Objective:To explore the risk factors of acute kidney injury (AKI) after robot-assisted radical prostatectomy.Methods:The clinical data of 605 patients who underwent robot-assisted radical prostatectomy in Nanjing Drum Tower Hospital from June 2017 to June 2019 were retrospectively analyzed. The independent risk factors of AKI were analyzed by Logistic regression.Results:Univariate analysis showed that age ( P = 0.001), anemia ( P = 0.036), hypoalbuminemia ( P = 0.001), coronary heart disease ( P = 0.040), hypertension ( P = 0.042), use of ACEI/ARB drugs ( P = 0.025), duration of MAP < 55 mmHg (1 mmHg = 0.133 kPa)( P = 0.000) presented statistical significance( P < 0.05). Multivariate Logistic regression analysis showed that there were significant difference in age ( P = 0.016), hypoalbuminemia ( P = 0.009), duration of MAP < 55 mmHg ( P = 0.003). Conclusions:Age, anemia, hypoalbuminemia, coronary artery disease, hypertension, use of ACEI/ARB drugs, duration of MAP < 55 mmHg are risk factors of postoperative AKI, among which age, hypoalbuminemia, duration of MAP < 55 mmHg are independent risk factors.

Objective:To evaluate the influence of the sleeve lengths and implant lengths on accuracy of static computer-assisted implant surgery (sCAIS).Methods:Twenty-eight models of bilateral mandibular single tooth loss were included. Fifty-five implants were placed under the guidance of sCAIS (Straumann Bone Level 4.1 mm×10 mm). According to the height of metal sleeve of static guide plate, 55 implants were divided into 11 groups (free hand group, 1 mm group, 2 mm group, 3 mm group, 4 mm group, 5 mm group, 6 mm group, 7 mm group, 8 mm group, 9 mm group, 10 mm group), with 5 implants in each group. Eight research models were included. Group with 5 mm sleeve guides were used to place implants of different length, (Straumann Bone Level width 4.1 mm, height was 8 mm, 10 mm and 14 mm), 5 implants in each group. Eighteen patients with mandibular single tooth loss were included in the Department of Oral Implantology, Tianjin Stomatological Hospital from October 2018 to June 2019. There were 10 males and 8 females, 18-46(33.7±7.9) years old. A total of 18 implants were implanted and divided into 3 groups (free hand group, 3 mm group and 5 mm group) with 6 implants in each group. Digital software was used to compare the implant positions before and after implantation. Non-parametric Kruskal-Wallis test or one-way ANOVA were used to analyze the results.Results:There was no significant difference in implant vertical deviation between different sleeve height groups (1-10 mm) and free hand group, but the neck deviation in free hand group[(1.04±0.13) mm] was significantly higher than that in different sleeve height groups (1-10 mm) ( P<0.05). The tip deviations of free hand group, 1 mm group and 2 mm group [(1.32±0.43), (0.83±0.10) and (0.78±0.11) mm, respectively] was significantly higher than that of 10 mm group [(0.31±0.14) mm]( P<0.05). The angle deviation of free hand group and 1 mm group (3.99°±0.85° and 2.59°±0.69°), respectively] was significantly higher than that of 10 mm group (0.61°±0.03°) ( P<0.05). The tip deviations of implants in the 14 mm group [(0.83±0.22) mm] was significantly higher than that in the 8 mm and 10 mm groups [(0.44±0.07) and (0.49±0.06) mm, respectively]. Clinical studies showed that there was no significant difference in neck deviation, tip deviation and angle deviation between 3 mm group and 5 mm group ( P>0.05), but deviations were significantly lower than those in free hand group ( P<0.05). Conclusions:The length of the sleeves has significant influence on the accuracy of the surgical guide. There was no significant difference in accuracy of the implant guide with 3 mm or 5 mm metal sleeves. The vitro study has some limitations and needs further systematic research.

OBJECTIVETo compare the postoperative analgesia efficacy, rehabilitation parameters and complication between multimodal analgesia and traditional analgesia after radical gastrectomy for gastric cancer patients.

METHODSPatients with gastric cancer who underwent surgery in our hospital from October 2016 to December 2016 were enrolled in this prospective study. According to the non-randomized method, patients were assigned to multimodal analgesia group(n=32) and traditional analgesia group(n=33) in gastric cancer treatment team A and B in Department of Gastrointestinal Surgery, West China Hospital, Sichuan University. The treatment measures of group A were as follows: (1) The ratio of 1/1 diluted ropivacaine (100 mg, 10 ml) was infiltrated around the incision before abdomen closure, with incision sutured layer by layer. (2) Parecoxib sodium (40 mg) was injected intravenously every 12 hours after operation for 5 days. (3) Oxycodone-acetaminophen tablet was given orally on the first day or the second day after operation, 50 mg twice a day. (4) Patient-controlled analgesia was not used after operation. Patients in group B received direct suture of incision and patient-controlled analgesia. The pain score, postoperative rehabilitation and 30-day postoperative complications were collected and analyzed.

RESULTSMultimodal analgesia group had lower pain scores at 1 d (4.8±0.9), 2 d (4.3±1.0), 3 d (2.9±0.8), 4 d (2.4±0.7) and 5 d (1.7±0.7) after surgery, as compared to traditional analgesia group (5.9±0.9, P=0.000), (5.1±0.7, P=0.001), (3.9±0.8, P=0.000), (3.0±0.6, P=0.000), (2.6±0.7, P=0.000), with significant difference. Postoperative hospital stay [(8.2±1.6) days vs. (10.6±2.2) days, P=0.000], time to ambulation [(47.5±13.8) days vs. (66.2±16.8) days, P=0.000], time to first flatus [(76.4±25.2) days vs. (120.0±29.9) days, P=0.000], time to first defecate [(117.3±42.2) days vs. (159.7±30.7) days, P=0.000] and time to first fluid diet [(83.8±21.6) days vs. (141.9±33.9) days, P=0.000] in the multimodal analgesia group were significantly shorter than those in the traditional analgesia group. There was no significant difference between the two groups with respect to 30-day postoperative complication rate(9.4% vs. 9.1%, P=1.000).

CONCLUSIONSMultimodal analgesia can significantly reduce the postoperative pain and is beneficial to rehabilitation, meanwhile it does not increase the risk of postoperative complications. Multimodal analgesia is safe and effective for gastric cancer patients undergoing radical gastrectomy.

Acetaminophen ; administration & dosage ; therapeutic use ; Amides ; administration & dosage ; therapeutic use ; Analgesia, Patient-Controlled ; China ; Comparative Effectiveness Research ; Defecation ; Drug Combinations ; Eating ; Flatulence ; Gastrectomy ; rehabilitation ; Humans ; Isoxazoles ; administration & dosage ; therapeutic use ; Length of Stay ; statistics & numerical data ; Oxycodone ; administration & dosage ; therapeutic use ; Pain Management ; methods ; Pain, Postoperative ; drug therapy ; Postoperative Complications ; Prospective Studies ; Recovery of Function ; drug effects ; Stomach Neoplasms ; surgery ; Surgical Wound ; rehabilitation ; therapy ; Suture Techniques ; Treatment Outcome ; Walking

OBJECTIVETo discuss the clinical features of perianal Crohn disease (PCD).

METHODSClinical data of 52 PCD patients who were treated at the Department of Colorectal Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine from June 2011 to October 2014 were analyzed retrospectively. Montreal classification, clinical symptoms, the subtype of perianal lesions, history of perianal surgery and medical treatment, disease active indexes, serum inflammation markers and nutritional indexes were included.

RESULTSAmong 52 patients, there were 40 males and 12 females with a mean age of (27.9±9.1) years. According to Montreal classification, 51.9%(27/52) of patients had ileocolic involvement and 75.0%(39/52) had inflammatory disease behavior. Thirteen (25.0%) and 15(28.8%) patients had abdominal pain and diarrhea respectively at admission. With respect to the subtype of perianal lesions, there were 32(61.5%) cases of anal fistula and 16(30.8%) cases of perianal abscess. Thirty-nine(75.0%) and 33(63.5%) patients had a history of perianal surgery and medical treatment before admission resepectively. Laboratory findings revealed high C-reaction protein level in 63.5%(33/52), high erythrocyte sedimentation rate in 61.5%(32/52), elevated platelet in 32.7%(17/52), low body weight in 44.2%(23/52), low albumin in 26.9%(14/52) and anemia in 42.3%(22/52) of patients.

CONCLUSIONSThe clinical features of PCD patients include male predominant, early onset disease, high prevalence of ileocolic involvement and inflammation disease behavior. Features prompting underlying PCD diagnosis include characteristic gastrointestinal symptoms, requiring multiple perianal surgery, and abnormality of inflammation markers and nutritional indexes.

Objective To analyze retrospectively the correlation between the difficult airway and thyromental height by three-dimensional reconstruction among the Chinese. Methods Eithty patients who had been scanned by helical CT in the head and neck were allocated into two groups according to Cormack-Lehane grading:paients with Ⅰ-Ⅱ grade were allocated into group 1, and paients with Ⅲgrade were allocated into group 2. Reconstructed images were obtained by AW4.4 workstation and the following parameters were recorded and analyzed:the length from the oral to the under jaw(a), the length from the under jaw to the skin of the neck (b), the vertical distance from the under jaw to the neck was equal to thyromental height(c), the vertical distance from the oral to the cervical vertebra(d), the angle with the under jaw as the vertices and with two lines (a and b) for edge (angle ofα). Results The c value in two groups had no significant difference:(3.97 ± 0.82) cm vs. (3.64 ± 0.62) cm, P>0.05. The d value in group 2 was significantly higher than that in group 1:(8.69 ± 0.48) cm vs. (8.25 ± 0.80) cm, P<0.05. The c/d value and c/a value in group 2 were significantly lower than those in group 1: 0.42 ± 0.07 vs. 0.48 ± 0.12, 0.80 ± 0.18 vs. 0.95 ± 0.25, P<0.05. Conclusions Thyromental height by three-dimensional reconstruction has no significant differences in evaluating the difficult airway among the Chinese. The ratio of the vertical distance from the under jaw to the neck and the vertical distance from the oral to the cervical vertebra, and the ratio of the vertical distance from the under jaw to the neck and the length from the oral to the under jaw shows negative correlation with difficult airway.

Recently, herbal medicine including traditional Chinese medicine (TCM) has gained huge attention in the world. In 2015, the global trades of herbal medicine reached 93.15 billion US dollars. And, the latest statistics from the Ministry of Industry and Information Technology of People's Republic of China showed that total sales of Chinese patent medicine and raw herbs reached 120 billion US dollars in 2014. Therefore, the aim of this study was to analyze the situation of international marketing on herbal medicine and how much TCM shared in it. The PubMed database, search engines and government websites and research reports were searched for analyses. The results showed that total trades of TCM products in both domestic and foreign markets, were about 135 billion US dollars, including Chinese patent medicine, raw herbs, herbal extracts, herbal health care products, whose proportion of the global marketing was 80%.

Aim To determine whether AngⅡin para-ventricular nucleus (PVN)was involved in the chronic intermittent hypoxia (CIH ) induced-hypertension in rats.Methods Male Sprague-Dawley rats were ran-domly divided into Sham and CIH groups,the Sham rats were exposed to continuous normoxia,while the CIH rats were submitted to CIH (8 h per day for 15 days).The conscious noninvasive method with tail cuff was performed in rats to record the systolic blood pres-sure during establishing the model of CIH induced hy-pertension.Mean arterial pressure (MAP)and heart rate (HR)were recorded in vivo on a PowerLab data acquisition system after CIH.Rats were fixed on the stereotaxic instrument to conduct microinjection in the PVN.We used Western blot to measure Ang Ⅱ level and AngⅡtype 1 receptor (AT1 R)protein expression in PVN.Results The level of PVN Ang Ⅱin CIH rats was significantly higher than that in Sham rats,a-long with increased AT1 R protein expression.Microin-jection of Ang Ⅱ(0.03,0.3,3 nmol)in bilateral PVN dose-dependently increased MAP in both CIH and Sham rats,and this response was significantly augmen-ted in CIH rats.Losartan (50 nmol),AT1 R antago-nist,had no effect on MAP in Sham rats,but caused significant MAP decreases in CIH rats,and prevented Ang Ⅱ-induced increases in MAP in both CIH and Sham rats.Conclusion The results suggest that the increased AngⅡrelease and enhanced AT1 R activation in the PVN contribute to CIH induced-hypertension in rats.

BACKGROUND:C-reactive protein has been shown to rapidly increase during the occurrence of inflammation and tissue injury, and can indicate the degree of inflammatory reaction.
OBJECTIVE:To analyze the correlation between survival time and C-reactive protein in rabbits after transplantation of polytetrafluoroethene artificial trachea with support ring.
METHODS:The cervical trachea of rabbits was replaced by polytetrafluoroethene artificial trachea with support ring. Survival time of the rabbit, and the changes in serum C-reactive protein at 1-7 days after transplantation were observed. Linear regression was used to assess the univariate association between serum C-reactive protein and survival time.
RESULTS AND CONCLUSION:The linear correlation was observed between changes of serum C-reactive protein and survival time in rabbits with artificial trachea replacement operation. C-reactive protein levels in rabbits with<13 days of survival time were increased and positively associated with the number of days after transplantation. However, C-reactive protein levels in rabbits with>13 days were decreased and negatively associated with the number of days after transplantation. In rabbits with positive correlation and negative correlation, the median survival time and 95%confidence interval (CI) were respectively 10 days (95%CI 8.614-11.386 days) and 27 days (95%CI 23.970-30.030 days). The survival rate in negative correlation group was significantly higher than positive correlation group (x2=29.364, P<0.01). Results suggested that the prolonged survival time of rabbits after artificial trachea replacement operation was related to the decreased concentration of serum C-reactive protein.

PARP1 is an important part of DNA repair machinery. In recent years, PARP1 as novel anti-cancer therapeutic target has been broadly explored. In this study, we expressed hPARP1 enzyme in the baculovirus system and tested its activity. We inserted hPARP1 gene into the pFastBac1, a baculovirus transfer vector and then transformed it into DH10Bac containing a shuttle vector of Bacmid. After co-transfecting the recombinant plasmid into Sf9 insect cells, the expressed hPARP1 was purified by 3-aminobezamide affinity chromatography. The expression of hPARPI was visualized by SDS-PAGE and Western blotting; the activity of expressed and purified hPARP1 was confirmed by the reaction of consumption of NAD+ by hPARP1 in vitro. After the purification by 3-aminobezamide affinity column, 3.2 mg protein was obtained and its specific activity was 1.988 nmol/(min x microg).
Animals ; Baculoviridae ; genetics ; Blotting, Western ; Electrophoresis, Polyacrylamide Gel ; Genetic Vectors ; Humans ; Insecta ; Poly (ADP-Ribose) Polymerase-1 ; Poly(ADP-ribose) Polymerases ; biosynthesis ; Recombinant Proteins ; Sf9 Cells ; Transfection

Objective To investigate the application of low-dose adaptive sequence scan of dual-source CT coronary angiography in patients with high heart rate and evaluate the image quality.Methods Seventy-two patients who underwent coronary CT angiography with heart rate> 70 bpm were divided into 2 groups.Group A was adaptive sequence scan, and Group B was retrospective ECG-gating helical scan.Examinations were performed on a dual-source CT scanner (Somatom Definition) .All images were transferred to a workstation for further processing and analysis.The image quality was evaluated using same criteria.The image quality of coronary artery segments was compared in two groups using rank sum test, and the radiation dose was compared using t test Results A total of 501 coronary artery segments were evaluated in group A and 400 segments in group B.The mean ranks in image quality of coronary artery segments in group A was 475.42, whereas 420.41 in group B.There was a statistical difference in image quality between the two groups (Z= - 3.509,P=0.000).The effective dose was on average (6.2±0.9) mSv in group A, whereas on average (14.7±1.9) mSv in group B, there was a statistical difference between the two groups(t= - 27.011, P=0.000).Conclusions Adaptive sequence scan in dual-source CT coronary angiography is feasible in patients with high heart rates.This scan mode can substantially reduce radiation dose and maintain the diagnostic image quality.