Objectives To investigate the risk factors of cardiorenal syndrome type 1 (CRS1) in patients with acute myocardial infarction (AMI).Methods The medical date of hospitalized patients with AMI from January,2013 to February,2014 in Hunan Provincial People~ Hospital were reviewed.A total of 265 patients with AMI was divided into CRS1 and non-CRS1 groups.The univariate comparison and multivariate Logistic regression analysis were performed to obtain the CRS1 risk factors.Results In the 265 AMI patients,CRS1 was found in 59 patients (22.3％).Age,history of diabetes,Killip classification,left ventricular ejection fraction (LVFF),baseline serum creatinine,blood urea nitrogen,uric acid,baseline evaluated glomerular filtration rate (eGFR),serum sodium,the left anterior descending artery lesion,emergency percutaneous coronary intervention (PCI),β-blocker,and angiotensin converting enzyme inhibitor/angiotensin receptor antagonist (ACEI/ARB) were statistically different between CRS1 and non-CRS1 groups (all P ＜ 0.05).Multivariate logistic regression showed that age,history of diabetes,Killip classification,reduced LVEF,reduced eGFR,hyponatremia,the left anterior descending artery lesionn,emergency PCI non-undergo,and β-blocker non-use were independent risk factors for CRS1 after AMI.Conclusions CRS1 is a common complication in AMI patients,which is associated with many factors.Our data suggest that patients with AMI should be more comprehensively assessed and monitored,thereby preventing the occurrence of CRS1.

Objective To explore the significance of sample cultivation and drug resistance of the patients in PICU with severe lower respiratory tract specimens.Methods 1 107 pathogenic bacteria of lower respiratory tract samples collected were analyzed and the drug resistance was kept watch on.Results A total of 1107 samples were cultured into 948 strains of pathogens,with the positive rate of 85.64%,and 616 strains of Gram negative bacteria accounting for 64.98%,of which 145 strains of Pseudomonas aeruginosa(15.30%),Klebsiella pneumoniae 135(14.24%),Acinetobacter spp 131(13.82%),large intestine Egypt Greek bacteria 89(9.4%);Gram positive cocci 129(13.61%),the main pathogen was staphylococcus aureus and Fungi 203(21.41%),the main pathogen was candida albicans.Carbapenems was the most active antibiotics for gram negative bacill,and vancomycin for gram positive cocci.Conclusion Infectious bacteria have high selectivity to the sensitive antibiotics,and doctors should carefully use antibiotic according to the susceptibility test results in order to reduce hospital infection and the emergence and spread of resistant strains.

BACKGROUND:The use of cemented or uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly remains controversial.Therefore,it is necessary to conduct a comparative study on the effectiveness and safety of these two methods.OBJECTIVE:To compare the clinical efficacy of cemented and uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly.METHODS:Clinical data of 93 elderly patients with unstable intertrochanteric fractures in Department of Orthopedics,Shandong Energy Zaozhuang Mining Group General Hospital from May 2009 to May 2014 were analyzed retrospectively.All patients were divided into cemented (cemented bipolar hemiarthroplasty for fractures,n=54) and uncemented (uncemented bipolar hemiarthroplasty for fractures,n=39) groups.RESULTS AND CONCLUSION:(1) The amounts of postoperative drainage and blood transfusion in the cemented group were significantly less than those in the uncemented group (P ＜ 0.05),but the operation time was significantly longer (P ＜ 0.05).(2) There were no significant differences in the intraoperative blood loss,ambulation time,hospitalization time,postoperative complications,hip function,and mortality at 3 and 12 months postoperatively between two groups (P ＞ 0.05).(3) Postoperative X-ray showed that all patients had good prosthesis position.There were 10 patients (3 cases in the cemented group,7 cases in the uncemented group) with postoperative prosthesis subsidence,but all of them were less than 3 mm.(4) None of patients had heterotopic ossification,osteolysis around the prosthesis and acetabular cartilage wear during follow-up.Additionally,25 patients (16 cases in the cement group,9 cases in the uncement group) died during follow-up,without prosthesis loosening,and the remaining 68 patients were followed up for 2-7 years,(4.5±2.3) years on average,and none needed revision because of prosthesis loosening.(5) These results indicate that for senile unstable intertrochanteric fractures,both cemented and uncemented hemiarthroplasty can achieve satisfactory curative effectiveness and exhibits good safety.Notably,the cemented prosthesis has advantages in reducing postoperative drainage volume and blood transfusion.

Objective To comprehend the status and risk factors of overweight and obesity among urban and rural inhabitants of Shenchi county.Methods With stratified cluster sampling,two residents" committees were selected as investigation spots from each town of Longquan,Yijing,Bajiao and Hezhi of Shenchi county.Permanent inhabitants aged 20 to 74 yrs were investigated on their status of overweight and obesity and its realted risk factors.Results In this study,2231 inhabitants were investigated,among which male 871 and female 1 360.The prevalence rate of overweight and obesity were 28.6%(standardized rate was 26.7%) and 5.1% (standardized rate was 4,5%).There was a statistic significance in prevalence rate of overweight between male and female(X~2=4.595, P0.05).It was discovered that the age,the degree of education, the annual income of family,drinking,exercise status,alimentary control status,family history and so on had the relation with BMI, the exercise and diet control status assumed negative association by multiple linear regression.Conclusion There is a high prevalence rate of overweight and obesity among residents in Shenchi county in Shanxi province.We should make the comprehensive intervention measures according to its status and risk factors,and make the prevalence rate decreased.

Objective To investigate the difference of tumor cell proliferation between the center and the edge tissues of human colon cancer and its relationship with the expression and methylation of p16 and p14 gene.Methods The expression of Ki67,P14 and P16 protein was assessed by immunohistochemistry,methylation status and mRNA expression of p16 and p14 gene in different area of colon cancer tissue were analyzed by methylation-specific PCR.RT-PCR and microdissection technique. Results There was significant difference in expressions of Ki67 between the center(100.0%) and the edge (30.1%) tissue in 42 cases of colon cancer(P

OBJECTIVETo analyze the causes of delayed union or nonunion of the ulna after intramedullary nailing in pediatric forearm fractures.

METHODSFrom February 2005 to February 2010,5 patients with forearm fractures who were treated with titanium elastic nailing (TEN) were identified to fulfill the criteria of having developed a delayed union or nonunion of the ulna. The causes of delayed union or nonunion were investigated according to mechanism of injury, fracture location, treatments methods and postoperative management. All patients were male and the age was 3 to 14 years old with an average of 9.4 years. All fractures were located on the mid-third part of forearm. Two cases had a re-fracture. Among them, 3 cases caused by high-energy injury and 2 cases by falling down. Open reduction were performed in 4 cases while the other one was treated with closed reduction. Four patients were immobilized in an above-elbow cast, postoperatively.

RESULTSAll patients were followed up from 7 to 19 months with an average of 11.4 months. There were 4 delayed union and 1 nonunion. Three patients healed after the removal of the nail and avoidance of weight-bearing. Two patients healed by replacing another fixation. No patients had soft-tissue irritation or nail-entry-site infections.. The clinical effect was evaluated according to Daruwalla and Price scores with 3 excellent and 2 good of the results.

CONCLUSIONSUsing titanium elastic nailing for the treatment of pediatric both-bone forearm fractures is a good method. However,strict indication selection should be followed to avoid delayed union or nonunion.

Adolescent ; Child ; Child, Preschool ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Retrospective Studies ; Ulna Fractures ; physiopathology ; surgery

Objective To investigate the clinical effect and safety of San' ao Pian's treatment on subacute cough induced by airway inflammation.Methods Ninety cases with subacute cough induced by airway inflammation were selected as our subjects.They were randomly divided into control group(n =45) and San'ao Pian group(n =45).Patients in control group were given regular treatment,and in San'ao Pian group were received San'ao Pian's(1.0 g/time oral,3 times/day) for 2 weeks plus regular treatment.The changes of clinical symptoms such as cough,sputum,and wheeze were observed and recorded at the 3th,7th,14th day.Results (1) The main symptoms regarding of cough were improved in two groups(P ＜ 0.01).The day cough symptoms score in San'ao Pian group were (2.18 ±0.62),(1.22 ±0.46),(0.83 ±0.45) at the 3th,7th,14th days after treatment,lower than that of control group ((2.78 ± 0.55),(2.05 ± 0.41),(1.86 ± 0.68)) and the differences were significant(F within group =10.23,P ＜ 0.05 ; F between =8.46,P ＜ 0.05 ; F intercross group =12.05,P ＜ 0.05).The same trend was seen in night cough symptoms score ((2.12 ± 0.51) vs.(2.38 ±0.38),(1.18±0.44) vs.(1.85±0.49),(1.01 ±0.32) vs.(1.24±0.37) ;Fwithingroup=6.38,P ＜ 0.05 ; F between group =7.59,P ＜ 0.05 ; F intercross group =8.13,P ＜ 0.05).(2) The total efficacy rate of San'ao Pian's was 86.7％,including 22 cases were cured,17 cases markedly effective,higher than that of control group (68.9％),including 14 cases were cured and 17 cases markedly effective,and the difference was significant.Conclusion San'ao Pian's is proved with better clinical effect in terms of treating subacute cough induced by airway inflammation.

Objective:To evaluate the feasibility and safety of laparoscopic jejunostomy with central venous catheterization set (CVC, Arrow International Inc., USA) during the operation of totally minimally invasive Ivor-Lewis esophagectomy (MIIE). Methods:The clinical data of 88 patients with esophageal squamous cell carcinoma who were admitted to the Fudan University Cancer Hospital from February 2013 to April 2014 were retrospectively analyzed. Among them, 48 patients with early mid-lower esophageal cancer un-derwent laparoscopic jejunostomy with CVC, and 40 patients accepted nasogastric tube nutrition. Short-term clinical outcomes were collected. Results:No significant difference in nutrition index was found between the two groups, but the rate of unplanned extubation in the laparoscopic jejunostomy with CVC group was less than that in the nasogastric tube nutrition group. Conclusion:Laparoscopic jejunostomy with CVC set is a safe and feasible technique. It is potentially accepted as an optional approach in MIIE for post-operative nutrition support.

Objective To sensitize the T-cell in the peripheral blood of the active tuberculosis pa-tients by rCFP-10/ESAT-6 fusion protein, phytohaemaggiutinin(PHA) and physiologic saline, and to detect the IFN-γ to approach the significance of the tuberculosis infection. Methods One hundred and eleven pa-tients were diagnosed by clinical definite, 292 undergraduate students were chosen by X-ray and PPD-selec-fion as volunteers. 3.0 ml of blood was taken from each volunteer, rCFP-IO/ESAT-6, PHA and physiologic saline were added into each 1.0 ml, respectively. The A valule and antibody of IFN-γ were assayed by ELISA. Results Treated with rCFP-10/ESAT-6 group: the A value average of patients group was 1. 3885±0.6236, students group was 0.2944±0.0917. Intergroup t'=16.4259, P<0.05, set>0.42 as cut-off, the positive rate of patients group was 93.58%, students group was 13.07%. Treated with PHA group: the A value average of patients group was 1.2463±0.5541, of which the other was 0.5613±0.064, t'=19.1797,P<0.05. Treated with physiologic saline group:the A value average of patients group was 0.0772±0.0444,of which the other was 0.0290±0.0235,t'=13.9487,P<0.05. All had significant deviation. The antibody positive rate of the patients group was 66.36%, the students group was 7.19%. Conclusion rCFP-10/ESAT-6 as specific antigen, the sensitivity of IFN-γ release assay by ELISA is above 90%. No matter specific or non-specific disposal, the active tuberculosis patients have higher IFN-γ, release level and antibody than the control group.

Objective To study the inhibitory effects of TPP,a desmosdumotin-C B ring para-fluoro modified derivative,on human breast cancer MCF-7 cell proliferation,and investigate the possible mechanisms.Methods MTT assay was used to measure the proliferation suppression of MCF-7 cells after treated with 1.0,2.5,5.0,10.0,and 20.0 μg/mL TPP for 48 h,and then the cell apoptosis rate and expression rate of NF-κB P65 positive cells were tested by flow cytometry after 20.0 μg/mL TPP treatment for 0,24,and 48 h.Results MTT assay showed that,after treatment for 48 h,1.0,2.5,5.0,10.0,and 20.0 μg/mL TPP all exhibited the inhibitory effects and showed a dose-dependent relationship.Flow cytometry results showed that 20.0 μg/mL TPP induced cell apoptosis after treatment for 24 and 48 h.TPP (20.0 μg/mL) significantly reduced the rate ofNF-κB P65-positive cells in MCF-7 cells after treatment for 48 h.Conclusion TPP could inhibit the proliferation of MCF-7 cells,which may be induced by cell apoptosis.Down-regulation of NF-κB is possible to be related with apoptosis.