ABSTRACT
Objective:To discuss the application effect of enhance recovery after surgery (ERAS) combined with system nursing in patients with thoracolumbar fracture accompanied by nerve injury.Methods:A retrospective case-control study was conducted to analyze the clinical data of 84 patients with bilateral thoracolumbar fractures accompanied by nerve injury admitted to Henan Provincial People's Hospital from August 2017 to January 2020. All patients were treated with posterior thoracolumbar spinal canal decompression, bone grafting and internal fixation. There were 55 males and 29 females, aged 36-49 years [(43.2±5.2)years]. The injury segments were located at T 10-T 11 in 6 patients, T 11-T 12 in 38, T 12-L 1 in 31, and L 1-L 2 in 9. According to the Frankel classification of neurological function, 19 patients were rated as grade A, 22 grade B, 38 grade C, and 5 grade D. A total of 42 patients were treated by ERAS combined with system nursing (ERAS group), and 42 patients by routine rehabilitation nursing (routine nursing group). The hospitalization time, incidence of perioperative complications, and patients' satisfaction with nursing work were recorded. The visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated at postoperative 1 week and 3 months. The Frankel classification of neurological function and the MOS item short from health survey (SF-36) score were measured at postoperative 3 months. Results:All patients were followed up for 3-4 months [(3.2±1.7)months]. The hospitalization time in ERAS group was (10.9±1.6)days, significantly shorter than (14.4±1.2)days in routine nursing group ( P<0.05). The incidence of perioperative complications in ERAS group was 10%(4/42), significantly shorter than 29%(12/42) in routine nursing group ( P<0.05). The satisfaction rates in ERAS group and routine nursing group were 93%(39/42) and 76%(32/42), respectively ( P<0.05). At 1 week and 3 months after operation, the VAS in ERAS group [(1.7±0.4)points, (1.2±0.3)points]was significantly lower than those in routine nursing group [(4.8±0.9)points, (3.1±0.7)points]( P<0.05). At 1 week and 3 months after operation, the ODI in ERAS group [(13.5±1.8)points, (10.3±1.4)points] was significantly lower than those in routine nursing group [(17.9±2.0)points, (15.6±2.1)points]( P<0.05). At 3 months after operation, according to the Frankel classification, there were 2 patients with grade A, 9 with grade B, 13 with grade C, 13 with grade D and 5 with grade E in ERAS group, and there were 8 patients with grade A, 8 with grade B, 12 with grade C, 10 with grade D, and 4 with grade E in routine nursing group. The recovery rate of grade A or above in ERAS group was 95%(40/42), significantly higher than 81%(34/42) in routine nursing group ( P<0.05)]. At 3 months after operation, the SF-36 score in ERAS group was better than that in routine nursing group ( P<0.05). Conclusion:For patients with thoracolumbar fracture accompanied by nerve injury, ERAS combined system nursing can shorten the hospitalization time, reduce perioperative complications, improve patients' satisfaction, reduce pain, promote the recovery of nerve function, and improve the quality of life.
ABSTRACT
Objective To investigate ultrasonographic characteristics of peripheral pulmonary lesions in AIDS-related tuberculosis,and to discuss their relationship with blood CD4+T lymphocyte level. Methods Ultrasonographic and clinical data of 63 cases of AIDS-related tuberculosis, which were confirmed by ultrasound-guided lung biopsy,were analysed retrospectively. Results Ultrasonographic characteristics classified as solid hypoechoic in 38 cases ( 60.3% ),diffused astral sign in 16 cases ( 25.4% ), and mixed solid-liquid echo in 9 cases (14.3% ).Blood CD4+T lymphocyte count was significantly lower in patients who showed diffused astral sign in pulmonary lesions ultrasonography,than those in patients who showed solid hypoechoic and mixed solid-fluid echo ( P < 0.001 ). Conclusions Ultrasonography of peripheral pulmonary lesions may reveal various imaging characteristics in AIDS-related tuberculosis. The declining level of blood CD4+T lymphocyte count may determine the ultrasonographic features of pulmonary lesions.
ABSTRACT
Tumor suppressor p53 protein can regulate the tran-scription of target genes, to control cell apoptosis, aging and other life activities,but mutant p53 is prone to losing antitumor function, thus promoting tumor development. At present, p53 protein has become one of the hot targets for the treatment of cancer. This article mainly introduces the structure and mechanism of small molecular compounds with restoring activity of mutant p53 as the target.
ABSTRACT
According to the official website of the Department of Health & Social Care,Mainly media and Independent research sector in UK and the literature analysis,it obtained related information about PFI in the UK's National Health Service(NHS).Through the description of status quo of the development of Private Finance Initiative(PFI) programs,it analyzed the existential issues,influences and improvement measures,so as to provide references for China's Public-Private Partnership(PPP)/PFI programs.
ABSTRACT
By visiting the official website of the Department of Health and Social Care,Mainstream Media and Independent Research Sector in UK.,and literature analysis,it accessed to relate information about private sector participated in health care services,and conducted the systematic description on the progress,and finally summarized the relevant experience and development trends.
ABSTRACT
A questionnaire survey of 1 000 clinicians having experience in treating uncomplicated lower urinary tract infections from different levels of hospitals was conducted to mainly evaluate the applicability and effectiveness of clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection(hereinafter referred to as Guideline). The research was conducted with the three-level quality control strictly throughout the process, and the data was real and reliable. The survey's results showed that: most clinicians considered that the Guideline had good clinical applicability. The availability and price of the recommended medicine were moderate. Traditional Chinese medicine had obvious features and advantages in treating lower urinary tract infection for it could reduce the usage of antibiotics and shorten the course of antibiotic application. In the recommendation section, clinicians proposed increasing medication guidance, updating the Guideline timely, as well as increasing treating methods and techniques, strengthen propaganda and promotion, and improve the use of evidence-based methods. In the evaluation of effectiveness, the majority of clinicians agreed that the definition in both traditional Chinese medicine (TCM) and Western medicine and differential diagnosis in the Guideline were accurately described and the basic principle of treatment as well as the treating method of TCM were recommended appropriately. The TCM formulas and Chinese patent medicine had good effect. Some clinicians suggested refining the syndrome differentiation of stranguria. Some clinicians considered that the formulas and herbs recommended in Guideline didn't have obvious effect and some had doubts about the manipulation of fumigation and washing in the part of other methods recommended in Guideline. Moreover, specification and procedure of manipulation of fumigation and washing using herbs and the acupuncture included in characteristic TCM therapy treating uncomplicated lower urinary tract infection remained to be developed.
Subject(s)
Humans , Acupuncture Therapy , Anti-Bacterial Agents , Diagnosis, Differential , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Urinary Tract InfectionsABSTRACT
Objective To establish a real-time quantitative polymerase chain reaction (qPCR) assay for B-cell lymphoblastic leukemia according to individualized and specific immunoglobulin gene rearrangements in leukemia cells, and to use it for the monitoring of minimal residual disease (MRD) of B-cell lymphocytic leukemia. Methods The immunoglobulin gene rearrangements of bone marrow samples from 15 cases of B-cell lymphoblastic leukemia were analyzed with a validated European BIOMED-2 system, and the individualized and specific qPCR-based quantification of leukemic immunoglobulin gene rearrangements was established. Results Unique and specific gene rearrangements of immunoglobulin light and heavy chains were identified in 14 cases and Ig-qPCR based on these gene rearrangements had a sensitivity of 10-5 and high specificity which met the international criteria in 10 patients. Leukemia MRD quantification with immunoglobulin gene rearrangement-based qPCR was similar as compared with other MRD detection methods. Conclusion Immunoglobulin gene rearrangement-based leukemia MRD quantification is feasible, sensitive, specific, precise and much valuable for clinical decision of treatments in B-cell lymphoblastic leukemia.
ABSTRACT
Objective To classify the types of hepatic vein and to measure their corresponding liver venous drainage volumes based on analysis of data obtained from a computer-assisted surgery system with an aim to provide an anatomical basis on individualized anatomical hepatectomy.Methods Thin-layer computed tomography (CT) imaging on 570 patients were reconstructed using the Hisense CAS.The types of hepatic vein were classified according to their anatomical variations.The margins of the hemilivers or sectors and their corresponding hepatic venous drainage volumes were displayed.Results The major hepatic veins were classified into three types:Type Ⅰ (270/570,47.4%),type Ⅱ (294/570,51.6%),and type Ⅲ (6/570,1.0%).The left hepatic vein (LHV) was classified as type Ⅰ in 190/570 (33.3%),type Ⅱ in 79/570 (13.9%),and type Ⅲ in 301/570 (52.8%).The middle hepatic vein (MHV) was classified as type Ⅰ in313/570 (54.9%),type Ⅱ in 174/570 (30.5%),and type Ⅲ in 83/570 (14.6%).The right hepatic vein (RHV) was classified as type Ⅰ in 456/570 (80.0%),type Ⅱ in 79/570 (13.9%),and type Ⅲ in 35/570 (6.1%).Type Ⅰ was further classified into four subtypes of A (26/456,5.7%),B (404/456,88.6%),C (20/456,4.4%),and D (6/456,1.3%).The LHV volume was (25.0± 6.6) %,the MHV volume was (34.8 ± 9.5) % and the RHV volume was (25.1 ± 11.6) % in 63 patients with inferior right hepatic veins (IRHV).The IRHV and other branches volumes were (14.7 ± 7.4) %.The RHV volume was (40.7 ± 8.6) % in 68 patients without IRHV.Conclusions Hepatic venous variations are complex.Significant differences existed in the hepatic venous drainage volumes.The Hisense CAS clearly delineated the relationship between the intrahepatic vascular structures and the liver carcinoma which hopefully can lead to improvement in the success rate of complex hepatectomy.
ABSTRACT
Objective To classify the types of hepatic vein and to measure their corresponding liver venous drainage volumes based on analysis of data obtained from a computer-assisted surgery system with an aim to provide an anatomical basis on individualized anatomical hepatectomy.Methods Thin-layer computed tomography (CT) imaging on 570 patients were reconstructed using the Hisense CAS.The types of hepatic vein were classified according to their anatomical variations.The margins of the hemilivers or sectors and their corresponding hepatic venous drainage volumes were displayed.Results The major hepatic veins were classified into three types:Type Ⅰ (270/570,47.4%),type Ⅱ (294/570,51.6%),and type Ⅲ (6/570,1.0%).The left hepatic vein (LHV) was classified as type Ⅰ in 190/570 (33.3%),type Ⅱ in 79/570 (13.9%),and type Ⅲ in 301/570 (52.8%).The middle hepatic vein (MHV) was classified as type Ⅰ in313/570 (54.9%),type Ⅱ in 174/570 (30.5%),and type Ⅲ in 83/570 (14.6%).The right hepatic vein (RHV) was classified as type Ⅰ in 456/570 (80.0%),type Ⅱ in 79/570 (13.9%),and type Ⅲ in 35/570 (6.1%).Type Ⅰ was further classified into four subtypes of A (26/456,5.7%),B (404/456,88.6%),C (20/456,4.4%),and D (6/456,1.3%).The LHV volume was (25.0± 6.6) %,the MHV volume was (34.8 ± 9.5) % and the RHV volume was (25.1 ± 11.6) % in 63 patients with inferior right hepatic veins (IRHV).The IRHV and other branches volumes were (14.7 ± 7.4) %.The RHV volume was (40.7 ± 8.6) % in 68 patients without IRHV.Conclusions Hepatic venous variations are complex.Significant differences existed in the hepatic venous drainage volumes.The Hisense CAS clearly delineated the relationship between the intrahepatic vascular structures and the liver carcinoma which hopefully can lead to improvement in the success rate of complex hepatectomy.
ABSTRACT
Objective To evaluate the efficacy and safety of HLA identical and haploidentical related allogeneic hematopoietic stem cell trans?plantation in the treatment of acute myeloid leukemia(AML)and myelodysplastic syndrome(MDS). Methods A total of 21 patients with AML and 8 patients with MDS who underwent allogeneic hematopoietic stem cell transplantation in our hospital from April 2011 to April 2016 were ana?lyzed retrospectively,including 16 cases of HLA?identical allogeneic HSCT,10 cases of haploidentical allogeneic HSCT,and 3 cases of syngeneic HSCT. BUCY2 or TBI plus CY ± chemotherapeutic agents was the regular conditioning regimen. No graft versus host disease(GVHD)prophylax?is was required for syngeneic HSCT,but cyclosporine in combination with methotraxate was essential for allogeneic HSCT,cyclosporine,methotrax?ate,antithymocyte globulin,mycophenolate mofetil and glucosteroids for haploidentical HSCT. Results All patients achieved fully donor?originat?ed hematopoiesis. Two patients died of severe acute GVHD within 100 days post HSCT. Acute GVHD with gradeⅡ?Ⅳoccurred in 23.1%(6/26) patients,chronic GVHD in 50%patients,therapy and relapse?relevant mortality was 4/29(13.8%)and 6/29(20.7%)cases within a median follow?up of 23(1?60)months,respectively. Two?year overall survival and leukemia free survival rates are 68.09%( 95%CI:45.77%?82.78%)and 60.22%(95%CI:38.19%?76.55%),respectively. High risk AML is still the main challenge to long?term leukemia free survival. Conclusion HLA identical and haploidentical allogeneic HSCT for AML and MDS is safe ,effective and feasible. Minimal residual disease monitoring and pre?ventative as well as preemptive intervention is necessary for improving prognosis of high risk AML.
ABSTRACT
Objective To study the relationship between bronchial asthma and smoking status in Chinese people.Methods Asthma epidemiological survey and stratified-cluster-random method survey were performed in residents over 14 years in 8 provinces (cities) of China from February 2010 to August 2012.Asthma was diagnosed based upon case history,clinical signs and lung function test.Smoking status was investigated by questionnaire.Results Sampling population was 180 099 and 164 215 were valid.A total of 2 034 subjects were diagnosed as asthma including 79 692 men and 84 523 women.The overall prevalence rate of asthma was 1.24% (2 034/164 215).Smokers were 23.8% (39 137/164 215) in the whole population.Smokers were 34.5% (702/2 034) in asthmatic patients,compared with 23.7% (38 435/ 162 181) in no-asthmatic population.The incidence of asthma was 1.79% and 1.06% in smokers and nonsmokers respectively (P <0.001),suggesting that OR of smoking was 1.70 (95% CI 1.55-1.86,P < 0.001).According to asthma control test (ACT) score,the level of asthma control in non smoking group was higher than that in smoking group(43.2% vs 35.3%).The times of hospitalization due to acute exacerbations (0.51 vs 0.41 events/person/year),total hospitalization rate (27.35 % vs 20.12%),annual emergency room visits (0.80 vs 0.60 events/person/year) and emergency room visit rate (31.77% vs 24.47%) were all much higher in smoking asthmatic patients than those in non smoking asthmatic patients,indicating that the level of asthma control in smoking patients was significantly worse than in non smoking patients.Conclusions The smoking rate in Chinese people over 14 years is still high.The prevalence rate of asthma in smokers is significantly higher than that of non-smokers.The level of asthma control in smokers is significantly worse than that in non smokers.
ABSTRACT
Objective To investigate the effect of FCGR3A polymorphisms on NK cell function. Methods Peripheral blood samples from can?cer patients were collected and FCGR3A polymorphisms were confirmed by PCR. In vitro proliferation rates,ADCC activity,and expression of NK cell activating receptors were compared under trastumab stimulation. Results This study showed that the wild?type FCGR3A exhibited a higher affinity to trastumab along with better NK cell proliferation and ADCC activity than the mutant type. Compared to the patients with wild?type FC?GR3A,the proliferation rates of NK cells in patients with the mutant type were reduced by approximately 8?fold. In addition,the expression of NK cell activating receptors in patients with wild?type FCGR3A was higher than in patients with the mutant type. Conclusion Mutations in FC?GR3Areduce NK cell function,causing a poor reaction to monoclonal antibody.
ABSTRACT
To determine heat-shock protein (Hsp)90 expression is connected with cellular apoptotic response to heat stress and its mechanism, chicken (Gallus gallus) primary myocardial cells were treated with the Hsp90 promoter, aspirin, and its inhibitor, geldanamycin (GA), before heat stress. Cellular viability, heat-stressed apoptosis and reactive oxygen species level under different treatments were measured, and the expression of key proteins of the signaling pathway related to Hsp90 and their colocalization with Hsp90 were detected. The results showed that aspirin treatment increased the expression of protein kinase B (Akt), the signal transducer and activator of transcription (STAT)-3 and p-IKKα/β and the colocalization of Akt and STAT-3 with Hsp90 during heat stress, which was accompanied by improved viability and low apoptosis. GA significantly inhibited Akt expression and p-IKKα/β level, but not STAT-3 quantity, while the colocalization of Akt and STAT-3 with Hsp90 was weakened, followed by lower cell viability and higher apoptosis. Aspirin after GA treatment partially improved the stress response and apoptosis rate of tested cells caused by the recovery of Akt expression and colocalization, rather than the level of STAT-3 (including its co-localization with Hsp90) and p-IKKα/β. Therefore, Hsp90 expression has a positive effect on cellular capacity to resist heat-stressed injury and apoptosis. Moreover, inhibition of Hsp90 before stress partially attenuated its positive effects.
Subject(s)
Apoptosis , Aspirin , Cell Survival , Chickens , Heat Stress Disorders , Heat-Shock Proteins , Hot Temperature , HSP90 Heat-Shock Proteins , In Vitro Techniques , Proto-Oncogene Proteins c-akt , Reactive Oxygen Species , TransducersABSTRACT
Objective To investigate the level of subpopulations of myeloid-derived suppressor cells (MDSCs) in elderly tumor-bearing mice versus elderly tumor-free mice,and to study the difference in immune suppressive functions between different subpopulations and their mechanisms.Methods A total of 20 healthy C57BL/6 elderly mice(aged 18-20 months) were randomly chosen to establish Lewis lung cancer models.The amount of monocytic-MDSCs (MO-MDSCs) and polymorphonuclear granulocytic-MDSCs(PMN-MDSCs) in tumor-free and tumor-bearing elderly mice was evaluated by using flow cytometry.MO-MDSCs and PMN-MDSCs were separated with Magnetic-Activated Cell Sorting (MACS) MicroBeads and their morphological characteristics were observed after May-Grunwald-Giemsa staining.The effects of MO-MDSCs and PMN-MDSCs on the proliferation of T cells were determined by Brdu-enzyme-linked immunosorbent assay(ELISA).And the immune suppressive mediators secreted by the subpopulations were detected by Real-time polymerase chain reaction(PCR).Results Compared to the tumor-free group,the proportion of MO-MDSCs in the spleen of tumorbearing group were increased [(12.44± 1.20) % vs.(38.42±3.66) %,t=5.67,P<0.001],while PMN-MDSCs were not [(10.34±0.68) % vs.(12.18±1.27) %,t=2.21,P=0.09].The result of Brdu-ELISA showed that MO-MDSCs could suppress the proliferation of T cells [(0.30 ± 0.18) vs.(3.38±0.96),t=8.33,P<0.001],while PMN MDSCs could not [(2.69±0.45)vs.(3.38±0.96),t =1.72,P=0.11].The result of PCR showed that as compared with PMN-MDSCs,Mo-MDSCs had the increased expression levels of arginase-1 (ARG-1),inducible nitric oxide synthase (iNOS),interleukin-10 (IL-10),interferon-γ(IFN-γ) (t =4.31,8.89,1.70,3.13,respectively,P < 0.01 or 0.05),while the expression levels of interleukin-13 (IL-13),transforming growth factor-β(TGF-β) had no differences (t=4.94 and 2.75,P =0.39 and0.47).Conclusions MO-MDSCs are significantly increased in elderly Lewis lung cancer mice models.MO-MDSCs could mediate lung tumor evasion by suppressing the proliferation of T cells through highly expressing ARG-1,iNOS,IL-10 and IFN-γ.
ABSTRACT
OBJECTIVE To investigate the toxicological effect of patulin(PAT)on the growth of human normal liver cells L-02 and its possible mechanisms. METHODS After cells were treated with PAT 1.25, 2.5,5,10 and 20μmol·L-1 for 24 or 48 h,cell viability was examined using MTT assay. L-02 cells were treated with PAT 5 and 10 μmol · L- 1 for 24 h ,respectively. Cytomorphology and mitochondrial membrane potential (MMP) were observed under a fluorescence microscope. Apoptosis,MMP and reactive oxygen species (ROS)were analyzed by flow cytometry. Mitochondria apoptosis pathways were detected by Western blotting. RESULTS PAT exhibited a strong inhibitory effect on L-02 in a concentration-dependent and time-dependent manner. IC50 of PAT treatment for 24 or 48 h was 6.61 and 2.78 μmol · L-1,respectively. MMP was decreased,while the percentage of low MMP cells increased from(9.2±2.3)%in controls to(23.4±4.5)%( PAT 5μmol·L-1)and(47.1±5.5)%(PAT 10μmol·L-1), respectively. Compared to untreated cells,the early apoptosis population increased from(3.8±1.1)%to(29.8±4.5)%( PAT 5μmol·L-1)and (24.1±6.2)%(PAT 10μmol·L-1)(P<0.01),respectively. Further?more,the accumulation of ROS was also observed. The effect of PAT on ROS and cell viabilities could be attenuated by glutathione. CONCLUSION PAT can significantly inhibit the growth of L-02 and induce apoptosis via ROS-dependent mitochondria pathways.
ABSTRACT
Objective To evaluate the effect of injecting botulinum toxin A (BTX-A) to the external urethral sphincter on detrusor wall thickness (DWT) and the bladder function of spinal cord injury patients with detrusor-sphincter dyssynergia (DSD).Methods Twenty-one adult patients with DSD due to spinal cord injury were recruited.A single 100 IU dose of botulinum toxin A was injected into their external urethral sphincters via an uhrasound-guided transperineal route.DWT,detrusor leak-point pressure (DLPP),post-void residual volume (PRV) and maximum bladder capacity(MBC) were assessed by urodynamic examination and ultrasound evaluation before and 4 and 8 weeks after the injection.Results Four weeks later a significant decrease in PRV was observed,but no significant difference in DWT,DLPP or MBC.After eight weeks the mean DWT value had decreased by 17%,a significant reduction.There were also significant improvements in DLPP,PRV and MBC at eight weeks compared with the of baseline values.Conclusions BTX-A injection to the external urethral sphincter can reduce DWT and improve bladder function in spinal cord injury patients with DSD.
ABSTRACT
? AIM: To compare the effects on the retina inner segment and retinal pigment epithelium ( RPE ) of intravitreally injecting bevacizumab, ranibizumab and aflibercept into monkey eyes.? METHODS: Fourteen healthy cynomolgus monkeys (Macaca fascicularis, aged 3-8y,10 males,4 females) were raised at the Covance Laboratories under standard conditions. The 14 monkeys were grouped into 4 groups. Three of the groups with 4 monkeys each were injected intravitreally with one of the drugs, either bevacizumab, ranibizumab or aflibercept, while the 4th group with 2 monkeys served as a negative control. On 1d and 7d of injection, 2 monkeys from each drug treatment group were sacrificed under general anaesthesia and the 4 eyes were enucleated. All the enucleated eyes were fixed in formalin, embedded in paraffin wax, cut into 4. 0 μm sections and deparaffinized according to standard procedures. Image-Pro Plus was used for all the photos to measure the content of vascular endothelial growth factor ( VEGF) in the inner segment and RPE. The ANOVA test from JMP10. 0 statistical program was used to evaluate the results.?RESULTS:Retinal sections were checked for their anti-VEGF immune reactivity. The untreated control samples had the highest level of VEGF in the RPE and inner segment. All of these three drugs can reduce the level of VEGF in the RPE and inner segment, but Avastin seems to be more effective than Eylea in this regard. Lucentis treatment at 1d seems to be more effective than Eylea at VEGF 1d. But at 7d, both Lucentis and Eylea have the same effect on reducing VEGF expression level in the RPE and inner segment.?CONCLUSION: All of these three drugs can reduce the level of VEGF in the RPE and inner segment.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the effectiveness of high-frequency jet ventilation via Wei jet nasal airway and controlled ventilation with improved laryngeal mask airway during bronchial thermoplasty.</p><p><b>METHODS</b>Twenty-eight patients undergoing bronchial thermoplasty were equally divided into two groups: group A (high-frequency jet ventilation through Wei jet nasal airway) and group B (controlled ventilation with improved laryngeal mask airway). Pulse oxygenation,heart rate,and mean arterial blood pressure were recorded after entering the operating room (T0), 1 minute after administration/induction (T1), bronchoscope inserting (T2), 15 minutes (T3)/30 minutes (T4)/45 minutes (T5) after ventilation,at the end of the operation (T6), and at the recovery of patients' consciousness (T7). The pH,arterial oxygen partial pressure,and arterial carbon dioxide partial pressure were recorded at T0, T4, and T6. The endoscope indwelling duration,operative time,patients' awakening time,adverse events during anesthesia,satisfactions of patients and operators, anesthesic effectiveness were also recorded.</p><p><b>RESULTS</b>The arterial carbon dioxide partial pressur in group A at T4 and T6 were significantly higher than in group B (P<0.05). The pH in group A at T4 and T6 was significantly lower than in group B (P<0.05). The endoscope indwelling duration and the operative time in group B were significantly shorter than in group A (P<0.05) while the recovery of consciousness in group B was significantly longer than in group A (P<0.05). The satisfaction for operators and the efficacy of anesthesia in group B were better than in group A (P<0.05). The number of adverse events in group B was significantly smaller than in group A (P<0.05).</p><p><b>CONCLUSION</b>The improved laryngeal mask airway with controlled ventilation is more suitable for bronchial thermoplasty.</p>
Subject(s)
Humans , Blood Gas Analysis , Bronchoscopy , Catheter Ablation , Heart Rate , High-Frequency Jet Ventilation , Laryngeal MasksABSTRACT
Objective To study characteristics and immune mechanisms of CD11b+ GR-1-myeloid-derived suppressor cells (CD11b+ GR 1+ MDSCs) in elderly mice,as compared with those of healthy young mice.Methods Totally 20 healthy C57BL/6 young mice (aged 1-2 months) and 20 elderly mice (aged over 18 months) were randomly chosen and splenetic CD11b+ GR-1+ MDSCs were sorted with the MDSCs Isolation Kit.In vitro assays,the effects of young and elderly CD1 1b+ GR 1+ MDSCs on the proliferation of T cells were determined by Brdu Elisa.Transwell co-culture and real-timePCR were used to identify the mechanisms of different immune suppressive functions of CD11b+GR 1+ MDSCs sorted from young mice and elderly mice.Results Compared with young MDSCs,elderly MDSCs could evidently suppress the proliferation of T cells (t=8.67,P<0.001),and this function could be reversed by trans-well co-culture (t=6.93,P<0.001).The results of realtime PCR revealed that,compared with young MDSCs,elderly MDSCs expressed higher levels of arginase-1 (ARG-1),inducible nitric oxide synthase (iNOS),reactive oxygen species (ROS),interleukin 10 (IL-10),IL13 and transforming growth factor (TGF)-β (t=9.04,4.86,7.04,6.92,4.51,5.46,respectively,P<0.05 or P<0.01).Conclusions CD11b+GR-1+MDSCs sorted from healthy elderly mice can evidently suppress the proliferation of T cells through cell-cell contact and secretion of suppressive medium.
ABSTRACT
Objective To investigate the ultrasonographic and pathological changes of peripheral pulmonary lesions in acquired immunodeficiency syndrome (AIDS) complicated with Penicillium marneffei pneumonia (PMP) and their clinical significance.Methods The ultrasonographic and pathological data of peripheral pulmonary lesions in 31 cases of AIDS complicated with PMP who were diagnosed in Fourth People's Hospital of Nanning were retrospectively reviewed.Results Among 31 cases of PMP,20 cases (64.5%) showed star-like diffuse sonogram,7 cases (22.6%) low solid echo and 4 cases (12.9 %) black hole-like sonogram in ultrasonographic changes of peripheral pulmonary lesions.In pathological examination,Penicillium marneffei were seen in all samples:periodic acid-Schiff stain (PAS) and periodic acid-Schiff diastase stain (PAS-D) were all positive.Twenty four cases (77.4%) mainly showed infiltration of inflammatory cells,and 7 cases (22.6 %) mainly showed necrosis and fibrous hyperplasia.Among 20 patients with star like diffuse sonogram,19 were mainly infiltration of inflammatory cells in pathological changes,and 19 were CD4+ T lymphocyte counts of 100-200/μL.Among 4 patients with black hole-like sonogram,all were necrosis in the central and hyperplasia in the peripheral in pathological changes,and CD4-T lymohocyte counts were all<50/μL.Conclusions In AIDS patients complicated with PMP,ultrasonographic features were probably correlated with pathological changes in biopsy tissues and CD4-T lymphocyte counts.