ObjectiveTo evaluate the clinical efficacy of Chaigui Zengmian prescription （composed of Bupleuri Radix， Codonopsis Radix， Scutellariae Radix， Cinnamomi Ramulus， Paeoniae Radix Alba， Astragali Radix， Atractylodis Macrocephalae Rhizoma， and Scorpio） in treating recurrent respiratory tract infections in children with syndrome of Qi deficiency in lung and spleen and the influences of this prescription on immune factors. MethodSixty-six children suffering from recurrent respiratory tract infections due to Qi deficiency in lung and spleen were selected and randomized into a control group （33 cases） and an observation group （33 cases）. The control group received spleen aminopeptide oral lyophilized powder and the observation group was treated with self-made Chaigui Zengmian prescription granules. Both groups were treated for two months （as two consecutive courses of treatment）. The traditional Chinese medicine （TCM） symptom scores and the serum levels of total immunoglobulins （IgA， IgM， and IgG） and T-helper cells （Th1， Th2， and Th1/Th2） were measured in both groups before and after treatment and then compared. Result① After treatment， the TCM symptom scores of both groups declined and the observation group had lower scores than the control group （P<0.05）. ② The observation group［87.50%（28/32）］ had higher total response rate than the control group［96.88%（31/32）］（Z=7.921，P<0.05）.Also the observation group［28.13%（9/32）］ had more cured children than the control group［6.25（2/32）］ （χ²=5.379，P<0.05） ③ After treatment， the serum levels of IgA， IgM， IgG， Th1， and Th1/Th2 elevated while that of Th2 declined （P<0.05）， and the changes were more obvious in the observation group than in the control group （P<0.05）. ConclusionChaigui Zengmian prescription is effective in treating recurrent respiratory tract infections in children with the syndrome of Qi deficiency in lung and spleen. It can alleviate the symptoms and rectify immune disequilibrium， demonstrating a clinical application value.

Objective Analyzing risk factors for prolonged ICU stay after cardiac surgery of Infective Endocarditis(IE)provides a basis for preventing extended ICU durations in postoperative IE cases.Methods From January 1,2019,to March 31,2021,a total of 223 patients with infective endocarditis who underwent cardiac surgery in the cardiac surgery department of Guangdong Provincial People's Hospital were included.Patients were divided into non-prolonged group(<3 days)and prolonged group(≥3 days)based on postoperative ICU stay duration.There were 156 cases in the non-prolonged group and 67 cases in the prolonged group.Single-factor analysis of risk factors for prolonged ICU stay was conducted using t-tests or rank-sum tests.Variables with P<0.05 in the single-factor analysis were further subjected to binary logistic regression for multivariate analysis.The accuracy of the model was evaluated using the ROC curve.Results Among the 223 patients,67 experienced prolonged ICU stay,with an incidence rate of 30%.Single-factor analysis results included gender,age,history of coronary heart disease,history of stroke,preoperative heart failure,aortic valve regurgitation area,left ventricular end-diastolic diameter,left ventricular ejection fraction(LVEF)<60%,extracorporeal circulation time,aortic cross-clamp time,use of Intra-Aortic Balloon Pump(IABP),endotracheal tube reintubation,pulmonary infection,use of Continuous Renal Replacement Therapy(CRRT),and prolonged mechanical ventilation time(>24 hours),among others.Multivariate analysis results revealed that preoperative LVEF<60%(OR=3.004,P=0.041),postopera-tive use of IABP(OR=31.686,P=0.008),and mechanical ventilation time>24 hours(OR=8.135,P<0.001)were independent risk factors for prolonged ICU stay after cardiac surgery.The model's AUC value for predicting risk factors for prolonged ICU stay was 0.858(95%CI:0.806～0.901,P<0.001).Conclusion Preoperative left ventricular ejection fraction(LVEF)<60%,the use of IABP,and mechanical ventilation time>24 hours were identified as independent risk factors for prolonged ICU stay after infective endocarditis(IE)surgery.In clinical practice,it is important to comprehensively address and manage various risk factors with the aim of reducing ICU stay duration and improving the overall success rate of the surgery.

Objective To screen the distribution frequency of Mur blood group among voluntary blood donors in Hezhou,Guangxi,and further analyze the molecular basis of of Mur antigen positive samples.Methods The Mur pheno-type of voluntary blood donors in Hezhou was serologically screened using microplate method,and the distribution frequency of Mur antigens in different ethnic groups was analyzed.Genetic typing was performed on these positive samples with PCR-SSP method to verify the accuracy of the serological method,and the genetic background was sequenced and analyzed.Re-sults Among 3 298 samples from voluntary blood donors in Hezhou,432(13.10%,432/3 298)were screened positive for Mur antigen,and PCR-SSP genotyping validation showed that all 432 samples were electrophoretic positive.Among them,the proportion of Han blood donors with positive Mur antigen was12.79%(331/2 587),Yao ethnic group was13.25%(64/483),Zhuang ethnic group was 16.51%(36/218),and no statistically significant difference was found in the three groups(P＞0.05).Further sequencing results showed that 428 samples were GYP(B-A-B)Mur,also known as GYP.Mur type(12.98%,428/3 298),the other 4 samples were GYP(B-A-B)Bun,also known as GYP.Bun type(0.12%,4/3 298).Conclusion The Mur blood type frequency is high in the voluntary blood donors in Hezhou,Guangxi,and is predominant characterized by GYP.Mur genotype.Due to ethnic integration,no significant difference was noticed in the frequency of Mur blood type distribution between Han,Zhuang and Yao population.Therefore,conducting extensive Mur blood group antigen and antibody testing in Hezhou is of great significance for ensuring clinical blood transfusion safety.

PURPOSE: Adipogenic differentiation of adipose tissue-derived mesenchymal stem cells (AMSCs) is critical to many disease-related disorders, such as obesity and diabetes. Studies have demonstrated that miRNA-138 (miR-138) is closely involved in adipogenesis. However, the mechanisms affected by miR-138 remain unclear. This work aimed to investigate interactions between miR-138 and lipoprotein lipase (LPL), a key lipogenic enzyme, in AMSCs. MATERIALS AND METHODS: Human AMSCs (hAMSCs) isolated from human abdomen tissue were subjected to adipogenic differentiation medium. Quantitative real-time polymerase chain reaction and Western blot assay were applied to measure the expressions of miR-138, LPL, and the two adipogenic transcription factors cytidine-cytidine-adenosine-adenosine-thymidine enhancer binding protein alpha (C/EBPα) and peroxisome proliferator-activated receptor gamma (PPARγ). The relationship between miR-138 and LPL was predicted utilizing the miRTarBase database and validated by dual luciferase reporter assay. RESULTS: Showing increases in C/EBPα and PPARγ expression levels, hAMSCs were induced into adipogenic differentiation. During adipogenesis of hAMSCs, miR-138 expression was significantly downregulated. Overexpression of miR-138 by transfection inhibited hAMSCs adipogenic differentiation in vitro. Mechanically, LPL was a target of miR-138. LPL expression was upregulated during adipogenesis of hAMSCs, and this upregulation was reversed by miR-138 overexpression. Functionally, silencing of LPL by transfection exerted similar inhibition of the expressions of C/EBPα and PPARγ. Meanwhile, LPL ectopic expression was able to partly abolish the suppressive effect of miR-138 overexpression on adipogenic differentiation of hAMSCs. CONCLUSION: Upregulation of miR-138 inhibits adipogenic differentiation of hAMSCs by directly downregulating LPL.
Abdomen ; Adipogenesis ; Blotting, Western ; Carrier Proteins ; Ectopic Gene Expression ; Humans ; In Vitro Techniques ; Lipoprotein Lipase ; Lipoproteins ; Luciferases ; Mesenchymal Stromal Cells ; Obesity ; PPAR gamma ; Real-Time Polymerase Chain Reaction ; Transcription Factors ; Transfection ; Up-Regulation

Objective: To study the treatment of huge empyema with free vastus lateralis muscle flap. Methods: From May 2015 to December 2015, 3 cases of empyema were treated with free vastus lateralis muscle flaps, (unilateral vastus lateralis muscle flap, n=2; bilateral vastus lateralis muscle flaps with Flow-through technique, n=1). The volumes of defects were 12.4 cm×5.1 cm×6.4 cm, 11.8 cm×6.9 cm×5.6 cm, and 14.4 cm×7.6 cm×9.4 cm, respectively. Result: All flaps was survived after 23-29 months follow-up. The pus cavities were filled well. There was no empyema reoccurred. The patients felt good, without chest distress. The donor site of flap healed well. The function of lower limb was not affected. Conclusions Vastus lateralis muscle can fill the pus cavity of empyema successfully, without the sacrifice of chest shape. Free vastus lateralis muscle flap is an ideal choice to repair large empyema defection. For young patient, bilateral free vastus lateralis muscle flap can be used if the cavity is too large to fill with one flap.

82 spastic cerebral palsy and normal children were selected, including 27 younger and 27 older spastic cerebral palsy( observation group) ,and 14 younger and older normal children( control group) . The tumor necrosis factor α( TNF-α) levels were measured in the serum with ELISA. The TNF-α levels in the serum of the younger and older spastic CP groups were higher than those of the control groups ( P<0.01 ) . In observation groups, the TNF-α levels of younger spastic cerebral palsy were higher than those of the older (P<0.01). On the contrary, the normal children in the control group of different ages had no difference of TNF-α. TNF-αexpression was signifi-cantly higher in the serum of the spastic CP group than that in the control group ( P<0.01 ) . TNF-α expressed continuously in vivo of children with spastic cerebral palsy involve subsequent brain injury.

BACKGROUND: Whether the differences exist between adipose-derived stem cells isolated from different parts of rats when cultured in vitro has been poorly understood. OBJECTIVE: To compare the growth characteristics and adipogenic ability of adipose-derived stem cells isolated from different parts of rats. METHODS: Freshly isolated adipose-derived stem cells were obtained from 5 mL inguinal groove and greater omentum adipose tissue of F344 rats using type Ⅰ col agenase digestion method. Then, adipose-derived stem cells were counted and cultured in vitro. Morphological and growth characteristics of adipose-derived stem cells derived from the two sites were observed. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was utilized to examine the doubling time of adipose-derived stem cells from different parts. The passage 2 adipose-derived stem cells were induced adipogenical y. Fourteen days after being induced, the differentiated cells were stained with oil red O and the positive cells were counted. The adipogenic differentiation ability of adipose-derived stem cells from the different parts was assessed. RESULTS AND CONCLUSION: (1) The number of adipose-derived stem cells from the greater omentum fat tissue in the same group was (281±10)×107/L, which was significantly higher than that from the inguinal groove fat tissue [(85±10)×107/L] (P < 0.01). Adipose-derived stem cells from the greater omentum and inguinal groove fat tissue achieved the exponential growth period on days 5 and 6, respectively, and achieved the platform period on days 9 and 10, respectively. The corresponding doubling time was 50 hours and 60 hours, respectively. After being passaged, adipose-derived stem cells grew in fibroblast-like shape actively. The adipogenic differentiation rate of adipose-derived stem cells from the greater omentum fat tissue was higher than that from the inguinal groove fat tissue [(38.90±2.86)% vs. (35.30±3.29)%, P < 0.01]. This shows that the number and the adipogenic differentiation ability of adipose-derived stem cells from different parts of the same F344 rat are different.

Objective To explore the clinical value of transumbilica single-port laparoscopic surgery in the treatment of bilateral varicocele.Methods From Jan. 2010 to Sep. 2010,42 patients with bilateral varicocele underwent laparoscopic high ligation of bilateral spermatic vein.Of these patients,20 were treated with transumbilica single-port laparoscopic surgery,22 with traditional laparoscopic surgery.The two groups of patients were compared for the parameters such as intraoperative blood loss,testicular artery preservation,operating time,time of activities after surgery,time of intestinal function recovery and hospitalization duration.The semen quality 1 year after the surgery was compared with that before treatment.At the out-patient re-examination at 1,3,6months and 1 year after the surgery,the incision,scrotum,spermatic cord,testis were checked for possible complications.The relief of discomfortness in the scrotum was also followed up.Results Both operation procedures were successful,without severe complications.In the single-port laparoscopic surgery produced blood lose ( [ 5 ± 1 ] ml vs.[ 5 ± 1 ] ml,t =- 0.452,P ＞ 0.05 ),the operating time ( [ 41 ± 7 ] min vs.[ 39 ± 3 ] min,t =0.686,P ＞ 0.05 ),postoperative intestinal function recovery time ( [ 11 + 1 ] h vs.[ 11 + 2 ] h,t =- 1.631,P ＞0.05 ) and postoperative hospital stay ( [ 3.1 + 0.7 ] d vs.[ 3.4 + 0.7 ] d,t =- 1.447,P ＞ 0.05 ) which were all comparable to that from conventional laparoscopic surgery.There was significant difference in the population using analgesics,single-port laparoscopic surgery vs.conventional laparoscopic surgery ( 1 case [ 5.0％ ] vs 7case [ 31.8％ ].The difference was statistically significant (x2 =4.886,P ＜ 0.05 ).The single-port laparoscopic surgery produced neglectable scar at the incision.All of the patients were questionaired for their satisfaction with the incision 1 year after the surgery.The difference was statistically significant (x2 =7.636,P ＜ 0.01 )Conclusion Single-port laparoscopic high ligation of bilateral spermatic vein produces comparable outcomes to that of conventional laparoscopic surgery,but it is a more microinvasive procedure producing good aesthetic appearance,representing the trend of laparoscopic technique.

Objective To evaluate the effect of auxiliary trocar located on various positions on obese patients treated with retroperitoneoscopic radical nephrectomy.MethodsRetrospective analysis was performed for 61 consecutive obese patients who underwent retroperitoneoscopic radical nephrectomy for localized renal cell carcinoma at our institution from March 2004 to December 2010.An auxiliary trocar was placed into retroperitoneal space according to the position of tumor.It was placed infro-costal magin in the mid-axillary line with uppre-median pole tumor,and 4 cm medial to mid-axillary line and 1 cm cephalad to illac spine with lower-median pole,respectively.ResultsAll 61 patients were completed successfully with no conversion to open surgery.Mean operating time was ( 153.1 ± 23.5 ) min.Mean estimated blood loss was (57.6 ±29.7) ml.Mean hospital stay after operation was (5.7 ±2.6) d.The rupture of peritoneum and liquefaction of fat were occurred in 5 and 4 patients respectively.There was no major intraoperative and postoperative complications occurred.Conclusions Reasonable position of the auxiliary trocar according to the tumor's location would be safe and feasible on obese patients treated with retroperitoneoscopic radical nephrectomy.Obese patients with localized renal cell carcinoma would better benefit from minimally invasive procedure.

Objective To introduce a new method for correcting prominent malar complex deformity. Methods Through an intraoral incision, the highest area of zygomatic body marked preoperatively was grinded. Then an L shape incomplete osteotomy of the zygomatic body was performed with a reciprocating saw, and a complete osteotomy just 1 cm anterior to the articular tubercle of the zygomatic arch was made. Light pressure on the posterior part of the arch produced a greenstick fracture of the anterior osteotomy site, resulting in posterior-inward repositioning of the malar complex. Internal fixation was unnecessary. Results Operative procedures for reductive malar complex plasty were performed in 650 cases, which included 60 males and 590 females whose age ranged from 19 to 39 years.Incisions of all cases healed well. One case had maxillary sinusitis 2 weeks postoperatively, and recovered after 1 week by using antibiotics and drainage. There was 1 case with skin necrosis about 1 cm in diameter in the area of zygomatic body because of local liposuction, and the wound was healed by changing dressing. The forehead wrinkle of one side had disappeared in 1 case 1 week postoperatively, but had recovered 2 weeks later. Postoperative follow-up for 2-24 months showed satisfactory results.Conclusions This modified method has many advantages, such as simplicity, without internal fixation, short operation and recovery time, and little complications. The authors conclude that this technique is an effective and safe method of reduction malarplasty.