Risk factors for healthcare-associated bloodstream infection of carbape-nem-resistant Enterobacterales / 中国感染控制杂志

Objective To analyze the characteristics and influencing factors of healthcare-associated bloodstream infection(HA-BSI)of carbapenem-resistant Enterobacterales(CRE).Methods Retrospective nested case-control study was adopted.Fifty-six patients with CRE HA-BSI in a tertiary general hospital from January 2020 to Decem-ber 2022 were selected as the CRE group.With a 1:1 ratio,56 patients with carbapenem-sensitive Enterobacterales(CSE)BSI during the same period was selected as the CSE group.Distribution of infection strains and departments was analyzed,and the relevant factors for CRE BSI were analyzed by univariate and multivariate logistic regression analyses.Results The distribution of CRE BSI was mainly in intensive care unit(ICU,n=23,41.07％)and de-partment of hematology(n=17,30.36％).The main infection strains were Klebsiella pneumoniae(n=32,57.14％)and Escherichia coli(n=16,28.57％).Univariate analysis showed that malignant tumor,hospitalization history within 60 days,stay in ICU for＞48 hours before infection,mechanical ventilation,indwelling central venous cathe-ter,combined use of at least two kinds of antimicrobial agents,and duration of antimicrobial use ≥10 days were all related to CRE BSI(all P＜0.05).Multivariate logistic regression analysis found that stay in ICU＞48 hours before infection and duration of antimicrobial use ≥10 days before infection were independent risk factors for CRE HA-BSI(P＜0.05).Conclusion Clinical departments,especially ICU,should pay attention to the epidemiological history of patients,identify patients with high-risk factors for CRE BSI as early as possible,use antimicrobial agents ratio-nally and standardize invasive procedure,so as to reduce the occurrence of CRE HA-BSI.

Lower Baseline LDL Cholesterol Affects All-cause Mortality in Patients with First Percutaneous Coronary Intervention / 生物医学与环境科学（英文）

OBJECTIVE@#Foreign studies have reported that coronary artery disease (CAD) patients with high baseline low-density lipoprotein cholesterol (LDL-C) may have a good prognosis, which is called the "cholesterol paradox". This study aimed to examine whether the "cholesterol paradox" also exists in the Chinese population.@*METHODS@#A total of 2,056 patients who underwent the first percutaneous coronary intervention (PCI) between 2014 and 2016 were enrolled in this retrospective cohort study and classified into two groups based on baseline LDL-C = 2.6 mmol/L (100 mg/dL). The outcomes of interest included major adverse cardiovascular events (MACE), all-cause mortality, recurrent nonfatal myocardial infarction, unexpected coronary revascularization, or any nonfatal stroke.@*RESULTS@#All-cause mortality occurred in 8 patients (0.7%) from the low-LDL-C group and 12 patients (2.4%) in the high-LDL-C group, with a significant difference between the two groups (adjusted hazard ratio: 4.030, 95% confidence interval: 1.088-14.934; P = 0.037). However, no significant differences existed for the risk of MACE or other secondary endpoints, such as unexpected revascularization, nor any nonfatal stroke in the two groups.@*CONCLUSION@#In this study, a high baseline LDL-C was not associated with a low risk of clinical outcomes in CAD patients undergoing first PCI, which suggested that the "cholesterol paradox" may be inapplicable to Chinese populations.

A multi-center retrospective study of perioperative chemotherapy for gastric cancer based on real-world data / 中华胃肠外科杂志

Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.

Analysis of influencing factors of curative effect of dacryocystorhinostomy with nasal endoscope in patients with dacryocystitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the related factors that affect the efficacy of dacryocystorhinostomy performed with a nasal endoscope in the treatment of dacryocystitis.<p>METHODS:We retrospectively analysed the clinical data and postoperative results of 380 patients with dacryocystitis who were treated by dacryocystorhinostomy with a nasal endoscope in our hospital from July 2015 through April 2019. We observed the functional recovery of the lacrimal bursa, nasal cavity, anastomotic orifice and lacrimal passage and analysed the related factors that may affect the postoperative condition in cases of dacryocystitis.<p>RESULTS: In this study, 380 patients(413 eyes)with dacryocystitis were followed up for more than 6mo. The curative effect was measured by the function of the lacrimal passage after 6mo. Twenty-seven eyes of 27 cases(6.5%)showed no healing. The results of univariate analysis indicated that the severity of nasal septum deviation, the presence of a small lacrimal sac, repeated probing of the lacrimal passage, laser treatment or catheterization of the lacrimal passage and recurrent dacryocystitis(whether discovered in a routine revisit after the operation or in the early stage of the operation)influenced the curative effect of dacryocystorhinostomy in the patients. The results of Logistic regression analysis showed that the severity of nasal septum deviation, the presence of small lacrimal bursa and regular revisits after the operation were the main risk factors affecting the curative effect of nasal dacryocystitis under a nasal endoscope.<p>CONCLUSION: Dacryocystorhinostomy with a nasal endoscope is effective in the treatment of dacryocystitis, including difficult cases, and the postoperative cure rate is high. Skilled surgical technique, standard postoperative treatment and good compliance by patients are crucial to the success of the operation.

Up-Regulation of MiR-1915 Inhibits Proliferation, Invasion, and Migration of Helicobacter pylori-Infected Gastric Cancer Cells via Targeting RAGE

PURPOSE: Helicobacter pylori (HP)-infected gastric cancer (GC) is known to be a fatal malignant tumor, but the molecular mechanisms underlying its proliferation, invasion, and migration remain far from being completely understood. Our aim in this study was to explore miR-1915 expression and its molecular mechanisms in regulating proliferation, invasion, and migration of HP-infected GC cells. MATERIALS AND METHODS: Quantitative real-time PCR and western blot analysis were performed to determine miR-1915 and receptor for advanced glycation end product (RAGE) expression in HP-infected GC tissues and gastritis tissues, as well as human gastric mucosal cell line GES-1 and human GC cell lines SGC-7901 and MKN45. CCK8 assay and transwell assay were performed to detect the proliferation, invasion, and migration capabilities. MiR-1915 mimics and miR-1915 inhibitor were transfected into GC cells to determine the target relationship between miR-1915 and RAGE. RESULTS: MiR-1915 was under-expressed, while RAGE was over-expressed in HP-infected GC tissues and GC cells. Over-expressed miR-1915 could attenuate cellular proliferation, invasion, and migration capacities. RAGE was confirmed to be the target gene of miR-1915 by bioinformatics analysis and luciferase reporter assay. Moreover, HP-infected GC cellular proliferation, invasion, and migration were inhibited after treatment with pcDNA-RAGE. CONCLUSION: MiR-1915 exerted tumor-suppressive effects on cellular proliferation, invasion, and migration of HP-infected GC cells via targeting RAGE, which provided an innovative target candidate for treatment of HP-infected GC.

Expression Changes of Serum Transferrin Receptor and Its Mechanism in Children with Acute Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression changes of serum transferrin receptor（sTFR） and its related mechanism in children with acute leukemia（AL）.@*METHODS@#Forty-six children with acute leukemia treated in our hospital from June 2016 to June 2017 were selected and enrolled in the AL group, 40 healthy children were enrolled in the control group. The related clinical data were recorded, including age, sex and CNSL level. RNA interference technology was used to silence TFR genes of KG-1a and TCHu147 cells, MTT method and flow cytometry were used to analyze the effect of TFR gene on proliferation and cell cycle of KG-1a cells and TCHu147 cells. Western blot was used to detect the level of cyclin related to leukemic cells after siRNA interference.@*RESULTS@#The level of sTFR in AL patients was significantly higher than that of healthy people (P<0.05). The mRNA and protein expression levels of TFR in peripheral blood leukemic cells were all higher than those in healthy people (P<0.05). The level of sTFR closely related to the white blood cell（WBC） count, the proportion and absolute number of leukemic cells, hepcidin（Hepc） level, and risk grade in AL patients (P<0.05). The proliferation ability of KG-1a and TCHu147 cells after TFR siRNA interference was significantly inhibited (P<0.05). Fow cytometry showed that after the TFR siRNA interference, the ratio of KG-1a and TCHu147 cells in G/G phase was 62.51%±5.39% and 63.37%±4.27%, respectively, which increased significantly as compared with the blank and negative control group (P<0.05); the ratio of KG-1a and TCHu147 in G/M phase was 5.74%±1.34% and 7.37%±1.56%, respectively, which significantly decreased as compared with the blank control and the negative control group (P<0.05).@*CONCLUSION@#The peripheral blood leukemic cells of AL patients can synthesize more TFR protein, lead into the increase of sTFR level. It can effectively interfere the division of leukemia cells by downregulating the expression of TFR gene.

Case-control study on therapeutic effects between posterior corpectomy, decompression and reconstruction and combined anterior-posterior surgery for the treatment of severe thoracolumbar fractures with incomplete paraplegia / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical outcome between posterior corpectomy, decompression and reconstruction and combined anterior-posterior surgery in the treatment of severe thoracolumbar three column fractures with incomplete paraplegia, and to provide a basis for procedure selection.</p><p><b>METHODS</b>Clinical and radiographic results of posterior corpectomy, decompression and reconstruction (group A) and combined anterior-posterior surgery (group B) in the treatment of severe thoracolumbar three column fractures with incomplete paraplegia were analyzed retrospectively from January 2008 to December 2012. In group A, there were 18 patients (10 males and 8 females). The fractures were located on T11 in 1 case, T12 in 5 cases, L1 in 6 cases and L2 in 6 cases. In group B, there were 15 patients (9 males and 6 females). The fractures were located on T1 in 1 case, T12 in 5 cases, L1 in 5 cases and L2 in 4 cases. Neurological status was judged by Frankel grades. The X-ray and CT were used for evaluation of the restoration of anterior height of the fractured vertebral body, the correction of Cobbs angle, the decompression scope of spinal canal and the fusion. Complications related to operation were also considered. Results: The followup periods ranged from 12 to 18 months (averaged 16 months). The mean operation time, perioperative bleeding, postoperative drainage were (200 ± 43) min, (1100 ± 344) ml, and (400 ± 112) ml respectively in group A; and (290 ± 68) min, (1 500 ± 489) ml, (900 ± 269) ml respectively in group B. There was statistically significant difference between groups A and B (P < 0.05). There were significant improvements in anterior height of fractured vertebral body and Cobbs angle after operation. But there was no significant difference between groups A and B (P > 0.05). In Frankel grades, all patients had one grade or more improvement postoperatively. There was no significant difference between two groups (P > 0.05).</p><p><b>CONCLUSION</b>Treatment of thoracolumbar vertebra burst fractures with subtotal vertebrectomy, decompression and reconstruction of anterior column through posterior approach has a similar clinical result compared to the operation through combined anterior and posterior approach, but the posterior surgery decreased surgical trauma. It is an effective and safe surgical method.</p>

Surgical treatment of lumbosacral tuberculosis by anterior debridement,bone graft,and posterior pedicle screw-rod internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effectiveness of anterior debridement,bone graft, and posterior pedicle screw-rod internal fixation in the treatment of lumbosacral tuberculosis.</p><p><b>METHODS</b>From January 2005 to June 2012,18 patients with lumbosacral tuberculosis undergoing the surgical treatment by anterior debridement, bone graft, and posterior pedicle screw-rod internal fixation were reviewed retrospectively. There were 12 males and 6 females with an average age of 44 years old ranging from 35 to 67. Among them, 2 cases were simple low back pain,3 cases were low back pain combined with radiating pain of lower extremity and 13 cases were muscle strength hypesthesia. According to Fankle grading,the nerve function was grade C in 3 cases,grade D in 10 cases,grade E in 5 cases. Of these cases,L4.5 was involved in 8 cases,L5 in 4 cases and L5S1 in 6 cases. The lumbosacral angle was 150 to 270 and the erythrocyte sedimentation rate (ESR) was 45 to 93 mm/h before treatment. The clinical indexes including the lumbosacral incidence, Frankel grade and ESR were reviewed at follow-up.</p><p><b>RESULTS</b>All 18 cases were followed up for 14 to 22 months. The mean operation time was 180 min. The amount of bleeding was 400 to 800 ml. Except 1 case with iliac vein injuried and 4 cases with abdominal distension,no spinal injuries and severe relative complication occurred, and neurologic function improved in various degrees. Pain in lumbosacral area and radicular pain in lower extremities disappeared. The X-ray and CT films demonstrated that bony fusion was obtained in all patients during 9 to 13 months postoperatively. The lumbosacral angle and ESR were improved significantly.</p><p><b>CONCLUSION</b>Anterior debridement, bone graft, and posterior pedicle screw-rod internal fixation is an effective method in dealing with lumbosacral spine tuberculosis.</p>

Programming analysis of subthalamic nucleus deep brain stimulation / 中华神经医学杂志

Objective To analysis the effect of subthalamic nucleus deep brain stimulation (STN-DBS) on Parkinson's disease (PD) and the regulatory strategies of these stimulation parameters.Methods Six patients with PD,admitted to and received STN-DBS in our hospital from February 2012 to December 2012,were chosen in our study; the clinical symptoms of all patients were evaluated by Unified Parkinson's Disease Rating Scale (UPDRS) before and 1 mouth after STN-DBS operation;stimulation parameters were also recorded.Results The UPDRS Ⅰ scores of these patients were not significantly different between before and 1 month after STN-DBS (P＞0.05).As compared with those before surgery,the UPDRS Ⅱ,Ⅲ and Ⅳ scores of these patients 1 month after STN-DBS were significantly decreased (P＜0.05).All patients received unipolar stimulation with stimulus frequencies of equal to or greater than 130 Hz,stimulus voltages of 1.97±0.23 V and stimulus pulses of 90-120 μs.Follow-up was performed for 2～8 months,showing stable symptoms and no stimulation-related complications in all the patients.Conclusion STN-DBS could significantly improve the motor function and living quality on medium-late term PD patients; under high-frequency stimulation,the voltage and pulse width could be programmed by the energy per pulse (V· μs) value.

Systemic review of fast-track surgery in patients undergoing laparoscopic colorectal resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of fast track surgery(FTS) in patients undergoing laparoscopic colorectal resection.</p><p><b>METHOD</b>Randomized controlled trials(RCT) or clinical controlled trials(CCT) on fast-track surgery in patients undergoing laparoscopic colorectal resection were obtained from databases including CNKI, Wanfang, PubMed, EMBACE, and Cochrane Library between January 2000 and March 2012. Meta-analysis was performed with RevMan 5.1.</p><p><b>RESULT</b>There were 6 RCTs and 7 CCTs including 1795 patients. There were 955 patients in the FTS group and 840 in the control group. The time to passage of flatus was shorter(WMD=-1.37, 95%CI:-1.55~-1.19, P<0.05), time to resumption of diet/drink was shorter(WMD=-2.62, 95%CI:-2.69~-2.55, P<0.05), length of postoperative hospital stay was decreased(WMD=-1.63, 95%CI:-1.92~-1.34, P<0.05) and the incidence of postoperative complications were less(OR=0.52, 95%CI:0.41~0.67, P<0.05) in the FTS group. However, there were no differences in readmission(P>0.05).</p><p><b>CONCLUSION</b>Fast-track surgery in patients undergoing laparoscopic colorectal resection can promote bowel function recovery, decrease the incidence of postoperative complications and length of hospital stay.</p>

Maxillary sinus floor augmentation using gene-enhanced tissue engineered bone / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of maxillary sinus elevation with gene-enhanced tissue engineering bone in dogs.</p><p><b>METHODS</b>bone marrow stromal cells (BMSC) derived from dog marrow were cultured, and transduced with the adenovirus carrying bone morphogenetic protein-2 (BMP-2) gene (AdBMP-2), the adenovirus carrying green fluorescent protein (GFP) gene (AdGFP) in vitro. The bone formation ability of gene modified BMSC with scaffold was examined in nude mice and in elevated maxillary sinus of dog. Student's t-test was used for statistical analysis with SPSS 11.0 software package.</p><p><b>RESULTS</b>Gene transfection efficiency reached up to (83.95 ± 2.43)% as demonstrated by GFP expression. Ectopic bone formation was detected in nude mice. As for maxillary sinus floor elevation in a dog model, new bone formation area in the AdBMP-2 gene transduced BMSC with Bio-Oss group was significantly higher than in BMSC with Bio-Oss group at 120 d (P < 0.05).</p><p><b>CONCLUSIONS</b>AdBMP-2 gene transduced BMSC can stimulate ectopic bone formation in nude mice, and promote bone formation and maturation in the dog maxillary sinus.</p>

Community survey, treatment and long-term follow-up for human cystic echinococcosis in northwest China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Human cystic echinococcosis (CE) is a parasitic zoonosis of major public health importance throughout the world. CE is endemic throughout central Asia including northwestern China. In China, CE has been reported in 21 provinces, autonomous regions and municipalities, covering approximately 87% of China's territories. It is most common in the pastoral and semi-pastoral western provinces and regions. This study aimed to reveal the natural history, curative effect and possible re-infection risk factors of human CE through long termed follow-up of treated and untreated CE cases in Hobukesar, Xingjiang, China.</p><p><b>METHODS</b>Follow-up studies on CE were performed twice in Hobukesar from August 2005 to October 2008, after an initial mass screening performed in 1995 and 1996. Ultrasound scan was the primary diagnostic method.</p><p><b>RESULTS</b>Among 24 patients with confirmed CE, 22 were treated (surgery in 19 and chemotherapy in three). Two recurrent cases and one re-infection case were subsequently found during follow-up. The CE type of one of the recurrent cases reverted from CE4 to CE3, as classified using World Health Organization (WHO) guidelines.</p><p><b>CONCLUSIONS</b>Ultrasound was required to differentiate primary, recurrent and re-infection cases during epidemiological investigation and follow-up of CE. Most patients did not change their habits, which may be one possible cause of reinfection. One recurrent case suggested that, despite initial suggestion from the WHO Informal Working Group on Echinococcosis, CE4-type cysts are not inactive.</p>

Resection of anterior clinoidal meningiomas via a pterional extradural approach / 中华神经医学杂志

Objective To investigate the application of pterional extradural approach in surgery of anterior clinoidal meningioma resection. Methods The clinical data and treatment efficacy of 17 patients with clinoidal meningiomas, admitted to our hospital and performed surgery via a pterional extradural approach from June 2007 to May 2010, were retrospectively analyzed. Results Of the 17 patients with clinoidal meningiomas, 12 received total removal of the tumors, 4 subtotal removal and 1 partial removal. Of the 15 patients with pre-operative visual failure, 11 were markedly improved in visual acuity and visual field, 3 with no obvious changes and 1 with hypopsia. No death was noted.Conclusion The pterional extradural approach in anterior clinoidal meningioma resection can help to block the blood supply to the tumor base and detach the infra-clinoidal tumor from the internal carotid artery.

Preoperative management of cardiac surgery with glucose-6-phosphate dehydrogenase deficiency / 中国地方病学杂志

Objective To observe the perioperative management of cardiac surgery and extracorporeal circulation method in patients with glucose-6-phosphate dehydrogenase deficiency(G6PD).Methods Ten patients with G6PD deficiency underwent uneventful cardiac surgery procedures between January 2005 and December 2010.Twenty patients who had non-G6PD deficiency were as a control group,the selected conditions were the same gender,age,body mass,the risk of heart disease surgery.The preoperative management in patients with G6PD deficiency mainly focused on avoiding the drugs implicated in haemolysis,reducing the surgical stress,using moderate hypothermia extracorporeal circulation and enhancing blood conservation.Observed indicators included the assisted ventilation time,urine volume,the drainage volume of chest tube,the amount transfusion of red blood cells and plasma,the level of hemoglobin and serum total bilirubin in the 2nd day after surgery,ICU stay.Results Compared with the control group,patients with G6PD deficiency had no significant difference in duration of ventilation after the operation,drainage,urine,Hgb,bilirubin levels,and blood transfusion[(9.3 ± 4.5)h vs (8.6 ± 5.7)h,(2100 ±670)ml vs (1950 ± 490) ml,(253 ± 146)ml vs (260 ± 120)ml,(1.3 ± 1.0)U vs (1.8 ± 1.2)U,(96 ± 25)g/L vs (99 ± 12)g/L,and (24 ± 8)μmol/L vs (27 ± 1 l)μmol/L,t =0.978,2.032,1.257,0.891,2.182,2.271,and 1.329,all P ＞ 0.05].The duration of ICU discharge was significantly longer in the glucose-6-phosphate dehydrogenase deficient group[ (2.6 ± 0.6)d vs (1.8 ± 1.5)d,t =2.704,P ＜ 0.05].Conclusions Cardiac surgery can be performed safely in patients with G6PD deficiency with enhanced perioperative management.

A clinical study of tension-free inguinal hernioplasty in patients with different ages / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the application of mesh and hernia ring for tension-free hernia repair in inguinal hernioplasty in patients with different ages.</p><p><b>METHODS</b>A total of 190 patients with inguinal hernia undergoing tension-free hernia repair were divided into two groups with age above and below 60 years, and the surgical effect and complications were compared.</p><p><b>RESULTS</b>Tension-free hernia repair with mesh and hernia ring was superior to conventional hernia repair in terms of operative time, mean time for exercise and pain in patients above 60 years, but not in patients below 60 years.</p><p><b>CONCLUSION</b>Surgical repair of inguinal hernia should be performed with individualized surgical plans.</p>

Intestinal mucosal barrier dysfunction after abdominal operation and its clinical significance / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the plasma glutamine (Gln) level and relationships between the intestinal mucosal permeability and bacterial translocation and between bacterial translocation and systemic inflammatory response syndrome (SIRS) after abdominal operation.</p><p><b>METHODS</b>The peripheral blood was collected from 42 patients before and 2 and 7 days after elective abdominal operation. The plasma Gln concentration and lactulose/mannitol (L/M) ratio were measured and the whole blood bacterial DNA concentration was determined by polymerase chain reaction (PCR). The relationship between intestinal mucosal barrier dysfunction and the occurrence of postoperative SIRS was analyzed.</p><p><b>RESULTS</b>The plasma Gln level was significantly lowered (P<0.01) and L/M ratio increased (P<0.01) in these patients 2 and 7 days after the operation in comparison with the preoperative level. No bacterial DNA was detected before surgery, but PCR yielded positive results in 4 patients (9.5%, 4/42) at 2 days and in another patient at 7 days (2.4%, 1/42) after the operation. The 4 patients with positive PCR results 2 days after the operation showed significantly lower plasma Gln concentration (P<0.01) and higher L/M ratio (P<0.01) than those with negative results. SIRS occurred in 24 patients after surgery, whose plasma Gln level was significantly lower (P<0.01) and L/M ratio significantly higher (P<0.01) than that in the SIRS-free patients 2 days after the operation. Five of the 26 SIRS patients showed positive PCR results, while none of the 16 non-SIRS patients were positive, but this difference was not statistically significant (P>0.05).</p><p><b>CONCLUSION</b>Decreased plasma Gln and increased intestinal mucosal permeability are closely related to postoperative bacterial translocation and the intestinal mucosal barrier dysfunction, which may contribute to the occurrence of postoperative infection.</p>

The effect of chelerythrine on the hypertrophy of cardiac myocytes of neonatal rats induced by different glucose levels and its mechanism / 药学学报

The purpose of this study is to investigate the effect of chelerythrine on the hypertrophy of cardiomyocytes of neonatal rats induced by different glucose levels and its mechanism. Using cultured neonatal ventricular myocytes as a model, groups were divided as: control (5 mmol x L(-1)); high glucose level (10, 15, 20, and 25.5 mmol x L(-1)); high glucose level (25.5 mmol x L(-1)) add different concentrations of chelerythrine (1 and 8 micromol x L(-1)); and control glucose level (5 mmol x L(-1)) add different concentrations of chelerythrine (1 and 8 micromol x L(-1)). Different groups of cardiomyocytes after adding corresponding treat factors were cultured for 48 hours. Cardiomyocytes' diameters and protein level were measured and the expression of PKC-alpha, PKC-beta2, p-PKC-alpha, and p-PKC-beta2 were measured by Western blotting. Compared with control group, neonatal myocytes cultured in high glucose levels showed increased cellular volumes, protein level and expression of PKC-alpha, PKC-beta2, p-PKC-alpha, p-PKC-beta2. When chelerythrine was added, cellular volumes, protein level and expression of PKC-alpha, PKC-beta2, p-PKC-alpha, p-PKC-beta2 were significantly reduced. But in 1 micromol x L(-1) chelerythrine group, the expression of PKC-beta2 was not significantly reduced. The result suggested that chelerythrine can reverse the hypertrophy induced by different glucose levels on the cardiac myocytes, it may have protective effect against diabetic cardiomyopathy via PKC passageway.

Influence of various glucose levels on the structure and function of cultured neonatal rats cardiomyocytes / 中华心血管病杂志

<p><b>OBJECTIVE</b>To study the influence of various glucose levels on the structure and function of cultured neonatal rats cardiomyocytes.</p><p><b>METHOD</b>Cultured neonatal ventricular cardiomyocytes were treated with various glucose levels for 5 days: control (5.5 mmol/L); high (25.5 mmol/L); intermittent high (5.5 mmol/L or 25.5 mmol/L in every 12 hours interval); high (25.5 mmol/L) + PKC inhibitor Ro-31-8220 (50 nmol/L). Then, the cell beating frequency was counted, the cardiomyocytes diameters were measured and the expressions of PKC-alpha, PKC-beta(2), p-PKC-alpha, p-PKC-beta(2), NF-kappaB and c-fos were determined by Western blot.</p><p><b>RESULTS</b>Compared with control group, cardiomyocytes beating frequency, diameters as well as the expressions of PKC-alpha, PKC-beta(2), p-PKC-alpha, p-PKC-beta(2), NF-kappaB and c-fos were significantly increased in high glucose concentration (all P < 0.05) and intermittent high glucose treatment further amplified these changes (all P < 0.05 vs. high glucose and control groups). High glucose induced changes could be significantly attenuated with PKC inhibitor Ro-31-8220.</p><p><b>CONCLUSION</b>High, especially intermittent high glucose could lead to diabetic cardiomyopathy by promoting cardiac hypertrophy, increasing beating frequency via activating PKC/NF-kappaB/c-fos pathways.</p>

Expression of c-myc mRNA on early restenosis after carotid endarterectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the expression and changes of protooncogene c-myc in early restenosis after carotid endarterectomy (CEA).</p><p><b>METHODS</b>Using New Zealand Rabbits, carotid atherosclerotic stenosis (CASS) model were created. The expression of c-myc in early restenosis after CEA were detected by quantitative real-time polymerase chain reaction (qRT-PCR).</p><p><b>RESULTS</b>In this experiment protooncogene c-myc was analysed at pre-operation, 4 hours and 1 d after CEA by qRT-PCR, and the level of mRNA of c-myc was reached maximum at 4 hours, and decreased following significantly, but still higher than pre-operation.</p><p><b>CONCLUSIONS</b>The activation of protooncogene c-myc may be generator factor of vascular smooth muscle cell proliferation.</p>

Experimental study of maxillary sinus lifting with tissue engineered bone / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of tissue engineering bone in maxillary sinus lifting.</p><p><b>METHODS</b>The marrow stromal stem cells of dog were cultured in DMEM containing 100 m1/L fetal bovine serum and induced to differentiate to osteoblasts, which were then inoculated together with Bio-Oss for 5 days. Sixteen dog's bilateral maxillary sinus were elevated. One side was grafted with a compound of BMSC and Bio-Oss and the other side grafted with Bio-Oss alone. The samples were studied by gross, CT, histomorphology and histomorphometrical analysis at the 30th, 90th day after the operation. t-test was used for statistical analysis.</p><p><b>RESULTS</b>In gross view and CT, new bone formation was observed in all maxillary sinus after 30 and 90 days respectively. Histomorphometrical analysis showed much more new callus in BMSC-Bio-Oss group than in Bio-Oss group (P < 0.05).</p><p><b>CONCLUSIONS</b>A better effect of new bone formation could be obtained with tissue engineered bone in maxillary sinus lifting.</p>