Effects and mechanism of cyclophosphamide on the ovarian structure and function of rats with premature ovarian failure / 解放军医学杂志

Objective To establish the premature ovarian insufficiency (POI) rat model with cyclophosphamide (CTX),and investigate the effects and mechanism of CTX on the ovarian structure and function.Methods Fifty female Sprague-Dawley (SD) rats were randomly divided into model group and control group.Rats in model group received intraperitoneal injection of loading dose CTX (50mg/kg),and maintenance dose of 8mg/(kg.d) for 14 days.Rats in the control group were given the same amount of saline during the same period.The modeling effects were judged by observation and comparison of estrous cycle,levels of sex hormone and morphological changes of organs between the two groups;the apoptosis of follicular granulose cell were detected by TUNEL,the contents of inflammatory cytokines in tissue homogenates were detected by ELISA,and the expressions of apoptosis related proteins were measured by Western blotting.Results Compared with control group,the estrous cycle in model group was disordered;the levels of serum anti-mullerian hormone (AMH) and estrogen (E2) decreased significantly (P＜0.01) and those of follicle stimulating hormone (FSH) increased markedly (P＜0.01);the quantity of follicles decreased obviously (P＜0.05);the endometrium atrophied,the uterine wall thinned and the glands decreased in number.Compared with the control group,the apoptosis of follicular granulose cells increased in model group;the contents of TNF-α,IL-1β and IL-6 in the tissue homogenate increased significantly (P＜0.01),the contents of vascular endothelial growth factor-α (VEGF-α) decreased markedly (P＜0.01);the expression of apoptosis related protein Bax was up-regulated remarkably (P＜0.01),while of Bcl-2 was down-regulated obviously (P＜0.01).Conclusion CTX may induce the changes of ovary structure and endocrine function,and the mechanism may be related to the local microenvironment changes and the imbalance of Bax/Bcl-2 expression in regulating the apoptosis of granulose cells.

Viral and Bacterial Etiology of Acute Diarrhea among Children under 5 Years of Age in Wuhan, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acute diarrhea remains the serious problem in developing countries, especially among children under 5 years of age. Currently, only two or three common diarrhea pathogens were screened at most hospitals in China. The aim of this study was to provide a wide variety of diarrhea pathogens and their antimicrobial resistance patterns in children under 5 years of age.</p><p><b>METHODS</b>Totally 381 stool samples collected from Tongji Hospital between July 1, 2014 and June 30, 2015 were tested by culture and/or polymerase chain reaction for eight kinds of bacteria and five kinds of viruses. An antimicrobial sensitivity test was performed using dilution method recommended by the Clinical and Laboratory Standards Institute.</p><p><b>RESULTS</b>Viral infections were mainly identified in infants (0-11 months), whereas bacterial infections were more prevalent in the age of 24-59 months. About 69.8% of samples were positive for at least one pathogen, 51.7% of samples were virus positive, followed by bacteria positive cases (19.4%), and 12.6% of cases displayed co-infections with two viruses or a virus and a bacterium. Rotavirus was the most prevalent pathogen, followed closely by norovirus, while Salmonella was the most commonly isolated bacteria, followed by diarrheagenic Escherichia coli (DEC) and Campylobacter. More than 40% of Salmonella spp. and DEC isolates were resistant to first-line antibiotics (ampicillin, trimethoprim-sulfamethoxazole, and tetracycline). Around 10% of Salmonella spp. isolates were resistant to ceftriaxone and ciprofloxacin simultaneously. Campylobacter spp. displayed high resistance to ciprofloxacin but kept low resistance to azithromycin and doxycycline.</p><p><b>CONCLUSIONS</b>The etiology of acute diarrhea varies in children of different age groups. The high frequency of infection with viruses suggests the urgent demand for new viral vaccine development. Proper use of antibiotics in the treatment of acute diarrhea is crucial due to the high level of antibiotic resistance.</p>

Early removal of the chest tube after lobectomies: a prospective randomized control study / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and safety of early chest tube removal after lobectomies for lung diseases.</p><p><b>METHODS</b>A prospective randomized control study was performed with data collected from lobectomies between March 2012 and September 2012. Eligible patients (n = 70) were randomized into two groups; early removal group (removal of chest tube when drainage less than 300 ml/24 h, n = 41) and traditional management group (removal of chest tube when drainage less than 100 ml/24 h, n = 29). Criteria for early removal were established and met before chest tube removal. The volume and character of drainage, time of extracting drainage tube and postoperative hospital stay were measured. All patients received standard care during hospital admission and a follow-up visit was performed after 7 days of discharge from hospital.</p><p><b>RESULTS</b>There were no differences between two groups with respect to age, sex, comorbidities, or pathologic evaluation of resection specimens. The median volume of drainage within 24 h after surgery was 300 ml and within 48 h was 250 ml, there was significantly different between two groups (Z = -2.059, P = 0.039). Patients undergoing early removal management had a shorter Chest tube duration (44 hours vs. 67 hours, Z = -2.914, P = 0.004) and a shorter postoperative hospital stay (5.0 days vs. 6.0 days, Z = -3.882, P = 0.000). Analysis of data showed no statistically significant differences between the rate of pleural effusions developed, thoracentesis and complications, one week after discharge from hospital.</p><p><b>CONCLUSIONS</b>Compared to the traditional management group (drainage ≤ 100 ml/24 h), early removal of chest tube after lobectomy (drainage ≤ 300 ml/24 h) is feasible and safe. It could result in a shorter hospital stay, and most importantly, reduces morbidity without the added risk of complications.</p>