Clinical studies and reflection of postoperative surgical site infection in gastric cancer / 中华消化外科杂志

Surgical site infection (SSI) is one of the most prevalent hospital-acquired infections in patients with gastric cancer. It is related to prolonged hospital stay, postoperative mortality and overall poor outcomes. Despite significant progress has been made in reducing the incidence of SSI, it proceeds to be a challenging and costly surgical complication. SSI is primarily caused by pathogens inoculated from the patient's flora at the time of surgery, which depending on the bacteria exposed and the host's ability to control bacterial contamination of the surgical wound. Factors influencing the incidence of SSI include age, gender, innate immune system of patients, as well as history of radiotherapy and chemotherapy, nutritional status, extent of overweight, history of diabetes mellitus and history of smoking. Surgery-related factors such as the operation time, surgical techniques, mode of anesthesia and surgical approach (open surgery or laparoscopic surgery) also impact the incidence of SSI. It can decrease the incidence of SSI by using antibiotics, skin disinfec-tion, nutritional support, glucose management before the surgery, by temperature control, hyperoxia, incisional and abdominal irrigation and closure during the surgery, and by wound protection and dressing use after the surgery. Through literature review, the authors find that the relevant guidelines for SSI prevention are inconsistent. It is suggested that implementing of these preven-tative methods should base on institutional and surgeon preferences, and using a normative approach to make a decision.

Shoutaiwan Regulate Lipopolysaccharide-induced Oxidative Stress and Pyroptosis in Human Extravillous Trophoblast Cells / 中国实验方剂学杂志

ObjectiveTo investigate the regulatory effect of Shoutaiwan on oxidative stress and pyroptosis in lipopolysaccharide （LPS）-induced human extravillous trophoblast （HTR-8/SVneo） cells and provide a new direction for deciphering the mechanism of action of Shoutaiwan. MethodLPS （100 μg∙L-1） was used to induce the injury of HTR-8/SVneo cells （modeling）. Five groups were designed in this study， including a blank group， a model group， a Shoutaiwan （10% Shoutaiwan-containing serum） group， an antioxidant （1 mmol·L-1 NAC） group， and NOD like receptor thermoprotein domain 3 （NLRP3） inhibitor （50 μmol·L-1 MCC950） group. Cell viability was detected by cell counting kit-8 （CCK-8） kit. Hochest 33342/PI double fluorescence staining and flow cytometry were employed to observe cell death. The levels of interleukin-18 （IL-18）， interleukin-1β （IL-1β）， malondialdehyde （MDA）， and superoxide dismutase （SOD） in cell supernatant was determined by enzyme-linked immunosorbent assay （ELISA）. DCFH-DA probe was used to measure the level of intracellular reactive oxygen species （ROS）. Western blot was employed to determine the protein levels of NLRP3， Caspase-1， gastermin D （GSDMD）， and IL-1β in cells， and Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） to measure the mRNA levels of NLRP3 and Caspase-1 in cells. ResultCompared with the blank group， the modeling decreased the cell viability （P<0.01）， elevated the levels of IL-1β， IL-18， ROS， and MDA， and weakened the activity of SOD （P<0.01）. Furthermore， it up-regulated the protein levels of NLRP3， Caspase-1， GSDMD， and IL-1β and the mRNA levels of NLRP3 and Caspase-1 （P<0.01）. Compared with the model group， Shoutaiwan， NAC， and MCC950 increased the cell viability （P<0.01）. Further， Shoutaiwan and NAC lowered the levels of MDA and ROS and increased the activity of SOD （P<0.01）. Shoutaiwan and MCC950 reduced the IL-1β and IL-18 in cell supernatant （P<0.01）， and down-regulated the protein levels of NLRP3， Caspase-1， GSDMD， and IL-1β and the mRNA levels of NLRP3， Caspase-1， and IL-1β （P<0.05，P<0.01）. ConclusionShoutaiwan can regulate oxidative stress and pyroptosis to attenuate the LPS-induced damage of HTR-8/SVneo cells， which may be the mechanism of Shoutaiwan in preventing recurrent spontaneous abortion.

Relationship between homology and genomics of Klebsiella pneumoniae in patients with neurocritical infection / 中国综合临床

Objective:To analyze the relationship between homology of Kleber pathogen pneumoniae (KP) in patients with neurocritical infections and the Genomics.Method:Five non-multidrug resistant pathogen KP were identified in 2015 to 2018, including the same cloning strain of P90 and P91, the same popular cloning system of P66,P90 and P91, and there is no homology between P20,P39 and other strains, which makes a second generation full genome sequencing. A variety of bioinformatics software were used for genomic analysis to understand the basic genomic information, chromosomal and plasmid distribution, single nucleotide polymorphism (SNP) differences and gene family clustering characteristics, meanwhile with the National Center for Biotechnology Information (NCBI) website registered 18 KP strains (2013--2016) to analyze the evolutionary affinity between strains.Results:The total genome sizes of P20, P39, P66, P90 and P91 were 5 469 543 bp, 5 480 332 bp, 5 768 352 bp, 5 745 666 bp, 5 722 999 bp. The GC contents were 57.07% (1 559 929+1 561 432)/5 469 543, 57.27% (1 566 970+1 571 424)/5 480 322, 56.96% (1 640 438+1 645 432)/5 768 352, 56.88% (1 634 285+1 634 038)/5 745 666, and 56.95% (1 627 360+1 631 781)/5 722 999, respectively. Compared with P20 reference strains, the total number of SNP in P39, P66, P90 and P91 were 32 682, 34 226, 34 292, 34 375, and the total mutation rates of gene coding region sequences were87.18% (28 491/32 682), 86.71% (29 679/34 226), 85.26% (29 238/34 292), 86.22% (29 638/34 375), respectively. Nonsynonymous mutations accounted for some advantages, and the rates were 44.57% (14 566/32 682), 44.01% (15 063/34 226), 48.01% (16 465/34 292), 48.75% (16 758/34 375), and synonymous mutations were 42.61% (13 925/32 682), 42.70% (14 616/34 226), 37.25% (12 773/34 292), 37.47% (12 880/34 375), respectively. P90 and P91 have 6 specific gene families, and P66 has 4 specific gene families. The same popular clone lines P66, P90 and P99 are on the same evolutionary branch of the phylogenetic tree. The same clone P90 and P99 are on the same subbranch. P20 and P39 without homology are on different evolutionary branches respectively. P20, P39, P66, P90 and P91 on the evolutionary branches of phylogenetic tree are closely related to the evolutionary grade of strain KP52-145 from France and strain ED23 from Taiwan, China submitted on NCBI website.Conclusion:Klebsiella pneumoniae in patients with neurocritical infection has the same clone, and the number of unique gene families among strains is the same. There are small differences in the number of unique gene families and the total number of SNPs among the same epidemic clone lines, and they are characteristic of the same evolutionary branch of the phylogenetic tree. The number of unique gene families and the total number of SNPs of non homologous strains are quite different, and they are in different evolutionary branches of the phylogenetic tree.

Progress of inhaled nitric oxide on treatment of persistent pulmonary hypertension of new-born / 中国小儿急救医学

Persistent pulmonary hypertension is a serious disease among new-borns.Despite the variety of causes, similar physiopathologic changes characterize this syndrome: a persistently raised pulmonary vascular resistance after birth, which leads to severe hypoxemia due to extrapulmonary shunting.The fundamental treatment is to reduce pulmonary vascular pressure and improve hemodynamics.Modern treatments such as inhaled nitric oxide, high-frequency oscillation ventilation, extracorporeal membrane oxygenation, and/or other pulmonary vasodilators could reduce mortality in neonatal persisitent pulmonary hypertension(PPHN). Inhaled nitric oxide is the main method for the treatment of PPHN, which can effectively improve oxygenation and reduce the need for extracorporeal membrane oxygenation(ECMO). The effect of inhaled nitric oxide is different with the gestational age changed.This article aims to summarize the clinical research progress of inhaled nitric oxide in the treatment of PPHN.

Effect of inhaled nitric oxide with mechanical ventilation in persistent pulmonary hypertension of newborn / 中国小儿急救医学

Objective@#To study the clinical effect of inhaled nitric oxide(iNO) with mechanical ventilation for the neonates with persistent pulmonary hypertension of newborn(PPHN).@*Methods@#A total of 40 neonates with PPHN poorly responding with routine treatment were treated with iNO therapy.Pulmonary artery pressure, blood gas ion analysis and respiratory function changes were observed at different time points before and after iNO.@*Results@#Treatment with iNO resulted in a rapid decrease in pulmonary artery pressure from(54.95±17.08) mmHg(1 mmHg=0.133 kPa) to(20.40±14.26) mmHg.Oxygenation of 40 cases improved in the first 0.5~1 hour after iNO therapy, the values of mean airway pressure(MAP)declined from(13.98±2.40)cmH2O(1 cmH2O=0.098 kPa) to(12.44±2.69)cmH2O, oxygenation index(OI)decreased from 26.89±18.62 to 13.84±5.52, PaO2/FiO2 increased from(60.34±23.49) mmHg to(144.46±23.49) mmHg, and the value of pH increased from 7.31±0.14 to 7.37±0.07.Furthermore, within 48 hours after treatment, PaO2/FiO2 and pH increased gradually, while MAP and OI decreased gradually, which all had statistical differences(P<0.01).@*Conclusion@#Mechanical ventilation combined with iNO therapy in the treatment of PPHN can rapidly improve the oxygenation status of neonates, reduce pulmonary vascular resistance, and then improve the survival rate and long-term prognosis.

Efficacy of pulmonary surfactant combined with caffeine citrate on neonatal respiratory distress syndrome treated with synchronized nasal intermittent positive pressure ventilation / 中国小儿急救医学

Objective@#To investigate the clinical effects of pulmonary surfactant(PS) combined with caffeine citrate on neonatal respiratory distress syndrome(NRDS) treated with synchronized nasal intermittent positive pressure ventilation(SNIPPV).@*Methods@#We collected and analyzed 99 neonates who were diagnosed with NRDS and required SNIPPV treatment from January 2016 to June 2019 in NICU of Shengjing Hospital of China Medical University.According to the different treatment, they were divided into PS+ citrate caffeine combination group and control group.The control group(53 neonates)was treated by PS alone.The combination group(46 neonates)was treated with PS combined with caffeine citrate.The indexes of ventilator time, the time of using oxygen, length of hospital stay and complications were compared between the two groups.@*Results@#The indexes of ventilator time, the time of using oxygen and length of hospital stay of combination group were significantly shorter than those of the control group.The differences were statistically significant(P<0.05). However, the incidences of ventilator associated pneumonia, gastrointestinal dysfunction, arrhythmia and other complications were not significantly different between the two groups(P>0.05).@*Conclusion@#PS combined with caffeine citrate in the treatment of NRDS with SNIPPV could effectively improve the pulmonary function of infants.It could improve the neonatal survival rate and reduce complications.It is worth to be recommended.

Effect of inhaled nitric oxide with mechanical ventilation in persistent pulmonary hypertension of newborn / 中国小儿急救医学

Objective To study the clinical effect of inhaled nitric oxide ( iNO) with mechanical ventilation for the neonates with persistent pulmonary hypertension of newborn(PPHN). Methods A total of 40 neonates with PPHN poorly responding with routine treatment were treated with iNO therapy. Pulmona-ry artery pressure,blood gas ion analysis and respiratory function changes were observed at different time points before and after iNO. Results Treatment with iNO resulted in a rapid decrease in pulmonary artery pressure from(54. 95 ± 17. 08) mmHg(1 mmHg＝0. 133 kPa) to(20. 40 ± 14. 26) mmHg. Oxygenation of 40 cases improved in the first 0. 5 ~1 hour after iNO therapy,the values of mean airway pressure(MAP) de-clined from(13. 98 ± 2. 40) cmH2 O(1 cmH2 O＝0. 098 kPa) to(12. 44 ± 2. 69) cmH2O,oxygenation index (OI)decreased from 26. 89 ± 18. 62 to 13. 84 ± 5. 52,PaO2/FiO2 increased from(60. 34 ± 23. 49) mmHg to (144. 46 ± 23. 49) mmHg,and the value of pH increased from 7. 31 ± 0. 14 to 7. 37 ± 0. 07. Furthermore, within 48 hours after treatment,PaO2/FiO2 and pH increased gradually,while MAP and OI decreased gradu-ally,which all had statistical differences(P<0. 01). Conclusion Mechanical ventilation combined with iNO therapy in the treatment of PPHN can rapidly improve the oxygenation status of neonates,reduce pulmonary vascular resistance,and then improve the survival rate and long-term prognosis.

Efficacy of pulmonary surfactant combined with caffeine citrate on neonatal respiratory distress syndrome treated with synchronized nasal intermittent positive pressure ventilation / 中国小儿急救医学

Objective To investigate the clinical effects of pulmonary surfactant ( PS) combined with caffeine citrate on neonatal respiratory distress syndrome(NRDS) treated with synchronized nasal inter-mittent positive pressure ventilation(SNIPPV). Methods We collected and analyzed 99 neonates who were diagnosed with NRDS and required SNIPPV treatment from January 2016 to June 2019 in NICU of Shengjing Hospital of China Medical University. According to the different treatment,they were divided into PS+ cit-rate caffeine combination group and control group. The control group(53 neonates)was treated by PS alone. The combination group(46 neonates)was treated with PS combined with caffeine citrate. The indexes of vent-ilator time,the time of using oxygen,length of hospital stay and complications were compared between the two groups. Results The indexes of ventilator time,the time of using oxygen and length of hospital stay of combination group were significantly shorter than those of the control group. The differences were statistically significant(P<0. 05). However,the incidences of ventilator associated pneumonia,gastrointestinal dysfunc-tion,arrhythmia and other complications were not significantly different between the two groups(P>0. 05). Conclusion PS combined with caffeine citrate in the treatment of NRDS with SNIPPV could effectively im-prove the pulmonary function of infants. It could improve the neonatal survival rate and reduce complications. It is worth to be recommended.

Application of health education based on mobile health education platform for patients after coronary stent implantation / 中华护理杂志

Objective To explore the effects of health education based on mobile platform for patients after coronary stent implantation. Methods Totally 118 patients underwent coronary stent implantation were recruited using convenience sampling method,and divided into the experimental group and the control group by random number table method with 59 cases in each group. The control group received face-to-face health education during hospitalization from nurses,and were followed up at 1 month,3 months and 6 months through phone or outpatient follow-up. The experimental group received health education based on mobile platform. Self-designed questionnaire was used to investigate health behavior and self-efficacy at 1 month,3 months and 6 months for two groups. Results The scores of health questionnaire in the experimental group were better than those in the control group at 1 month,3 months and 6 months,and the difference was statistically significant (P0.05),but at 3 months and 6 months the differences were significant (P<0.001). Conclusion Health education based on mobile health education platform for patients after coronary stent implantation can effectively improve health behavior and self-efficacy,and it is worthy of clinical popularization.

Role of E-cadherin gene promoter methylation in bladder carcinogenesis:a Meta-analysis / 天津医药

Objective To assess the role of E-cadherin (CDH1) promoter methylation in bladder carcinogenesis by meta-analysis. Methods The relevant database were searched by the retrieval strategy of Cochrane network. All included studies were collected following data:the first author’s surname, publication year of article, country, language of publication, design of study, sample size, ethnicity, histological subtypes, methylation detection method and genotype frequencies etc. This meta-analysis was performed using the STATA 12.0 software. The crude odds ratio (OR) with 95%confidence interval (CI) was calculated. Results Ten case-control studies were included in this meta-analysis. The methylation frequency of CDH1 was detected in 620 bladder cancer tissues and 341 normal or cancerous tissues. Results showed that the methylation frequency of CDH1 was significantly higher in bladder cancer tissue than that of normal or cancerous tissue (OR=3.09, 95%CI:1.13~8.50, P=0.029). Furthermore, the ethnicity-stratified analysis revealed that the methylation frequency of CDH1 was significantly higher in bladder cancer tissue of Asian populations than that of normal or cancerous tissue (OR=3.85, 95%CI:1.46~10.14, P=0.006), but no such association was found in Caucasian populations(OR=2.22, 95%CI:0.38-12.91, P=0.375). The subgroup analysis based on the detection methods revealed that there was a statistically significant difference in the methylation frequency of CDH1 between bladder cancer tissue and adjacent tissues and normal tissues under the MSP subgroup (P<0.001), while such association was not observed under the Q-MSP subgroup (P=0.818). Conclusion Pro?moter methylation of CDH1 gene may be involved in the occurrence and development of bladder cancer, which may serve as a biomarker for diagnosis and prognosis of bladder cancer.

A pilot research on the influence of psychological of the patients who received radiotherapy using position immobility by thermoplastic sheet / 中国医学装备

Objective:To explore the influence of psychological and to identify determinants for patients using position immobility by thermoplastic sheet in the course of radiotherapy. Methods:55 patients who received radiotherapy using position immobility by thermoplastic sheet were investigated with questionnaires. Results:There are 34.5%(19/55) patients admit under psychological stress during the treatment, which were affected by the tension from doctors’ consultation and the chemotherapy experience. Conclusion:Some patients were under psychological stress caused by the position immobility with thermoplastic sheet. Nursing intervention is necessary to improve, especially to the patients who show stress when consultation with doctors and who had chemotherapy experience.

Identification and differentiation of breast cancer stem cells under tumor microenvironment / 中国组织工程研究

BACKGROUND:Breast cancer stem cel s have a greater impact on the occurrence and metastasis of breast cancer. Under simulated tumor microenvironment, we can better analyze the proliferation and differentiation of breast cancer stem cel s. OBJECTIVE:To explore the tumor microenvironment effect on the differentiation of breast cancer stem cel s. METHODS:Breast cancer cel s and MCF-7 cel s were primarily cultured in fibroblast supernatant and serum-free PCM-2 medium, and formation of breast cancer cel s microspheres was observed. Proliferative ability of breast cancer cel s was detected using MTT colorimetry, and the surface markers of breast cancer stem cel s and epithelial-mesenchymal transition markers were measured using immunocytochemistry and RT-PCR methods. RESULTS AND CONCLUSION:The diameter of primary cel microspheres was larger in the serum-free PCM-2 medium than in the fibroblast supernatant, but the culture speed was faster in the fibroblast supernatant than the serum-free PCM-2 medium. At 3 days of primary culture, the expression of ALDH1 in primary cel s was greatly higher in the serum-free PCM-2 medium than in the fibroblast supernatant. However, the expressions of E-cadherin and vimentin were up-regulated in the fibroblast supernatant than in the serum-free PCM-2 medium. In addition, the expressions of E-cadherin and vimentin in MCF-7 cel s cultured in the fibroblast supernatant were up-regulated, while the expressions of ALDH1 and Oct-4 were downregulated. These findings indicate that the tumor environment has some certain effects on the growth and differentiation of breast cancer stem cel s, and some cytokines secreted from fibroblast supernatant can promote the proliferation and differentiation of breast cancer stem cel microspheres to some extent.

Significance of combined detection of five markers in patients with type 2 diabetes mellitus / 国际检验医学杂志

Objective To explore the relationship and clinical significance among glycosylated hemoglobin (HbA1c),fasting blood glucose (FPG),insulin (Ins),C peptide (CP)and urinary mirco-albumin (urine m-Alb)inpatients with type 2 diabetes melli-tus (T2DM).Methods A total of inpatients with type 2 diabetes were choose in this study and divided into mild diabetic group (HbA1c ≤ 9%)with 45 cases,severe diabetic group (HbA1c > 9%)with 44 cases.Twenty healthy persons were selected into control group.The levels of HbA1c,FPG,Ins,CP and m-Alb in urine of each group were detected and compared,the relationships of them were analyzed.Results There were significant differences on the levels of HbA1c,FPG,Ins,CP and m-Alb in urine of each group,and the former three indicators from low to high followed by the control group,the mild diabetic group,the severe diabetic group.There was no significant difference on the level of Ins between the control group and the severe diabetic group(P >0.05), but the level of Ins in the mild diabetic group was significant higher than that of the control group and the severe diabetes group (P <0.05).The CP level in the mild diabetic group was significant higher than that in the control group (P <0.05),and has a posi-tive correlation with the level HbA1c (r=0.427,P <0.05 ).The CP level in the severe diabetic group was significant lower than that in the control group,(P <0.05)and was negatively correlated with the level HbA1c (r=-0.415,P <0.05).Conclusion The joint detection of HbA1c,FPG,Ins,CP and urine m-Alb has positive significance to control type 2 diabetes,protect islet function and prevent diabetic nephropathy,CP is better than Ins on the assessment of the secretory function of islet,and CP might be in-volved in the occurrence and development of diabetic nephropathy.

Clinical Value of Arginine Stimulation Test in Evaluating Function of the First-Phase Insulin Release in Diabetic Patients / 现代检验医学杂志

Objective To investigate clinical value of arginine stimulation test to estimate the first-phase insulin release of pancreatic isletβ-cell and evaluation indicators of insulin release.Methods Choose inpatients with diabetes in the department of endocrinology,divide into type 1 diabetes mellitus group (T1DM group)12 cases,type 2 diabetes mellitus group a (T2DMa group,duration of no more than 1 year)57 cases and type 2 diabetes mellitus group b (T2DMb group,more than 1 year),82 cases.Theserum levels of blood glucose (PG),insulin (INS)and C-peptide (CP)were determined at fasting 0 mi-nutes and 2,4,6 minutes after arginine stimulation,and process the results statistically.Results After arginine stimulation, three groups of PG and the T1DM group of INS and CP had no obvious change and there were no statistical significance (F=0.150~0.696,P>0.05).In T2DMa group and T2DMb group,the peak level of INS and CP appeared at 2nd minute,and those in T2DMa group were higher than those in T2DMb group and these were statistical significance (F=12.145~40.518,P0.05).In T2DMa and T2DMb groups,those had positive correlation (r=0.768, 0.722,P<0.01).Conclusion Arginine stimulation test can be sensitively estimated the first-phase insulin release of pancre-atic isletβ-cell and that has certain clinical application value.△INS and △CP can be used to evaluating insulin release.

Treatment of 30 Cases of Vitiligo by Cupping Method plus External Application of Chinese Herbs / 针灸推拿医学（英文版）

Thirty patients with vitiligo were treated by cupping of skin lesion and compress of Chinese herbs, compared with western medical treatment. After 3-course's treatments the total effective rate ws 96.7% in treatment group and 76.7% in control group. There was a significant difference (P＜0.05)between the two groups shown by statistical analysis.

发育性髋关节脱位患儿的髋关节康复指导 / 中国康复理论与实践

@#目的探讨康复指导对发育性髋关节脱位患儿术后康复的作用。方法在术前和术后,根据手术特点,对48例(63髋)发育性髋关节脱位患儿进行髋关节康复指导。结果经1—2.5年随访 ,48例患儿(63髋)的康复优良率达95%。结论康复指导可促进发育性髋关节脱位患儿术后髋关节的康复。