Background There are a variety of microorganisms in ambient air, and susceptible people can be infected once contact with pathogenic microorganisms in the environment. In order to avoid the spread of pathogenic bacteria, disinfection is the simplest and most effective way of killing pathogenic bacteria in the environment to block the contact between pathogenic bacteria and humans. Sodium hypochlorite (NaClO) is the most widely used disinfectant, but its safety in ambient air disinfection is not clear yet. Objective To establish a model of bronchial epithelial cell (BEAS-2B) injury induced by NaClO, and to explore the mechanism of the toxic effect of NaClO disinfectants on BEAS-2B. Methods Cells were treated with concentration gradients of 0, 25, 50,100, 200, and 400 μmol·L⁻¹ of the diluted NaClO (100 mmol·L⁻¹) standard solution, respectively, and cell activity was measured by cell counting kit-8 (CCK-8) assay after 15 and 30 min. Cells treated with 0, 25, and 50 μmol·L⁻¹ NaClO were selected to observe the cell morphology under an inverted microscope, apoptosis was determined by flow cytometry Annexin V FITC / PI double staining to determine the final experimental concentration. The morphology of organelles such as mitochondria was observed under a transmission electron microscope. Mitochondrial membrane potential of the cells was detected by JC-1 staining. Intracellular Ca²⁺ concentration was measured with a Fluo-4 AM fluorescent probe. Total cellular reactive oxygen species (ROS) was detected with a 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) fluorescent probe, cell mitochondrial ROS with a dihydroethidium (DHE) fluorescent probe, and lipid peroxidation intermediate malondialdehyde (MDA) with a commercial kit. Results Compared with 0 μmol·L⁻¹, NaClO treatment group, cell morphology did not change a lot after 25 μmol·L⁻¹ NaClO treatment for 30 min, and the cells began to wrinkle and become round after 30 min treatment with 50 μmol·L⁻¹ NaClO, showing about 70% of normal cell viability (P<0.01). So 30 min 50 μmol·L⁻¹ NaClO treatment was selected for the subsequent experiment. The experimental results found that compared with the 0 μmol·L⁻¹ NaClO treatment group, the number of apoptotic cells increased (P<0.05), the mitochondrial membrane potential decreased (P<0.01), the intracellular Ca²⁺ concentration increased (P<0.05), the cellular ROS level increased (P<0.05), the mitochondrial ROS level increased (P<0.01), and the MDA content increased (P<0.01) in the NaClO treatment group.. Conclusion The study has successfully established a model of BEAS-2B injury induced by NaClO, and found that NaClO can lead to cell damage by inducing apoptosis and oxidative stress in BEAS-2B cells. According to the results, there are two possible reasons. First, NaClO solves in water to form hypochlorous acid (HClO) which is oxidative and increases the intracellular ROS level after entering cells, leading to cellular oxidative stress. Second, HClO enters cells to directly attack the mitochondrial membrane, resulting in the imbalance of potential inside and outside the mitochondrial membrane, and apoptosis caused by Ca²⁺ efflux.

OBJECTIVE: To investigate the long-term effectiveness of uncemented allograft-prosthesis composite (APC) for reconstruction of bone defects after proximal femur tumor resection. METHODS: Between June 2007 and March 2014, 21 patients who underwent uncemented APC reconstruction of proximal femur after tumor resection were retrospectively evaluated. There were 9 males and 12 females with an average age of 33.2 years (range, 19-54 years). There were 9 cases of giant cell tumor of bone, 5 cases of osteosarcoma, 4 cases of osteoblastic osteosarcoma, 2 cases of chondrosarcoma, and 1 case of undifferentiated pleomorphic sarcoma. Thirteen cases of benign bone tumors were all classified as stage 3 by Enneking staging; and 8 cases of malignant bone tumors were classified as grade ⅡB in 7 cases and grade ⅡA in 1 case according to the American Joint Committee on Cancer (AJCC) staging system. Among them, 7 patients underwent reoperation after recurrence, and the rest were primary operations; 8 patients presented with pathological fractures. The preoperative Harris hip score (HHS) and American Musculoskeletal Tumor Society (MSTS) score was 40 (30, 49) and 9.1±3.5, respectively. The length of osteotomy was 80-154 mm, with an average of 110 mm. At 1 year after operation and last follow-up, HHS and MSTS scores were utilized to evaluate the function of hip joint; the gluteus medius strength score was used to evaluation of the hip abduction function. Image examinations were taken at 1, 3, 6, 9, and 12 months after operation and every year thereafter to assess the union of allograft-host bone interfaces. Intra- and post-operative complications were also recorded. RESULTS: All patients were followed up 84-163 months (mean, 123.5 months). At 1 year after operation and last follow-up, the HHS and MSTS scores significantly improved when compared with the preoperative scores ( P<0.05). However, there was no significant difference in the HHS score, MSTS score, and gluteus medius strength score between the two time points after operation ( P>0.05). Image examination showed that all allograft-host bone interfaces achieved union after 5-10 months (mean, 7.6 months). At last follow-up, all patients had bone resorption, including 11 severe cases, 4 moderate cases, and 6 mild cases; the bone resorption sites included Gruen 1, 2, and 7 regions. Complications included 10 fractures and 1 prosthetic fracture. Local recurrence occurred in 3 patients and pulmonary metastasis in 3 patients. CONCLUSION Uncemented APC is a reliable method for the reconstruction of bone defects after proximal femur tumor resection. It has the good long-term effectiveness and possesses obvious advantages in the union at the bone-bone surface.
Adult ; Female ; Humans ; Male ; Allografts/pathology* ; Bone Neoplasms/surgery* ; Bone Resorption/pathology* ; Bone Transplantation/methods* ; Femur/surgery* ; Osteosarcoma/pathology* ; Prostheses and Implants ; Retrospective Studies ; Treatment Outcome ; Young Adult ; Middle Aged

Objective To evaluate the efficacy of the new treatment regimen versus the standardized scheme for the initial treatment of smear-positive tuberculosis in the elderly.Methods A total of 302 elderly patients meeting the inclusion and exclusion criteria were selected from 14 tuberculosis-designated medical institutions in Beijing.The patients received the initial treatment of smear-positive tuberculosis from January 2014 to August 2016 in the combined prospective and retrospective study.All patients were divided into observation group(n=63)receiving treatment with 6L2 HELfx regimen from August 1,2015 to August 31,2016,and control group (n =239) receiving treatment with 6L2HELfx regimen from January 1,2014 to January 31,2015.The nation-unified standard chemotherapy regimen 2RHZE/4RH was used in tuberculosis medical service institutions for all patients.The differences between the two groups were analyzed and compared in the completion of treatment,negative conversion of sputum culture or smear,adverse drug reactions and treatment outcome.Results The completion rate of long-course therapy was significantly higher in the observation group than in control group [90.5％ (57/63) vs.79.5％ (190/239),x2 =4.034,P =0.045].The rate of negative conversion of sputum culture or smear at the end of the 2nd month was higher in the observation group than in control group,but had no significant difference[87.0％ (47/54)vs.81.6％(155/190),x2 =0.879,P=0.349].The incidence of adverse reactions was much lower in observation group than in control group[46.0％ (29/63) vs.65.3％ (156/239),x2 =7.777,P =0.005].The success rate of treatment(cure or completion of long-course therapy)was higher in observation group than in control group [90.5％ (57/63) vs.77.4％ (185/239),x2 =5.350,P =0.021].ConclusioNS As compared with the standard chemotherapy regimen,the L and Lfxcontaining treatment regimen has better effects,higher success rate of treatment and less adverse reactions in elderly patients with the initial treatment of smear-positive tuberculosis.

Objective To explain the concept and surgical technique of 3D printing uncement radius distal prosthesis,evaluate and discuss the medium-term outcome of the prosthesis for giant cell tumor in distal radius.Methods From September 2015 to March 2017,13 patients diagnosed as giant cell tumor in distal radius were performed with en bloc resection combined with 3D print uncement prosthesis.All patients graded Campanacci Ⅲ or occurred local recurrence.Two patients with local recurrence had a local lesion curettage,inactivation and bone cement filling.There were 7 males and 6 females,with an average age of 37.8 years.Through the preoperative three-dimensional CT data,the 3D model of the distal radius was obtained based on the contralateral radius and the 3D printing uncemented distal radius prosthesis was made.Directly reconstrucion was conducted if the wrist joint ligament and joint capsule can be preserved.The surrounding soft tissue,remaining joint ligament and joint capsule were sutured to the prosthesis together combined with a brace if the wrist joint ligament and joint capsule can be only preserved partially.Radiocarpal joint was temporarily fixed by Kuntscher pin if the wrist joint ligament and joint capsule can't be preserved completely.Results In our series,the average resection length of the distal radius measured from the radial styloid process was 65.54±6.70mm.The length of prosthesis was consistent with the resection length and the length ratio of prosthesis to prosthetic stem is 1:1.The follow-up time was 17.77±4.97 months.There were no local recurrence and metastasis.At the end of the followup,except waist flexion,the wrist extension,wrist pronation,wrist supination,hand grip strength and Mayo wrist were significantly improved from 41.69°± 11.35°,41.92°± 11.09°,40.00°±7.64°,16.84±6.28 mmHg,47.69±9.27 points preoperatively to 57.46°±17.18°,55.00°±17.91°,53.46°±19.30°,23.08±6.29 mmHg,70.00±11.55 points,respectively.The DASH score was significantly decreased from 32.07±6.71 points to 19.15±8.41 points postoperatively.During surgery,there was one patient received temporary wrist fixation with kirschner's needle,which got a relatively poor postoperative function.Excluding this patient,comparing the resuits of 8 cases with directly suturing of wrist joint ligament and joint capsule and that of 4 cases with reconstructing by suturing and fixing with a brace,there were no statistical differences.There were no wrist dislocation or subluxation,aseptic prosthesis loosening,wrist joint degenerative changes or other prosthesis related complications.Conclusion 33D printing uncemented distal radius prosthesis is a good choice for the Campanacci grade Ⅲ or recurrent giant cell tumor in distal radius,because of its personalized design and uncemented fixation;in clinical application,we should pay attention to the evaluation of preoperative wrist joint capsule and surrounding ligament and the intraoperative soft tissue repair techniques.

OBJECTIVE: To summarize pseudocyst of auricle governor square included surgical curative effect, the advantages of the analysis of the operation. METHOD: The governor of the central square in auricle pseudocyst incision, 56 cases were retrospectively analyzed clinical data, surgical curative effect and advantages were summarized. RESULT: Adopt the auricle pseudocyst governor of the central square of incision, postoperative follow-up of 6 months did not relapse. CONCLUSION Rectangle window method effective method of treating pseudocyst of auricle, able to cure pseudocyst of auricle, is a kind of simple, practical, and value in the basic-level hospital surgical method.
Cysts ; surgery ; Ear Auricle ; pathology ; Ear Diseases ; surgery ; Humans ; Otologic Surgical Procedures ; methods ; Postoperative Period ; Retrospective Studies

Objective To analyze the complications,treatments and prognosis of simultaneous pancreas-kidney transplantation,especially on surgical complications and treatments.Method The causes and outcomes of surgical treatment in 70 cases of simultaneous pancreas-kidney transplantation performed between Dec.1999 and June 2012 were retrospectively analyzed in our center.Result Sixteen patients (22.9％) underwent one or more reoperations.The causes for reoperation were as follows:2 cases of hematuria,4 cases of abdominal hemorrhage,4 cases of abdominal infection,4cases of pancreatic thrombosis,2 cases of renal graft's artery rupture,1 case of renal allograft rupture,1 case of intestinal fistula,and 1 case of pancreatic fistula.Eight pancreas grafts were lost in the first year.Pancreatectomy was performed on the other 5 cases:4 cases of pancreatic thrombosis,1 case of intestinal fistula,accounting for 43.8％ of the patients subject to reoperation.The recipients,kidney,pancreas survival rate in reoperation group at 1 year was 87.5％,75％,and 56.3％ respectively; and that in control group at 1 year was 98.1％,98.1 ％,and 98.1 ％ respectively.There was significant difference in kidney survival rate (P＜0.01,chi-square =6.79),and pancreas survival rate (P＜0.01,chi-square =17.47) between two groups.Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with end-stage renal disease,surgical treatment due to complications is still an important factor in short-term survival on the grafts.

Objective To investigate the regulatory effect of hydrogen sulfide (H2S) on endoplasmic reticulum stress (ERS) and lipid metabolism in livers in apoE knockout (apo E-/-) mice.Methods Male C57BL/6 J mice and homozygous apoE mice were fed with a western type diet and randomly divided into four groups:C57BL/6 J control group (injected intraperitoneally with normal saline),apoE group (injected intraperitoneally with normal saline),apoE-/-+NaHS group (injected intraperitoneally with an H2S donor NaHS 56μmol · kg-1 · d-1) and apoE-/-+ DL-propargylglycine (PPG) group (injected intraperitoneally with an acystathionine-γ-lyase inhibitor PPG 30 mg ·kg-1 · d-1).After 10 weeks,all mice were sacrificed and plasma lipids were detected.Lipid deposition was determined by oil red O staining.Glucose-regulated protein78 (GRP78),Thr-981 phosphorylated double-stranded RNA-activated protein kinase like endoplasmic reticulum kinase (PERK),subunit of eukaryotic translation initiation factor-2α (elF-2α),low density lipoprotein (LDL) receptor (LDLR),sterol regulatory element binding protein-2 (SREBP-2) in the livers were detected by Western bloting.The expressions of GRP78 and SREBP-2 mRNA were analyzed by realtime polymerase chain reaction (RT-PCR).Results Compared with C57BL/6 J control group,plasma levels of total cholesterol (TC),triglyceride (TG) and low density lipoprotein (LDL),liver lipid content and expressions of GRP-78,PERK and eIF-2α were significantly increased in apoE-/-mice,but body weight did not change.Compared with apoE-/-mice,plasma LDL level was decreased,liver lipid deposition was improved,expressions of GRP-78 and PERK in livers were increased,and the ratio of p-eIF-2α/ eIF-2α was increased in apoE-/-+NaHS group,but expression levels of SREBP-2 and LDLR in liver did not change.Conclusions H2S decreases serum LDL level and liver lipid content,and up regulates GRP78 protein and mRNA expressions,promotes PERK and eIF2α phosphorylations,improves endoplasmic reticulum function,but has no effect on the expressions of SREBP-2 and LDLR in apoE-/-mice fed with a high-fat diet.

Background and objective Lymphatic metastasis is the most important way for the spread of lung cancer and is one of the important factors affecting the prognosis. Existing studies showed that compared to middle or lower lobe NSCLC, upper lobe non-small cell lung cancer (NSCLC) has a higher probability of occurring regional mediastinal lymph node metastasis. hTe purpose of this study is to research the prognostic factors and lymphadenectomy of stage Ib upper lobe NSCLC. Methods A retrospective study of 147 consecutive subjects (76 and 71 for right and letf upper lobe NSCLC respec-tively) who had undergone curative resection for stage Ib upper lobe NSCLC was performed. A total of 925 lymph nodes were removed during the surgery in all enrolled patients and a total of 491 mediastinal lymph nodes (266 and 225 for superior and inferior mediastinal lymph nodes respectively) were removed. Kaplan-Meier product method and Log-rank test were used for univariate survival analysis and Cox regression model was used for multivariate survival analysis. Results ①Both univariate and multivariate analysis showed that age, tumor size and number of removed superior mediastinal lymph node stations were the important prognostic factors of stage Ib upper lobe NSCLC;②For stage Ib right upper lobe NSCLC, station 4 lymph node was of statistical signiifcance to the prognosis (P=0.021);while for stage Ib letf upper lobe NSCLC, station 5 lymph node was of statistical signiifcance to the prognosis (P=0.024). Conclusion In surgically treated stage Ib upper lobe NSCLC patients, age, tumor size and number of removed superior mediastinal lymph node stations are the important prognostic factors. And in this kind of patients, lobe-speciifc systematic lymph node dissection may be a more effcient procedure during the surgery.

It is for estimating the laboratory statistics from the view of clinical medicine objectively,completely and appropriately that we establish ＜ Laboratory Sciences and Clinical Medicine ＞ which fits the requirement for the modern medical laboratory specialists. In this selective course, we use problem-based learning ( PBL ) teaching method which is different from the traditional one, stimulating students to participate in the study actively and passionately,training them to think in a scientific way and to analyse and solve the problem in a rational way. As a result, it works well which makes us believe it is worth popularizing.

For the reform and development of clinical laboratory education, based on the previous course reform, Laboratory Medicine College of Chongqing Medical University has put the leading teachers'responsibility system of laboratory medicine course into practice. In the recent 3 years, the course is better organized.The students are more interested in the course and they communicate more with teachers than ever before. The effect of the course is obvious. The leading teachers' responsibility system in laboratory medicine course should be promoted.