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Objective:To investigate the influencing factors of surgical site infection (SSI) after abdominal surgery.Methods:The retrospective cross-sectional study was conducted. The clinical data of 567 patients undergoing abdominal surgery in 6 medical centers, including 445 cases in the Zhengzhou Central Hospital Affiliated to Zhengzhou University, 54 cases in the the First Affiliated Hospital of Zhengzhou University, 49 cases in the Shangqiu First People's Hospital, 10 cases in the Luoyang Central Hospital, 5 cases in the First Affiliated Hospital of Henan University of Science and Technology and 4 cases in the Henan Provincial People's Hospital, from June 1 to June 30, 2020 were collected. There were 284 males and 283 females, aged (51±18)years. Observation indicators: (1) incidence of SSI after surgery; (2) influencing factors of SSI. Follow-up was conducted using outpatient examination and telephone interview to detect the incidence of SSI. Patients without implant were followed up within postoperative 30 days, and patients with implant were followed up within postoperative 1 year. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measure-ment data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was performed using the chi-square test or Fisher exact probability. Univariate analysis was performed using the corresponding statistical methods. Multivariate analysis was performed using the Logistic stepwise regression model advance method. Results:(1) Incidence of SSI after surgery. All the 567 patients were followed up after surgery as planned. There were 27 cases with SSI after surgery including 9 cases with superficial incision infection, 9 cases with deep incision infection, 9 cases with organ/gap infection. Of the 27 cases with SSI after surgery, 18 cases with positive results of incisional microbial culture including 8 cases with positive results of Escherichia coli, 6 cases with positive results of Klebsiella pneumonia, 3 cases with positive results of Enterococcus faecium and 1 case with positive result of Pseudomonas aeruginosa. (2) Influencing factors of SSI. Results of univariate analysis showed that age, preoperative hemoglo-bin, preoperative albumin, preoperative fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site, surgical incision type, duration of intensive cure unite, duration of post-operative hospital stay, duration of total hospital stay, operation time, hospital expense were related factors affecting the incidence of SSI of patients undergoing abdominal surgery ( χ2=40.12, Z=?4.22, ?2.21, ?4.75, χ2=7.07, 16.43, 38.06, 17.50, Z=?4.43, ?4.42, ?7.14, ?7.15, ?5.90, P<0.05) and the American Association of Anesthesiologists Classification, preoperative oral antibiotics, surgical methods and postoperative intensive care unit stay were related factors affecting the incidence of SSI of patients undergoing abdominal surgery ( P<0.05). Results of multivariate analysis showed that age, preopera-tive fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site as appendix and rectum, surgical methods, surgical incision type as infective incision and polluted incision, operation time were independent factors affecting the incidence of SSI of patients undergoing abdo-minal surgery ( odds ratio=7.69, 1.21, 0.27, 5.82, 5.19, 19.08, 0.23, 27.76, 4.97, 1.01, 95% confidence intervals as 2.04?28.95, 1.04?1.41, 0.08?0.94, 1.36?24.85, 1.10?24.43, 4.48?81.25, 0.06?0.87, 2.54?303.53, 1.12?22.14, 1.01?1.02, P<0.05). Conclusion:Age, preoperative fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site as appendix and rectum, surgical methods, surgical incision type as infective incision and polluted incision, operation time are independent factors affecting the incidence of SSI of patients undergoing abdominal surgery.
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Thymus is an important immune organ in mammals.FoxN1 plays an important role in regulating the development of thymic epithelial cells.Pig is a domestic animal of meat type,and is also a new kind of experimental animal model.In order to better understand the development characteristics of pig own immunity,the expression pattern of Minzhu FoxN1 in 2 month,4 month,6 month and 8 month thymus were detected by real-time PCR and Western-blot.At the same time,the changes of FoxN1 expression in Minzhu and Large white pig after cold stress were also detected.The results showed that FoxN1 expression level reached the highest level in 4 month,and declined in 6 month.This expression pattern is consistent with human and mouse.Cold stress could rise the expression level of Minzhu FoxN1,while have no effect on the Large white pig.
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Objective To evaluate the efficacy and outcomes with the use of a saline-coupled bipolar sealer during liver resection.Methods 101 patients underwent liver resection for primary hepatic carcinoma at the People's Hospital Affiliated to Zhengzhou University from August 2015 to December 2016.The patients were divided into two groups according to whether the Aquamantys(R) system was used or not.In group A (n =62) the clamp crushing technique was used for liver parenchymal transection.In group B (n =39) the Aquamantys(R) system was used.The intraoperative and postoperative complication rates were compared.Results The operation time in group B was significantly longer than group A (216.4 min vs.253.5 min,P ＜ 0.05).The intraoperaitve blood loss in group B was significantly less than group A (381.1 ml vs.257.2 ml,P ＜ 0.05),and less blood transfusion was required (211.3 ml vs.90.9 ml,P ＜ 0.05).The volume of abdominal drainage fluid in group B in the first and the 5th day was significantly less than group A (242.6 ml vs.199.2 ml,P＜0.05;84.3 ml vs.70.4 ml,P＜0.05,respectively).The drainage tube in group B was taken off earlier than in group A (8.1 d vs.7.0 d,P ＜ 0.05).The average hospitalization stay after surgery in group B was also significantly shorter (13.4 d vs.11.6 d,P ＜ 0.05).There was no significant difference in the overall postoperative complication rate (P ＞ 0.05) between the 2 groups,and no death was observed.Conclusion The use of a saline-coupled bipolar sealer (Aquamantys(R)) in liver resection for hepatocellular carcinoma was associated with less intraoperative blood loss and was better for the patients' postoperative recovery.
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Objective To evaluate the influence of thermal damage on the cell proliferation,invasive metastasis and epithelial-mesenchymal transition of hepatocellular carcinoma (HCC) through experiments in vitro,and to explore the relationship between thermal ablation and the recurrence,metastasis of HCC.Methods The McA-RH7777 HCC cell thermal damage model was established by using external heating method.The effect of thermal damage on the proliferation of HCC cells was detected by Kit-8 assay (CCK-8),and the cell cycle changes were studied by flow cytometry.The effect of thermal damage on the invasion potential of HCC cells was assessed by using Transwell assay.Fluorescence quantitative polymerase chain reaction (RT-PCR) and Western blot were used to evaluate the influence of thermal damage on HCC cell invasion potential,and on the mRNA and protein expression levels of EMT-related molecular markers,including VEGF,MMP-9,Nm23,E-cadherinand vimentin.Results Heating treatment of McA-RH7777HCC cells was performed by putting the cells in 43.5℃ water basin for 30 min.Two to five days after heating treatment the cell proliferative ability was significantly higher than that of control group (P＜0.05).At 48-72hours after heating treatment the proportion of HCC cells in G1 phase was obviously reduced and the proportion of HCC cells in S+G2 phase was significantly increased,the differences were statistically significant (P＜0.05).Compared with the control group,the difference in HCC cell invasion potential determined at 24 h after heating treatment was not significant,while the HCC cell invasion potential determined at 72 h after heating treatment was strikingly increased (22.3±2.46 vs.14.2±l.82,P＜0.001).Real-time PCR and Western blotting results indicated that at 72 h after heating treatment the expression levels of VEGF,MMP-9 and vimentin were significantly increased,while the expression level of E-cadherin was remarkably decreased,the differences were statistically significant (P＜0.05).Conclusion Thermal damage with sub-lethal heating dose can induce McA-RH7777 HCC cell to develop epithelial-mesenchymal transition and to enhance its proliferation and invasive metastasis potential,and HCC cells show higher malignant potential.
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We analyzed the best light intensity for callus induction and maintenance in Vitis vinifera and explored the mechanism of grape callus browning. Tender stem segments of grape cultivar "gold finger" were used to study the effects of different light intensities (0, 500, 1 000, 1 500, 2 000, 2 500, 3 000 and 4 000 Lx) on the induction rate, browning rate and associated enzyme activity and gene expression during Vitis vinifera callus formation. The callus induction rate under 0, 500, 1 000 and 1 500 Lx was more than 92%, significantly higher than in other treatments (P < 0.05). A lower browning rate and better callus growth were also observed during subculture under 1 000 and 1 500 Lx treatments. We found that chlorogenic acid, caffeic acid, p-hydroxybenzoic acid and coumaric acid contents were correlated with the browning rate of callus, among which chlorogenic acid content was positively correlated with the browning rate (P < 0.05). Peroxidase (POD) and polyphenol oxidase (PPO) activities were negatively correlated with the browning rate of callus (P < 0.01). The POD, PPO and phenylalanine ammonialyase (PAL) expression levels were positively correlated with the browning rate at P < 0.05 or P < 0.01. An appropriate light intensity for the tissue culture of Vitis vinifera was 1 000-1 500 Lx, higher or lower light intensities significantly impaired normal callus growth.
Subject(s)
Caffeic Acids , Chemistry , Catechol Oxidase , Chemistry , Culture Media , Chemistry , Gene Expression Regulation, Plant , Light , Peroxidase , Metabolism , Phenylalanine Ammonia-Lyase , Metabolism , Plant Stems , Radiation Effects , Tissue Culture Techniques , Vitis , Radiation EffectsABSTRACT
Objective To determine the clinical effects of type Ⅲ biliary atresia treated by hepatojejunostomy (Kasai procedure).Methods A retrospective study was performed on patients with type Ⅲ biliary atresia treated in our hospital between January 2009 to December 2013.Results The follow-up data were completed in 42 patients out of 48 patients (87.5％) who underwent Kasai procedure for type Ⅲ biliary atresia.The jaundice disappeared in 31 of 42 patients (73.8％).The rate of patients having cholangitis was 47.6％.There were significant differences in the 2-year survival among the groups of patients with mild cholangitis (75.0％,9/12),serious cholangitis (25.0％,2/8) and without cholangitis (86.4％,19/22) (P ＜ 0.05).Conclusions Hepatojejunostomy (Kasai procedure) is an effective operation to treat type Ⅲ biliary atresia.Our data suggested that the survival rates were related to the degree of bile drainage and cholangitis post surgery.
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BACKGROUND:It is important for the aged population to improve the locomotor activity, maintain a high-level quality of life, and delay the loss of self-care ability. OBJECTIVE:To analyze the physique properties and influencing factors of the aged population in some areas of Jiangsu province, and to investigate the rule of physiological aging process. METHODS:In nine test sites of three cities (Nanjing, Yanhceng and Changzhou) of Jiangsu Province, 520 effective samples were col ected and composed of 42.9%males and 57.1%females. We tested the reliability and validity of inspected questionnaire on the aged physique and sports, and then adopted the questionnaire to get general demographic information about their gender, age, education, used occupation, income and physical exercise. At the same time, physical tests were performed (including nine projects such as body shape, physical function, body quality). RESULTS AND CONCLUSION: ① More than half of the surveyed aged have reached overweight level according to their body mass index, while only a few have normal body mass index, especial y the females. ② Most of the surveyed aged have abnormal blood pressure, and a large number of the aged are in moderate to severe hypertension. ③ There is a gradual y reduction in upper and lower limbs muscle strength, balance ability and walking ability along the aging, a substantial drop is found after 75 years old. There is no obvious difference between male group and female group expect grip strength. ④ Physical exercise can delay the degenerative change in muscle strength and balance ability of the aged. Education has great influence on the physical quality and used occupation influences blood pressure. Having a retired wage also has significant effects on physical quality index and blood pressure, but no influence is found in body shape.
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Objective To probe the effect of combinative therapy of Chinese and western medicine on the long-term prognosis of diabetic patients.Methods The methodology of comparative analysis is used.Patients were randomly divided into two groups.Both groups were given the treatment of diet control and exercise.The group with the remedy of western medicine(Group A) was treated with the project to reduce the blood sugar by taking western medicine according to the blood glucose,weight,former dose-taking,together with basic therapy.The group with the combinative therapy of Chinese and western medicine(Group B) was given the same treatment as Group A in addition with syndrome differentiation treatment for Yin deficiency and extreme heat,Qi and Yin deficiency,Yin and Yang deficiency,Qi stagnation and blood stasis.After the course of the treatment,the change of blood glucose,blood lipid and TCM syndrome were collected for statistics,the complication was observed by two years follow-visit.Results The two groups showed no noticeable difference in blood glucose and blood lipid after the treatment.But Group B showed relative superior improvement in the reduction of low-glucose and other complication two years later.Conclusion The combinative therapy of Chinese and western medicine is effective in improving clinical symptom of diabetes patients,and it may prevent and reduce the incidence of diabetic complications.