Effects of enteral nutrition beginning at different time on aspiration rate and immune function in patients with severe traumatic brain injury / 中国康复理论与实践

@#Objective To investigate the effect of enteral nutritional support beginning at different time on aspiration events and immune function in the early post-traumatic (within 14 days) period in patients with severe traumatic brain injury.Methods From June, 2018, to February, 2021, 75 patients with acute traumatic brain injury admitted in the Department of Neurosurgery of the Second People's Hospital of Lianyungang were randomly divided into early feeding group (24 to 48 hours, n=35) and delayed feeding group (48 to 120 hours, n=40). The 14-day reflux rate, aspiration rate, incidence of aspiration pneumonia, immune indexes and complications were compared between two groups.Results There was no significant difference in the reflux rate, aspiration rate and the incidence of aspiration pneumonia between the two groups (P > 0.05). The levels of IgG, IgA, and complements C3 and C4 were significantly higher in the early feeding group than in the delayed feeding group (|t| > 1.720, P<0.001). The incidence of non-aspiratory lung infections was significantly lower in the early feeding group than in the delayed feeding group (χ2=4.728, P<0.05).Conclusion Initiating enteral nutrition within 24 to 48 hours after injury may preserve immune function and reduce the incidence of non-aspiratory lung infections in patients with severe traumatic brain injury.

Analysis of prognostic factors after surgical operation of lung cancer brain metastases / 国际肿瘤学杂志

Objective:To analyze the prognosis-related factors of patients with surgical treatment of lung cancer brain metastases.Methods:From January 2016 to November 2018, the clinical data of the patients with lung cancer brain metastases received surgical treatment in Department of Neurosurgery, Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College were retrospectively collected, and completed data of 83 patients were obtained. The single factor analysis was based on the log-rank method, and the multi-factor analysis was used by the Cox proportional hazard model, and the R software was used to map the influencing factors into the nomogram and verify them.Results:The median overall survival (OS) of 83 patients was 27.0 months. The median OS of patients with surgery alone was 15.7 months, the median OS of patients with surgery combined with radiotherapy, chemotherapy or targeted therapy was 27.7 months, and the difference was statistically significant ( χ2=8.735, P=0.003). The results of single factor analysis showed that gender ( χ2=4.652, P=0.031), smoking history ( χ2=8.239, P=0.004), postoperative targeted treatment ( χ2=13.697, P<0.001), postoperative adjuvant therapy ( χ2=8.735, P=0.003), pathology of metastatic tumor ( χ2=11.799, P=0.001), and lung cancer molecular graded prognostic assessment (Lung-molGPA) sore ( χ2=11.333, P=0.004) affected patients′ OS. The results of multivariate analysis showed that smoking history ( HR=0.311, 95% CI: 0.107-0.901, P=0.031), postoperative targeted therapy ( HR=3.563, 95% CI: 1.286-9.868, P=0.015), pathology of metastatic tumor ( HR=0.364, 95% CI: 0.137-0.965, P=0.042), Lung-molGPA score ( HR=0.595, 95% CI: 0.374-0.946, P=0.028) were independent prognostic factors for OS of patients with lung cancer brain metastases. In order to further evaluate the prognosis of patients, nomogram was drawn using these four independent prognostic factors. The model had high accuracy and could better evaluate the prognosis of patients. Conclusion:Lung cancer brain metastases patients with operative indication can benefit from surgery, and active adjuvant therapy after operation can further prolong the OS of patients. The nomogram constructed by smoking, targeted therapy, pathology of metastatic tumor and Lung-molGPA score can be used to evaluate individual patient outcomes and guide clinical treatment.

Correlation study between CT features of clear cell renal cell carcinoma whose diameter ≥7 cm and its Fuhrman grade / 实用放射学杂志

Objective To investigate the application value of CT features of clear cell renal cell carcinoma (CCRCC) whose diameter ≥ 7 cm in predicting its Fuhrman grade.Methods 53 patients with CCRCC confirmed by surgery and pathology were analyzed retrospectively,including 19 patients regarded as a low-grade (Grade Ⅰ and Grade Ⅱ) group,and other 34 ones as a high-grade (Grade Ⅲ and Grade Ⅳ) group.The CT features including necrosis,renal sinus involvement,shape,renal vein invasion,lymphnode metastasis,pseudo-capsule,blood vessels around the tumor and the boundary between the tumor and the perirenal fat were analyzed,and the differences in those CT features between two groups were analyzed with chi-square or Fisher exact test.Results The incidence of fuzzy boundary between the tumor and the perirenal fat in the high-grade group was higher than that in the low-grade group (x2 =6.129,P =0.013),however,the differences of the rest CT features between two groups were not statistically significant (P＞0.05).When the fuzzy boundary was used to predict the high-grade CCRCC,the sensitivity,specificity and accuracy was 61.8 ％,73.7 ％ and 66.0 ％,respectively.Conclusion When the diameter of the tumor ≥7 cm,only the fuzzy boundary between the tumor and the perirenal fat has certain value in predicting high-grade CCRCC.

Clinical features and comprehensive treatment of skull base osteosarcoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the clinical features and treatment of skull base osteosarcoma.</p><p><b>METHODS</b>The clinical data of 18 patients with skull base osteosarcoma, who were admitted to the CAMS Cancer Hospital from January 2005 to November 2013, were retrospectively analyzed. The patients were followed up by telephone, outpatient review and other means. Fifteen patients were followed up, 4 cases received surgery only, and 11 cases received surgery with adjuvant chemotherapy and/or radiotherapy. Kaplan-Meier survival curve analysis was used to analyze the clinical data and Log rank method was used for verification.</p><p><b>RESULTS</b>Nine patients died among the 15 patients who were followed up for 3-103 months (mean 25.0 months): seven patients died of local recurrence, and two patients died of distant metastasis, and six patients were still alive. Four patients received surgery only, with a median survival time of 25.0 months, and 11 patients received comprehensive treatment, with a median survival time of 47.0 months (P = 0.02). Five patients received sub-total resection, with a mean survival time of 47.0 months, and 10 patients received total resection, with a mean survival time of 45.0 months (P = 0.37). The 1- and 2-year recurrence rates were 46.6% and 68.9%, respectively. The overall 1-, 2-, 3- and 5-year survival rates were 82.4%, 61.8%, 36.0% and 36.0%, respectively, with a median survival time of 30.0 months.</p><p><b>CONCLUSIONS</b>To compare the long bone and head and neck osteosarcoma with skull base osteosarcoma, the skull base osteosarcoma has a lower total resection rate, a higher recurrence rate, and a poorer prognosis. Radical surgery and comprehensive treatment are appropriate for skull base osteosarcoma.</p>

Expression and clinical significance of anti-apoptosis gene, survivin, in acute leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the correlation between expression of surviving gene in acute leukemic cells and its clinical effects.</p><p><b>METHODS</b>By using semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) technique, surviving gene expression in 50 previously untreated acute leukemia (AL) patients was analysed. The apoptosis of primary leukemia cells cultured in vitro was assayed with terminal deoxyribonucleotidyl transferase mediated dUTP-biotin nick end labeling (TUNEL).</p><p><b>RESULTS</b>Surviving gene expression levels in cells of AL patients at diagnosis were significantly higher than that in normal bone marrow mononuclear cells (MNCs) (82.0% vs 33.3%, P < 0.05). The expression level was higher in ALL cells than in ANLL cells (89.5% vs 75.0%). Among 22 cases of ANLL, bone marrow remission (BMR) rate was higher in surviving gene negative expression cells from patients accepted a course of chemotherapy than in positive expression cells (83.3% vs 25.0%, P = 0.023). Among 13 ANLL patients received a course of HA regimen chemotherapy, the BMR was higher in patients surviving mRNA negative expression cells than in positive cells (100.0% vs 27.3%). Patients with surviving/beta-actin ratio>0.6 attained lower BMR.</p><p><b>CONCLUSION</b>Higher expression level of surviving mRNA in AL cells may be one of the reasons that leukemic cells are insensitive to chemotherapy.</p>

Clinical analysis of 111 cases of acute non-lymphocytic leukemia with pathological karyotypes / 中国实用内科杂志

ObjectiveTo explore the therapeutic effect of acute non-lymphocytic leukemia(ANLL) with pathological karyotypes.MethodsAnalyze karyotype with the R-banding technique.The experimental group contained 111 ANLL patients with pathological karyotypes and the control group contained 69 ANLL patients with normal karyotypes.ResultsThe complete remission (CR) rate was apparently lower in the group of pathological karyotypes than that in the group of normal karyotypes (44.14% vs 65.22%;P

Evaluation of the predictability of ablation depth in photorefractive procedures by Zeiss MEL80 and VISX Star S4 excimer laser / 眼科

Objective To evaluate the predictability of ablated depth in photorefractive procedures by Zeiss MEL80 and VISX Star S4 excimer laser.Design Prospective,comparative case series.Participants 168 eyes of 84 people with myopia and cylinder.Main Outcome Measures Corneal thickness and ablated depth.Methods The thickness of cornea by Zeiss MEL80 and VISX Star S4 were measured by anterior segment OCT.The actuality ablated depth and calculated depth were compared.Results There were no significant differences between actuality ablated depth and calculated depth in Zeiss MEL80.And in VISX Star S4,the actuality ablated depth was more than calculated depth.Linear regression of changes in ablated depth on myopia and cylinder yielded the following formulaus:△ablated depth(VISX Star S4)= 2.324 *|myopia|+ 5.270 *|cylinder|-6.772.Conclusions Different excimer laser has different changes between actuality ablated depth and calculated depth.To guarantee the safety of LASIK,Ophthalmologists should know the characteristics of the excimer laser.

Design and application of the management system of work attendance in our hospital / 医疗卫生装备

The management system of work attendance is developed by the support of local area network of No.1 Military Medical Project and by the use of PowerBuilder. The system is applied to record work attendance on net, by which the management department can check work attendance of all departments of our hospital at any time. The application of the system realizes the management of work attendance on network, enhances work efficiency and avoids trivial manual work of count and collection.

Kinetic Observation on the Invasion into and Proliferation in IEC-6 Cells of Toxoplasma gondii RH Strain Tachyzoites In vitro / 中国寄生虫学与寄生虫病杂志

Objective To study the invasion and proliferation in IEC-6 cells of Toxoplasma gondii RH strain tachyzoites in vitro.Methods T.gondii tachyzoites of RH strain were co-cultured with IEC-6 cells in vitro,the process of cell adhesion,invasion and proliferation by tachyzoites was observed consecutively with inverted microscope.At 5 min,10 min,20 min,30 min,1,2,4,6,12,24 and 48 h after co-culture,the tachyzoite invasion to IEC-6 and intra-cellular proliferation were observed with Giemsa-Wright's staining,respectively.The invasive rate of tachyzoites to IEC-6 was counted.Results T.gondii tachyzoites invaded the IEC-6 cells 5 min after culture,thenceforth the invasive rate increased gradually.The invasive rate was about 55.0% at the first hour after culture with 1-5 tachyzoites in one cell.In the second hour after culture,the rate reached highest with 81.8 % and there were many pseudocysts emerging.At the same time,tachyzoites invaded the cell nucleus and proliferated in the nucleus.At the 4th hour after culture,the invasive rate began to decrease(80.8?9.2)%,the pseudocysts began to break and tachyzoites were released to cluster.The clustering tachyzoites increased significantly at the 6th hour.At the 12th hour the clustering tachyzoites decreased and most tachyzoites were free,the number of complete cells decreased obviously.There were only a few cells and pseudocysts left at the 24th hour,and a great quantity of free tachyzoites existed out of the IEC-6 cells.There were plenty of mobile tachyzoites while none of IEC-6 cells existed after 48 h culture.Conclusion IEC-6 cell may be the suitable target cell of Toxoplasma gondii tachyzoite.The tachyzoites can invade the IEC-6 cells quickly in vitro and proliferate in the plasma and nucleus with a reproductive cycle of about 6 to 12 hrs.

Dynamic Observation of Attachment and Invasion of Toxoplasma gondii Tachyzoites to Intestinal Mucosa in BALB/c Mice by Chromogenic In Situ Hybridization Targeting SAG2 mRNA / 中国寄生虫学与寄生虫病杂志

Objective To observe dynamically the location and time of attachment and invasion of Toxoplasma gondii tachyzoites to murine intestinal mucosa by chromogenic in situ hybridization targeting SAG2 mRNA. Methods Thirty 7- to 8-week-old BALB/c mice were randomly divided into experiment group(24 mice)and control group(6 mice). Each animal in the experiment group was given 2?104 tachyzoites of RH stain in 0.2 ml PBS by intragastric administration and that in the control group was given 0.2 ml PBS. Four mice in the experiment group and one in the control group were sacrificed at 15 min,30 min,1 h,2 h,4 h and 8 h after infection,respectively,and paraffin sections of duodenum,jejunum and ileum were prepared to perform the in situ hybridization with Dig-labeled oligonucleotide probe complementary to SAG2 mRNA of T. gondii. Results Tachyzoites were found on the striated border of small intestine epithelial cells (absorptive cells,goblet cells and endocrine cells),in or between two absorptive cells or in the lamina propria. At 15 min-2 h after infection,there was significant difference in the number of attachment on jejunum and ileum (P

Intranasal Immunization with Mucosal Complex Vaccine Protects Mice Against Toxoplasma gondii / 中国寄生虫学与寄生虫病杂志

Objective To study the mucosal and systemic immune response after intranasal immunization with mucosal complex vaccine for Toxoplasma gondii,and to observe the protective effect on mice. Methods The mucosal complex vaccine was made of soluble tachyzoite antigen (STAg) and cholera toxin (CT),which were mixed and dissolved in PBS (1 ml PBS containing 1 mg STAg and 50 ?g CT). Fifty-two BALB/c mice were randomly divided into two groups: immunized group and control. Mice were intranasally immunized with 20 ?l mucosal complex vaccine (20 ?g STAg and 1?g CT) per mouse twice at an interval of two weeks,while the control mice were given PBS solution instead. Six mice of each group were killed by dislocation of cervical vertebra on day 14 after the last immunization. The specific IgG antibodies in serum and IgA in feces were detected by ELISA. Lymphocytes in spleen,Peyer's patches (PP) and intestinal intraepithelial lymphocyte(IEL) were isolated and counted. Percentage of CD4+ and CD8+ T cells was determined by immunocytochemistry. Other mice were challenged intragastrically each with 4?104 tachyzoites of RH strain Toxoplasma gondii on day 14 after the last immunization. Their health condition was observed and the number of tachyzoites in liver and brain was determined microscopically on the 30 th day after challenge. Results IgG antibodies in serum and IgA antibodies in feces of immunized mice were higher than the control (P