Objective To undertake animal experimentation and clinical study on the safety and efficacy of percutaneous transluminal angioplasty (PTA) and intraarterial papaverine (IAP) infusion for treatment of refractory symptomatic cerebral vasospasm (CVS). Methods In the experimental study, vasospasm was induced in rabbits by double injections of blood into the cisterna magna, IAP infusion was given on either the 4th day or the 7th day after occurrence of subarachnoid hemorrhage (SAH), and then neurological observation, angiography, light and electron microscopy were done. In the clinical study, since September 1996, 22 patients with refractory symptomatic CVS involving 50 vascular territories received dilation therapy by PTA and IAP within 24 hours of clinical neurological deterioration. Results In the experimental study, all the rabbits except two in the 'the 4th day' group showed angiographic dilation in all of the spastic basilar arteries, and neurological improvement; in the ' the 7th day' group angiographic dilation appeared in 4 (57. 1% ) out of 7 rabbits. After 24 hours, 1 rabbit in each group had recurrence of neurological deficits and angiographic constriction. In the clinical study after aneurysm clipping or endovascular coil embolization was done, within 72 hours of SAH all patients underwent endovascular treatment: PTA alone in 3 cases, IAP alone in 14 cases, PTA and IAP in the remaining 5 cases. All vessel segments were dilated satisfactorily after endovascular treatment. Clinical improvement was significant in 13 cases,moderate in 7, minimal or none in 2; 2 cases died on the 7th day after endovascular dilation treatment. Conclusion Endovascular dilating techniques, namely, PTA, IAP and a combination of PTA and IAP, are safe and effective for treatment of symptomatic CVS refractory to medical therapy.

Objective To investigate the profile and antibiotic resistance of bacteria in patients with ascites infection in intensive care unit (ICU) patients in order to provide a reference for rational clinical use of antibiotics. Methods A retrospective analysis was conducted. The bacteria isolated from ascetic fluid patients admitted from January 1st, 2004 to October 31st, 2015 to ICU of the First Affiliated Hospital of Anhui Medical University were identified, and their susceptibility to antibiotics was analyzed. Patients, who were admitted from January 1st, 2004 to December 31st, 2009 were assigned to group A, and patients admitted afterwards were assigned to group B. Results A total of 637 specimens of ascetic fluid were examined, with 185 positive culture (29.0%) during the 12 years, and 203 strains of bacteria were found. Among them 126 strains (62.1%) of gram-negative bacteria (G-), 54 (26.6%) of gram-positive bacteria (G+) and 23 (11.3%) strains of fungi were found. Compared the result of group B with that of group A, the proportion of G- bacteria was increased [71.2% (99/139) vs. 44.2% (27/64)], and that of G+ decreased [17.3% (24/139) vs. 46.9% (30/64)] in group B. The difference was statistically significant (χ2 = 20.34, P = 0.001). The main pathogenic bacteria were G-, and Enterobacteriaceae was the most common pathogenic bacteria in intra-abdominal infection of ICU patients. The isolation rate of Escherichia coli and Klebsiella pneumoniae(35.7%, 10.3%) ranked in the first and third in G- bacteria, respectively. The resistant rate of Escherichia coli against penicillin and third generation cephalosporin were > 95.0% and > 73.3%, and it showed a sensitive rate of 70% to β-lactam/inhibitor, amikacin and minocycline, and a higher sensitivity to carbapenems and tigecycline (11.1%, 0). Forty-eight strains of non-fermentation bacteria were found with a rate of 23.7%. The positive rates of Acinetobacter baumannii in groups A and B were 7.8% (5/64) and 23.7% (33/139), respectively, and they ranked first among non-fermentation bacteria. Twenty strains (62.5%) multidrug-resistant Acinetobacter baumannii were found. Acinetobacter baumannii showed a resistance rate of 84.6% to cefoperazone/sulbactam, 35.3% to minocycline, and 53.3% to tigecycline. Candida albicans was the most commonly isolated fungus in intra-abdominal infections (87.5%). No strains resistant to common antifungal drugs were isolated. Conclusions G- bacteria was the main pathogen in intra-abdominal infection in patients with ascites. Non-fermenters showed an increasing trend of producing infection, and the proportion of multidrug-resistant Acinetobacter baumannii infection increased year by year, and more attention should be taken by attending doctors.

Objective To investigate the clinical features, diagnosis and treatment of colorectal cancer in patients with incarcerated extracorporeal hernia. Methods The clinical manifestations, diagnosis and treatment of 9 cases of incarcerated hernias combined with colorectal cancer from January 2012 to December 2017 were retrospectively analyzed. Results All the patients were treated with surgery. Three cases underwent Hartmann surgery and incarcerated release, high ligation of hernia sac; 2 cases underwent tumor resection and tension-free hernia repair; 1 case underwent necrotic bowel resection, tumor resection and ileal stoma and tension-free hernia repair; 1 case underwent transverse colostomy and incarcerated release, high cyst ligation; 1 case underwent tension-free hernia repair and limited colon cancer radical resection; 1 case underwent high ligation of the hernia sac and limited tumor resection. Intraoperative and postoperative pathology confirmed that this group was all incarcerated abdominal hernia combined with colorectal cancer. There were 4 patients misdiagnosed before surgery. Conclusions The diagnosis and treatment often ignore the presence of colorectal cancer due to the typical clinical manifestations of incarcerated abdominal hernia. The preoperative misdiagnosis rate is high. Completing CT scans before surgery can help clarify the diagnosis and select a reasonable surgical approach.

Tumor necrosis factor-α induced protein 8 family is a group of newly discovered proteins induced by tumor necrosis factor-α. This protein family owns four highly homologous members:TIPE, TIPE1, TIPE2, TIPE3. With the deepening of the research, we found that TNFAIP8 family plays an important role in cell apoptosis, signal transduction, invasion and metastasis of tumor cell proliferation. This paper reviews the structure, mechanism, and biological function of the TNFAIP8 family.

OBJECTIVETo assess the embolic effects and biocompatibility of Eudragit mixture, a new liquid embolic agent.

METHODSIn vitro, the viscosity and precipitation time of Eudragit mixtures at several concentrations were measured to study the best proportion of components of the mixture. In vivo, a branch of the right external carotid artery was embolized with Eudragit mixture in 12 rabbits, and with n-butyl cyanoacrylate in another 12 rabbits for a comparative study of the general, angiographic and histopathologic changes between the two groups.

RESULTSEudragit mixture containing 7.5 g Eudragit, 50 ml absolute ethanol and 50 ml iopromide was shown in vitro to have good properties including rapid precipitation and soft elastic sponge formation upon contact with blood; in vivo, to be nontoxic, nonadherent to the microcatheter and able to embolize the vascular lumen completely without later recanalisation.

CONCLUSIONEudragit mixture is an effective, nontoxic, safe and promising liquid embolic agent.

Animals ; Carotid Artery Thrombosis ; pathology ; physiopathology ; therapy ; Cerebral Angiography ; Chemical Precipitation ; Embolism ; therapy ; Embolization, Therapeutic ; methods ; Enbucrilate ; therapeutic use ; Male ; Polymethacrylic Acids ; chemistry ; therapeutic use ; Rabbits ; Viscosity

Objective:To explore the efficacy of low-dose computed tomography (LDCT) baseline and follow-up scans of lung cancer screening and to analyze lung nodules and other thoracic lesions detected from baseline and follow-up. Methods:A total of 650 sub-jects were enrolled in the LDCT lung cancer screening program, and investigators mainly focused on the analysis of 548 subjects who participated in the follow-up scan. The investigators recorded the nodules and other lesions of baseline screening, compared them with the follow-up images, and recorded their progress. Results:A total of 101 subjects were positive in the baseline screening, with a positivity rate of 18.4%. Six cases of lung cancer were confirmed by pathology, with a detection rate of 0.92%(6/650). The detection rate of lung cancer in female non-smokers (1.59%) was higher than that in male smokers (1.04%) without significant difference (P=0.624). Detected in the follow-up scan were 19 cases of new nodule-positive subjects. The positive rate for new nodules was 3.5%(19/548). The difference between the three-and two-dimensional levels was statistically significant. Conclusion:The effect of LDCT screen-ing for early lung cancer is significant. The detection rate in female non-smokers was not significantly higher than that in male smok-ers. Thus, LDCT lung cancer screening is equally significant for both sexes. The computer-aided detection (CAD) volume measurement technique is better to evaluate the progress of nodules during the follow-up interval.

Objective:To investigate the potential molecular mechanisms of liver cancer cell-derived secretory autophagosomes, extracellular vesicles expressing LC3B (LC3B + EVs), in promoting the exhaustion of CD8 + T cells. Methods:The proportions of LC3B + EVs and PD-1 + CD8 + T cells in peripheral blood and ascites of liver cancer patients were measured by flow cytometry. Spearman correlation test was used to analyze the correlation between the proportions of LC3B + EVs and PD-1 + CD8 + T cells. Peripheral blood mononuclear cells (PBMCs) from healthy donors were treated with LC3B + EVs or heat shock protein 90α (HSP90α) blocking antibody-pretreated LC3B + EVs for 72 h in the presence of αCD3/CD28 antibodies and IL-2 in vitro. The proportions of PD-1 + CD8 + T and IFN-γ + CD8 + T cells and the concentrations of IL-2, TNF-α and IFN-γ in the supernatants were all detected by flow cytometry. Results:The proportions of LC3B + EVs and HSP90α + LC3B + EVs in plasma and ascites from liver cancer patients were significantly higher than those in healthy control group and non-cancerous ascites group. The level of plasma LC3B + EVs, especially HSP90α + LC3B + EVs, was significantly correlated with the percentage of exhausted PD-1 + CD8 + T cells. In addition, LC3B + EVs from human liver cancer cells up-regulated the percentage of exhausted CD8 + T cells in vitro. However, LC3B + EVs pretreated with HSP90α blocking antibody could significantly inhibit LC3B + EVs-induced CD8 + T cell exhaustion. Conclusions:Liver cancer cell-derived LC3B + EVs could effectively induce CD8 + T cell exhaustion mainly through the membrane-bound HSP90α.

The tetanus has been eliminated in the pregnancy women and newborns in China. However, there is a gap for adult tetanus immunization, and the risk of tetanus infection cannot be ignored. In order to clearly understand the effect of the tetanus to human beings and the current use of tetanus immunological preparation for adult post-exposure prophylaxis, the incidence of the tetanus, the use status of tetanus immunological preparation and recommendations for post-exposure prophylaxis at home and abroad were reviewed and summarized, which may provide academic evidence for post-exposure prophylaxis procedures and use of tetanus immunological preparation.

The tetanus has been eliminated in the pregnancy women and newborns in China. However, there is a gap for adult tetanus immunization, and the risk of tetanus infection cannot be ignored. In order to clearly understand the effect of the tetanus to human beings and the current use of tetanus immunological preparation for adult post-exposure prophylaxis, the incidence of the tetanus, the use status of tetanus immunological preparation and recommendations for post-exposure prophylaxis at home and abroad were reviewed and summarized, which may provide academic evidence for post-exposure prophylaxis procedures and use of tetanus immunological preparation.