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@#Objective To investigate the optimal treatment scheme for the first primary spontaneous pneumothorax (PSP) in young patients. Methods The clinical data of 171 patients with the first PSP were retrospectively analyzed who were treated in Huaihe Hospital of Henan University between November 2011 and October 2017. There were 157 males and 14 females with a median age of 18 years at onset and a median body mass index of 18.51 kg/m2. According to the treatment methods, they were classified into two groups, a conservative treatment group (a non-surgical group, n=86) and a surgical group (n=85). The characteristics including clinical data, efficacy evaluation criteria, complications and recurrence of the two groups were analyzed. Results As a result, 73.68% of the patients suffered PSP in their daily routine. The drainage duration in the non-surgical group was longer than that in the surgical group (4 d vs. 3 d, P=0.008). There was no statistical difference in the success rate of lung re-expansion between the two groups (98.85% vs. 100.00%, P=1.000). The proportion of the surgical group using postoperative analgesic drugs was higher than that in the non-surgical group (48.23% vs. 10.46%, P=0.000). The recurrence rate of the surgical group was lower than that of the non-surgical group (3.53% vs. 46.51%, P=0.000). No relationship between smoking and recurrence of pneumothorax was found in both groups (P=0.301, P=1.000). The success rate of lung re-expansion in the non-surgical group was not statistically different between the 24F subgroup and the 12F subgroup (39/39 vs. 33/34, P=0.458). No advantage of intraoperative pleural fixation was found in the surgical group (P=0.693). Conclusion Thoracoscopic surgery is the first choice for the treatment of the first PSP in young patients.
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Objective To explore the application of protective restrain nicrovideo in the skill training of psychiatric low qualification nurses.Methods Totally 108 psychiatric low qualification nurses were trained with protective restrain micro video.Two microvideos were produced for theory part;for practice part,three cases of restrain were adopted and three microvideos were produced via standardized patients play and nurse scene simulation.Each microvideo was played through the platform for each week,combining periodic evaluation,which served as training for low qualification nurses.Five weeks after training,theory and practice evaluation were performed,and self-designed questionnaire was used to investigate feedbacks from nurses with regard to protective restrain training using microvideos.Clinical practicing effects were surveyed after six months.Results After the training,all the nurscs met the standard,with a good score of 95.4％.88.9％ of the nurses said the training stimulated the learning interest and initiative,94.4％ of nnrses and 93.3％ of head nurses said that training standardized the restrain behavior,90.7％ of nurses and 93.3％ of head nurses said that it could improve the ability of solving clinical emergency.After training,the injury ratc of nurses was significantly reduced,and the qualification rate of restrain nursing and restriction record and patient satisfaction were significantly improved (P＜0.05).Conclusion Protective restrain microvideo can stimulate nurse's learning interest,regulate nursiug behavior,inprove clinical nursing quality and reduce injury rate.
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Objective To investigate the two kinds if thoracic cavity closed drainage contrast analysis and evaluate the pigtail catheter for treatment of spontaneous pneumothorax in adolescents.Methods This study included 53 adolescent patients with the first spontaneous pneumothorax in Huaihe Hospital of Henan University between January 2013 and December 2015.According to the different operation ways,they were divided into two groups:silicone tube and pigtail catheter group.The following post-operative data was evaluated:pain,subcutaneous emphysema,drainage time,hospital stay,new drain insertion,and wound healing at the site of insertion.Results There were 32 patients in the silicone tube group and 21 ones in the other group.The data revealed a significantly reduced the operation time and pain in the pigtail catheter group compared to the chest tube group(P ＜ 0.05).However,no statistical differences in success rate,postoperative hospital stay and complications incidence were found between the 2 groups.Conclusion Compared to common chest tube,the employment of pigtail catheter in the adolescent patients with pneumothorax significantly reduces the operation time and pain.Nevertheless,no statistically significant differences were discovered in success rate,postoperative hospital stay and the incidence of complications between the two corresponding groups.Thus pigtail catheter is competent in terms of closed thoracic drainage in adolescents who are the first diagnosed as spontaneous pneumothorax.
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Objective To construct the DNA vaccine pIRES2-MLAA34-HSP70,and to detect its immune effect.Methods The acute monocytic leukemia associated antigen gene MLAA-34 and heat-shock protein (HSP)70 gene were extracted by using RT-PCR.The specific overlapping primer was designed,and the fusion gene MLAA34-HSP70 was amplified by using SOE-PCR technique.Then the DNA vaccine pIRES2-MLAA34-HSP70 was constructed,and BALB/c mice were immunized with this DNA vaccine.The splenic lymphocyte killing activity was detected by using MTT,levels of IL-2,IL-4 and IFN-γ were also detected by using ELISA.Results The MLAA34-HSP70 gene (2 956 bp) and the DNA vaccine pIRES2-MLAA34-HSP70 was amplified and constructed successfully.The killing efficiency of DNA vaccine pIRES2-MLAA34-HSP70 in U937 cells was significantly higher than that in other experimental groups and control group (P＜0.01),and levels of IL-4,IL-2 and IFN-γin DNA vaccine pIRES2-MLAA34-HSP70 group were significantly higher than those in the other experimental groups and control group (P＜0.01).Conclnsion The DNA vaccine pIRES2-MLAA34-HSP70 is constructed successfully.It is shown that the DNA vaccine induces strong humoral immunity,which could enhance immune responses to tumor cells and specificlly kill MLAA34 positive cells.
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The definition and function of epidemiological investigation report on food safety accident is described and its impact on the business behavior,civil liability,administrative responsibility,and criminal responsibility of food producers,marketers,supervisory and management department is presented.It suggests that center for disease prevention and control should give attention to timeliness,authenticity,accuracy,normalization of epidemiological investigation report on food safety accidents and cases.The purpose is to avoid accountability on investigation of food safety accidents and ensure the epidemiological investigation report not been challenged in legal proceedings as evidence.
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To construct the pIRES2-MLAA34-HSP70 recombinant vector and express the MLAA34-HSP70 recombinant proteins in Escherichia coli [E. coli]. The MLAA34 and the HSP70 genes were extracted from U937 cells by RT-PCR, and then we amplified the fusion gene MLAA34-HSP70 by SOE-PCR and inserted it into the pIRES2-EGFP vector to construct the pIRES2-MLAA34-HSP70 recombinant vector. We amplified the fusion gene MLAA34-HSP70 successfully and identified the correctness of pIRES2-MLAA34-HSP70 recombinant vector by PCR and restriction endonuclease. Moreover, the MLAA34-HSP70 recombinant proteins expressed in E. coli were consistent with the expected molecular weight. We constructed the pIRES2-MLAA34-HSP70 recombinant vector successfully and the MLAA34-HSP70 recombinant proteins were successfully expressed by the induction of IPTG
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Apoptosis Regulatory Proteins , Antigens, Neoplasm , Artificial Gene Fusion , Gene Fusion , Polymerase Chain Reaction , Escherichia coli , Vaccines, DNAABSTRACT
Some locally advanced tumors involving multiple abdominal organs without distal metastasis may cause digestive tract obstruction.Some of these patients can achieve long-term survival after Ro resection,others can obtain digestive tract obstruction relief,pain anesis and survival prolongation after R1 resection combined with postoperative comprehensive treatment.In this review,the efficacy of complex pancreaticoduodenectomy combined with organs resection was introduced based on reviewing the literatures.After the surgery,some patients achieved R0 resection and long-term survival,and the quality of life was significantly improved in some patients.
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Objective To evaluate the correlation between plasma D dimer levels and ovarian cancer, as well as its pathologic staging.Methods According to the inclusion and exclusion criteria , articles published about the correlation between plasma D dimer levels and human ovarian cancer were searched by means of PubMed , Embase, CNKI and WanFang Data from their inception to December 31th , 2013.In addition , references′list of the included articles and their related citations in Pubmed were also reviewed for additional articles.After quality assessment of all studies , Meta-analysis and ANOVA were performed with RevMan 5.2 and SAS 9.1 for statistic analysis.Results A total of 13 articles were identified, including 679 cases of ovarian cancers , 685 cases of benign controls and 477 cases of healthy controls.Meta-analysis revealed that:(1) Plasma D dimer levels in ovarian cancer groups were higher than that in benign control groups ( Z =8.61, P <0.000 01 ) and healthy control groups ( Z =6.76, P <0.000 01);(2) Plasma D dimer levels in benign control groups were higher than that in healthy controls (Z=3.15, P=0.002); (3) Plasma D dimer levels in advanced ovarian cancer FIGO (Ⅲ-Ⅳ) were higher than that in early cancer FIGO (Ⅰ-Ⅱ) (Z=3.38, P=0.000 9);(4)But there were no difference between relapse groups and remission groups (Z=1.19, P=0.23).ANOVA revealed that:(1) There were significant difference of D dimer levels among ovarian cancer groups or benign groups , healthy control groups; ( 2 ) Significant increasing of D dimer levels was revealed by Pairwise ANOVA from healthy controls, benign controls to ovarian cancer.Conclusions Plasma D dimer levels were high in patients with ovarian cancer , especially in FIGO (Ⅲ-Ⅳ) ovarian cancer.No difference of D dimer levels were investigated between relapse phase and remission phase.
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In recent years,with increasing investment on laboratory medicine scientific research in China,the project management,implementation,evaluation system and quality improvement become more and more important for research managers and executives.In this paper,the main problems of project execution and implementation and accordingly proposed some constructive suggestions were analysed,in the aspects of the leading role of principal investigator,periodical discussion,peer guidance,scientific progress management,effective using of project funds and the establishment of appropriate reward and punishment mechanisms.It is hoped that these suggestions can be used to achieve success in laboratory medicine research project.
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<p><b>OBJECTIVE</b>To examine the incidence of hepatitis B virus (HBV) S gene mutation in recipients with recurrent HBV infection after liver transplantation (LT) and to evaluate the clinical significance of these mutants.</p><p><b>METHODS</b>Two-hundred-and-ninety-nine patients who received LT for HBV-related liver diseases in single centre were enrolled in the study and followed up. Serum HBV DNA was amplified by fluorescence quantitative polymerase chain reaction, and HBV-S gene mutation was detected by Sanger's enzymatic method.</p><p><b>RESULTS</b>Twelve of the 299 patients developed recurrent HBV after LT, and 2 of these 12 carried a mutant of the HBV-S gene (incidence rate of 16.67%). One of the patients had T126I and G145A mutations, and the other had a M 133L mutation. Cox regression modelling identified the risk factors of HBV recurrence after LT as HBV-YMDD mutants (P =0.01), HBV-S mutants (P =0.03) and compliance decrease (P =0.03).</p><p><b>CONCLUSION</b>HBV-S mutants may contribute to recurrence of HBV after LT, and the mechanism should be addressed in future studies.</p>
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Adult , Female , Humans , Male , Middle Aged , DNA, Viral , Genetics , Genetic Variation , Hepatitis B , Virology , Hepatitis B virus , Genetics , Liver Transplantation , Mutation , Postoperative Period , Recurrence , Viral Envelope Proteins , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical pathology of recurrent hepatitis B after orthotopic liver transplantation (OLT).</p><p><b>METHODS</b>The clinical manifestation and hepatic pathological characteristics of 12 patients with recurrent hepatitis B after OLT were examined in this study by using hematoxylin and eosin staining,immunochemical staining of hepatitis B surface antigen and hepatitis B core antigen,tissue in situ hybridization of hepatitis B virus (HBV) DNA, and Mallory's trichrome staining.The survival rate of these OLT patients was assessed by Kaplan-Meier analysis.</p><p><b>RESULTS</b>The early stage of recurrent HBV infection in patients with OLT was characterized by active HBV replication and mild-to-moderate inflammation in the liver. Three of the 12 patients who were treated with combination therapy group were carriers of YMDD mutants and all three showed improvement in liver function and hepatic histology after receiving adefovir dipivoxil,instead of lamivudine,in the early stage of recurrent hepatitis B after OLT. Among the patients treated with lamivudine monotherapy, four did not achieve improvement at the early stage of recurrent hepatitis B and developed fibrosing cholestatic hepatitis (FCH).</p><p><b>CONCLUSION</b>Recurrent hepatitis B in patients who underwent OLT was characterized by mild-to-moderate viral hepatitis at the early stage and FCH at the later stage. Effective antiviral intervention at the early stage may reverse recurrent hepatitis B and prevent the disease progression to fatal FCH.</p>
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Humans , Adenine , Antiviral Agents , Hepatitis B , Pathology , Hepatitis B Core Antigens , Hepatitis B Surface Antigens , Hepatitis B virus , Lamivudine , Liver Transplantation , Organophosphonates , RecurrenceABSTRACT
OBJECTIVE@#To systematically evaluate the efficiency and safety of total thyroidetomy (including near-total tyhroidectomy) versus subtotal thyroidectomy for multinodular goiter.@*METHODS@#The literatures were searched from Cochrane Library, PubMed, Embase, Chinese Biological Medical Datebase, Chinese National Knowledge Infrastructure, and Chinese Science and Technology Journal Full-text Database as of November 2013. We included all randomizad controlled trials on total (including near-total) versus subtotal thyroidectomy in the treatment of multinodular goiter. The collecting of data and quality assessment were respectively completed by 2 researchers. RevMan5.1 software was used for Meta-analysis.@*RESULTS@#We collected 7 literatures conforming to the standard, incuding 2 192 patients. The Metaanalysis outcomes showed that total thyroidectomy was associated with lower nodule recurrence rate (OR=0.13, 95% CI: 0.07-0.22, P<0.001) and higher in transient hypoparathyroidism rate (OR=2.33, 95% CI: 1.72-3.17, P<0.001). However, no statistical difference was seen comparing total and subtotal thyroidectomy in permanent recurrent laryngeal nerve paralysis rate (OR= 0.81, 95% CI: 0.24-2.74, P=0.74) and permanent hypoparathyroidism rate (OR=2.94, 95% CI: 0.48- 18.11, P=0.24).@*CONCLUSION@#Nodule recurrence rate of total thyroidectomy for multinodular goiter is lower than subtotal thyroidectomy and does not increase permanent complications.
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Humans , Goiter, Nodular , General Surgery , Hypoparathyroidism , Randomized Controlled Trials as Topic , Recurrence , Thyroidectomy , Methods , Vocal Cord ParalysisABSTRACT
Objective To explored vascular epithelium growth factor (VEGF) and transforming growth factor-β1 (TGF-β1) expression profiles in rat liver regeneration after selective portal vein embolization (SPVE).Methods The SPVE model was constructed by embolization of the left portal vein and regenerative liver tissues were collected in postoperative days 1-9.Fifty of the SD rats were divided into the SPVE group (45 rats) and control group (5 rats).The expressions of VEGF and TGF-β1 in regenerative rat liver tissues were detected with immunohistochemistry and Western blot.The relationship between VEGF/TGF-β1 and time-phased rat liver regeneration was analyzed.Results In the SPVE group compared to the control group,the expression of VEGF increased from post operative day 1 to 5,peaking at day 5.The expression of TGF-β1 increased from post operative day 3 to 7,peaking at day 7.Conclusions The results suggest that after SPVE,VEGF fluctuation may correlate with the start of hepatic regeneration,and TGF-β1 fluctuation may correlate with the termination of hepatic regeneration.
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Radical pancreaticoduodenectomy is extremely important for patients who suffered from pancreatic head cancer achieving long-term survival.Accurate understanding on composition of resection margin of pancreaticoduodenectomy specimens is pivotal for standardized labeling and testing.Standardization of pathological examination and accurate diagnosis of surgical margin status play an important role in prognosis of patients.Currently,different centers have a different definition of surgical margins for pancreatic head cancer.In this paper,based on the related literature,the authors discuss issues related to surgical margins of pancreatic head cancer.
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Objectives To study the current prevalence and recent epidemiological changes of Helicobacter pylori (H. pylori) infection among children and adults residing in regions with high ( Muping, Shandong) and low (Yanqing, Beijing) incidence of gastric cancer in China. Methods A total of 2065 asymptomatic children aged 8-15 years and adults aged 40-79 years in the above two regions were examined from May to July 2006. The data obtained in early 1990s in the same two areas and those of 11 656 patients undergoing endoscopy in our hospital in 1991 and 2006 were also collected and studied. Results The prevalence ofH. pylori infection in Muping was significantly higher than that in Yanqing among both children (37.69% vs25.58%, P<0.001) and adults (50.95% vs41.35%, P < 0. 01 ). From 1991 to 2006 H. pylori prevalence among children aged 8-10 years decreased in Muping (60. 00% vs 32. 07% , P < 0.001), but not in Yanqing (24.06% vs 19.10%, P > 0. 05 ) . A significant decrease in H. pylori prevalence among adults in both regions was observed when the results of 2006 were compared with the data obtained in 1990 in Muping (50.95% vs 73.78% , P < 0. 001 ) and in 1992 inYanqing (41.35% vs 55. 35% , P < 0. 01 ) . The detected rate of H. pylori infection in patients undergoing endoscopy in our hospital decreased from 51. 88% in 1991 to 33. 59% in 2006 (P <0. 001). Conclusions The prevalence of H. pylori infection is significantly higher in areas with a high incidence of gastric cancer in China as compared with that in areas with a low incidence of gastric cancer among both children and adults. H. pylori infection may be a risk factor in gastric carcinogenesis. In the past decade or more, H.pylori infection rates have decreased in Chinese population.
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Objective To investigate the incidence of peptic ulcer (duodenal ulcer and gastric ulcer) and the development of Helicobacter pylori (Hp) infection in the population during 10 years after Hp eradication.Methods Subjects were chosen from general population and performed endoscopy.Among them,the individuals confirmed to be Hp positive were randomly divided into treatment group and placebo group.The patients in treatment group received OAC triple therapy (omeprazole 20 mg,clarithromycin 500 nag and amoxicillin 1000 re.g,twice daily) for one week.After that,both groups continuously followed up by endoscopy during at 1st,5th,8th and 10th year for incidence and relapse of peptic ulcer as well as status of Hp infection.The patients in treatment group were examined by 13C-UBT for Hp eradication one month after the completion of treatment.Results At the 1st year,the incidence of peptic ulcer between the treatment group and placebo group were 3.7% and 12.85% (P=0.0002),respectively.At the 5th year,they were 5.86% and 14.93% (P=0.0017),respectively.At the 8th year,they were 4.4% and 9.39% (P = 0.044),respectively.The incidence of peptic ulcer of the treatment group significantly decreased after the eradication therapy compared to the placebo group.After the eradication,at the 1st year,the recurrence rates were 3.70% and 38.1% between the treatment group and the placebo group (P=0.0027).At the 5th year,they were 14.81% and 42.86% (P=0.03).At 8th year,they were 14.81 and 47.62% (P=0.03),respectively.At the 10th year,they were 25.93% and 57.14% (P=0.028).Then the recurrence rates of the treatment group significantly decreased compared to the placebo group.During the 10-year follow up study,the rate of Hp reinfection after a successful eradication in the treatment group was high,and it was 46.4% at the 10th year.Conclusion Both the incidence and recurrence of peptic ulcer significantly decreased after Hp eradication.It is necessary of Hp eradication in patients with peptic ulcer.Hp reinfection after a successful eradication is more frequent.
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Objective To evaluate the protective effects of hydrotalcite,Marzulene-s,selbex,gefarnate,sucralfate and rebamipide against the gastric mucosa lesions induced by ethanol,aspirin,hydrochloric acid or prednisolone in rats.The changes in intercellular space width of gastric epithelial in rats was observed. Methods Four kinds of models were used to observe the protective effects of six agents against the gastric mucosal lesions.① Ethanol model:a total of 84 male Wistar rats were divided into 7 groups with 12 each. The rats in group 1 to 7 were orally received hydrotalcite,Marzulene-S,gefarnate,sucralfate,rebamipide or normal saline for 3 days,respectively.On day 4,the rats were given 1 ml of absolute ethanol.The length of gastric lesion were measured by ulcer index.② Aspirin model:the rats were received 300 mg/kg of aspirin and 0.1 mol/L hydrochloric acid (0.5 ml/100 g).The following procedures were as ①.③ Hydrochloric acid model:the rats were received 1 ml of 0.7 mol/L hydrochloric acid. The following procedures were as ①. ④ Prednisolone model: all groups were administrated with above 6 agents or normal saline for 5 days.During the 2nd-5th day,the rats were subcu aneously injected with prednisolone (250 mg/kg) daily. Rats were killed on 5th day,and the lesions were mcasured by ulcer index.Gastric mucosal tissue of No.1,5 and ]0 rat in the control group and the hydrotalcite group were picked up to measure the intercellular space width using transmission electron microscopy. Results In four kind of models,the ulcer index were significantly lower in rats treated with mucosal protective agents than that in the controls (P＜0.05),expecially in hydrotalcite group (P＜0.01).The width of intercellular space in the hydrotalcite group was significantly narrower than that in controls (P＜0.05).Conclusions All of the mucosal protective agents can be against the gastric mucosal lesion induced by ethanol,hydrochloric acid,aspirin or prednisolone.Among them,the hydrotalcite is even better.The effect of hydrotalcite is further confirmed by observation of intercellular space width.