bloodstream infection.

Objective To study vascular anatomy between the pancreatic head and duodenum,providing anatomy basis for performing surgery of pancreatic head,duodenum and distal common bile duct in surgical practice. Methods Anatomy study was performed in 30 formaldehyde fixed and 10 fresh bodies in reference to blood supply to duodenum,the distal common bile and Vater ampulla. Results The anterior and posterior pancreaticoduodenal arterial arcade gives off branches to descending and horizontal portion of the duodenum. The posterior superior pancreaticoduodenal artery goes to distal common bile duct. The papilla artery arising from the posterior superior pancreaticoduodenal artery goes to Vater ampulla. Conclusions The pancreaticoduodenal anterior and posterior arterial arcades are main arteries that give off branches to the descending and horizontal portion of the duodenum,distal common bile duct and the Vater ampulla,hence should be carefully protected in duodenum-preserving resection of the pancreatic head.

Objective To investigate the impact of enhanced recovery after surgery (ERAS)on immune function in patients undergoing laparoscopic hepatectomy.Methods Sixty patients undergoing laparoscopic hepatectomy (34 males,26 females,aged 38-57 years,ASA Ⅰ or Ⅱ),were randomly divided into two groups:enhanced recovery after surgery group (group E)and non-enhanced recovery after surgery group (group C).The patients in group E received enhanced recovery after surgery,while the patients in group C received routine perioperative management and anesthesia methods.The operation method and time,the volume of bleeding,the intraoperative fentanyl con-sumption,the volume of fluid input,the preoperative and postoperative CVP and temperature were recorded in the two groups.Blood samples were obtained before induction (T0 ),at the end of opera-tion (T1 ),on day 1 (T2 ),day 3 (T3 ),day 7 (T4 )after operation for determination of plasma con-centration of IgA,IgM,IgG and the percentages of T lymphocyte subsets (CD3+ ,CD4+ ,CD8+ ) and CD4+/CD8+ ratio were detected with flow cytometry.Furthermore,the visual analogue scale (VAS)score and Ramsay score were evaluated 4 hours,8 hours,24 hours and 48 hours after opera-tion in two groups.Results Compared with group C,the intraoperative fentanyl consumption,the volume of fluid input and the postoperative CVP in group E were significantly decreased,while the postoperative temperature was significantly increased (P < 0.05 ).Compared with T0 , the percentages of CD3+ ,CD4+ ,the CD4+/CD8+ ratio and the plasma concentration of IgA,IgM,IgG in group E on T1-T3 were significantly decreased,the percentages of CD3+ ,CD4+ ,the CD4+/CD8+ratio and the plasma concentration of IgA,IgM,IgG in group C on T1-T4 were significantly decreased (P <0.05).Compared with group C,the percentages of CD3+ ,CD4+ ,the CD4+/CD8+ ratio and the plasma concentration of IgA,IgM,IgG in group E on T1-T4 were significantly increased (P <0.05),the visual analogue scale (VAS)score 4 hours,8 hours,24 hours after operation were signifi-cantly decreased (P <0.05).The comparision of Ramsay scores at all the time points between two groups were similar.Conclusion ERAS applied to patients undergoing laparoscopic hepatectomy can reduce the intraoperative fentanyl consumption,prevent the occurrence of hypothermia and provide satisfactory postoperative analgesia,which can significantly improve the immune function in patients.

Objective To analyze the value of the potential risk factors on predicting primary graft dysfunction (PGD) after bilateral lung transplantation for the patients with idiopathic pulmonary fibrosis (IPF).Methods A retrospective study was conducted. Fifty-eight patients with IPF who underwent the bilateral lung transplantation admitted to Wuxi People's Hospital Affiliated to Nanjing Medical University from June 2014 to March 2017 were enrolled. The grade 3 PGD happened within 72 hours after transplantation was taken as the outcome event, and these patients were divided into PGD and non-PGD groups. The age, gender, body mass index (BMI), underlying disease, and N-terminal-probrain natriuretic peptide (NT-proBNP) before operation, pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), and mean pulmonary artery pressure (mPAP) before and after operation, duration of operation, the volume of blood transfusion during operation and postoperation, the use of extracorporeal membrane oxygenation (ECMO) during the operation, blood purification treatment after operation, and shock within 3 days after operation were recorded. The differences of parameters mentioned above between the two groups were compared. The predictive factors of PGD were searched by binary logistic regression analysis, and the receiver operating characteristic curve (ROC) was plotted to analyze the predictive value of preoperative PADP for grade 3 PGD after transplantation.Results Among 58 patients who underwent the bilateral lung transplantation, 52 patients were enrolled. The rest patients were excluded because of incomplete clinical data. There were 17 patients in the PGDgroup, with a mortality rate of 47.06%. The non-PGD group included 35 patients with a mortality rate of 8.57%. PADP and mPAP ahead of operation, the dosage of red cells suspension after the operation, and the total amount of blood transfusion during and after the operation in PGD group were significantly higher than those in non-PGD group [PADP ahead of operation (mmHg, 1 mmHg = 0.133 kPa): 33.7±10.5 vs. 25.3±10.1, mPAP ahead of operation (mmHg): 40.4±14.1 vs. 32.8±11.1, the dosage of red cells suspension after the operation (mL): 700 (300, 1500) vs. 300 (300, 500), the total amount of blood transfusion during and after the operation (mL): 2250 (1850, 4275) vs. 1800 (1550, 2800)], with statistically significant differences (all P < 0.05). There were no significant differences in age, gender, BMI, underlying disease, NT-proBNP before operation, PASP before and after operation, PADP and mPAP after operation, duration of operation, amount of plasma and red cells suspension as well as total amount of blood transfusion during operation, plasma amount and total amount of blood transfusion after operation, amount of plasma and red cells suspension during and after operation, use of ECMO during operation, blood purification treatment after operation, and shock after operation between the two groups (all P > 0.05). It was shown by binary logistic regression analysis that the preoperative PADP was the independent risk factor of grade 3 PGD after lung transplantation [odds ratio (OR) = 1.084, 95% confidence interval (95%CI) = 1.016-1.156,P = 0.015]. It was shown by ROC curve that the area under the ROC curve (AUC) of the PADP before operation for predicting the grade 3 PGD after lung transplantation was 0.728. When the cut-off value was 36 mmHg, the sensitivity was 47.1%, and the specificity was 91.4%.Conclusions Compared with the non-PGD group, the patients with higher preoperative PADP were more common in the PGD group, and the patients in the PGD group were more likely to be characterized by grade 3 PGD after lung transplantation. The preoperative PADP was an effective predictor of grade 3 PGD after lung transplantation.