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Objective:To search, select and integrate the available evidence for the intracranial pressure management in patients with hemorrhagic stroke, to provide evidence-based references for clinical practice.Methods:According to the "6S" pyramid model, all literature on the management of intracranial pressure in patients with hemorrhagic stroke was retrieved from the websites and database including UpToDate, BMJ Best Practice, Cochrane Library, PubMed, Embase, relevant guideline net works and association websites as well as National stroke database,Yimaitong, CBM, CNKI, Wanfang Data, VIP and other databases, including Clinical decision-making, guidelines, evidence collection, systematic evaluation, expert consensus and evidence-related original research. The search time limit was from the establishment of the database to June 10, 2022. Two researchers independently evaluated the literature quality. The qualified literature was extracted.Results:A total of 19 pieces of literature were included, including 3 clinical decision-making, 5 guidelines, 3 systematic reviews, 4 expert consensuses, 3 randomized controlled studies and 1 case series study. Finally, 23 pieces of best evidence were summarized, involving 5 aspects such as assessment and monitoring, management goals, management scheme, treatment selection and methods, risk management.Conclusions:Active intracranial pressure management can improve the prognosis of patients with hemorrhagic stroke. It is recommended that health care professionals should select evidence in combination with specific clinical situations and formulate individualized intracranial pressure management programs.
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@#Objective To investigate the current status of occupational hazards and prevention and control of occupational ， - Methods ， diseases in micro small and medium sized manufacturing enterprises in Jiangxi Province. A total of 1 034 micro - small and medium sized manufacturing enterprises in Jiangxi Province were selected as the research subjects using a stratified cluster sampling method. The exposure of occupational hazards and the implementation of occupational hazards prevention and Results ， control measures were investigated. Among the 1 034 enterprises the small and micro enterprises accounted for ， 91.5%. The enterprises with serious occupational hazards were mainly concentrated in metallurgy building materials industry ， and machinery equipment and electrical appliance manufacturing industry. The exposure rate of occupational hazard factors in ， ， （ vs the categories of occupational hazard factors from high to low was physical factors dust and chemical factors 78.9% 52.8% vs ，P ） （ ）， ， 25.0% <0.01 . The exposure rate from high to low was metallurgy and building materials industry 60.8% machinery （ ）， ， equipment and electrical equipment manufacturing industry 42.9% light industry textile and tobacco processing industry （ ）， ， （ ）（P ） 32.0% chemical petrochemical and pharmaceutical industry 21.0% <0.01 . Noise exposure accounted for 98.3% in the workers exposed to physical factors. The implementation rate of prevention and control measures for occupational hazards ， in enterprises from high to low was the staffing of occupational health management personnel the establishment of ， ， occupational health management institutions the establishment of occupational health management systems the detection ， ， of occupational hazards the evaluation of the control effect of occupational hazards of construction projects and the - （ vs vs vs vs vs ，P ） pre evaluation of occupational hazards of construction projects 32.5% 25.7% 23.7% 16.2% 6.9% 4.2% <0.01 . Conclusion The focus of prevention and control of occupational hazards in manufacturing industry in Jiangxi Province is noise ， - and dust in small and micro metallurgy and building materials industry. Most of the micro small and medium sized manufacturing enterprises have not carried out the detection of occupational hazards and evaluation of occupational hazards in accordance with the law. The situation of occupational disease prevention and control is still challenging.
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@#Objective To investigate the current status of occupational hazards and prevention and control of occupational ， - Methods ， diseases in micro small and medium sized manufacturing enterprises in Jiangxi Province. A total of 1 034 micro - small and medium sized manufacturing enterprises in Jiangxi Province were selected as the research subjects using a stratified cluster sampling method. The exposure of occupational hazards and the implementation of occupational hazards prevention and Results ， control measures were investigated. Among the 1 034 enterprises the small and micro enterprises accounted for ， 91.5%. The enterprises with serious occupational hazards were mainly concentrated in metallurgy building materials industry ， and machinery equipment and electrical appliance manufacturing industry. The exposure rate of occupational hazard factors in ， ， （ vs the categories of occupational hazard factors from high to low was physical factors dust and chemical factors 78.9% 52.8% vs ，P ） （ ）， ， 25.0% <0.01 . The exposure rate from high to low was metallurgy and building materials industry 60.8% machinery （ ）， ， equipment and electrical equipment manufacturing industry 42.9% light industry textile and tobacco processing industry （ ）， ， （ ）（P ） 32.0% chemical petrochemical and pharmaceutical industry 21.0% <0.01 . Noise exposure accounted for 98.3% in the workers exposed to physical factors. The implementation rate of prevention and control measures for occupational hazards ， in enterprises from high to low was the staffing of occupational health management personnel the establishment of ， ， occupational health management institutions the establishment of occupational health management systems the detection ， ， of occupational hazards the evaluation of the control effect of occupational hazards of construction projects and the - （ vs vs vs vs vs ，P ） pre evaluation of occupational hazards of construction projects 32.5% 25.7% 23.7% 16.2% 6.9% 4.2% <0.01 . Conclusion The focus of prevention and control of occupational hazards in manufacturing industry in Jiangxi Province is noise ， - and dust in small and micro metallurgy and building materials industry. Most of the micro small and medium sized manufacturing enterprises have not carried out the detection of occupational hazards and evaluation of occupational hazards in accordance with the law. The situation of occupational disease prevention and control is still challenging.
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Objective:To observe the efficacy and safety of anlotinib combined with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) who failed second-line chemotherapy.Methods:A retrospective analysis was performed on 80 patients with advanced NSCLC who had failed second-line chemotherapy admitted in the Department of Oncology of Chaohu Hospital of Anhui Medical University from January 2017 to October 2019, and the patients were divided into control group ( n=36) and observation group ( n=44) according to the different treatment regimens. The control group was given pemetrexed + cisplatin, and the observation group adopted pemetrexed + cisplatin + anlotinib. The objective response rate (ORR), disease control rate (DCR), median progression-free survival (PFS), overall survival (OS), changes in levels of serum vascular endothelial growth factor (VEGF), carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) and treatment-related adverse reactions were compared between the two groups. Results:After 2 cycles of treatment, the ORR in the control group and observation group were 5.56% (2/36) and 18.18% (8/44), with no statistically significant difference ( χ2=1.85, P=0.174). The DCR in the two groups were 58.33% (21/36) and 81.82% (36/44), and the DCR in the observation group was significantly higher than that in the control group, with a statistically significant difference ( χ2=5.33, P=0.021). The median PFS in the two groups were 4.0 months and 6.0 months, and the median PFS in the observation group was longer than that in the control group, with a statistically significant difference ( χ2=28.47, P<0.001). The median OS in the two groups were 13.0 months and 14.8 months, with no statistically significant difference ( χ2=1.56, P=0.212). The levels of serum VEGF [(21.72±5.42) ng/L vs. (36.97±7.53) ng/L, t=14.13, P<0.001; (16.61±4.14) ng/L vs. (38.85±8.61) ng/L, t=23.09, P<0.001], CEA [(4.91±1.58) ng/ml vs. (6.62±2.84) ng/ml, t=4.64, P<0.001; (3.07±1.32) ng/ml vs. (7.08±3.31) ng/ml, t=11.50, P<0.001] and CA199 [(16.83±5.23) U/ml vs. (20.95±7.94) U/ml, t=3.75, P<0.001; (13.37±5.85) U/ml vs. (21.66±8.72) U/ml, t=7.55, P<0.001] in the control group and observation group after 2 cycles of treatment were significantly decreased compared with those before treatment, and the levels of serum VEGF, CEA and CA199 in the observation group were significantly lower than those in the control group ( t=4.78, P<0.001; t=5.68, P<0.001; t=2.76, P=0.007). The incidence of elevated blood pressure in the observation group was significantly higher than that in the control group [25.00% (11/44) vs. 2.78% (1/36), χ2=7.67, P=0.006]. Conclusion:Pemetrexed + cisplatin + anlotinib regimen for patients with advanced NSCLC who failed second-line chemotherapy can improve DCR, prolong PFS and improve the levels of serum tumor-related markers, with controllable adverse reactions.
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OBJECTIVE: To analyze the epidemiological characteristics of new occupational pneumoconiosis(hereinafter referred to as pneumoconiosis) in Jiangxi Province from 2010 to 2019. METHODS: The data of new pneumoconiosis cases in Jiangxi Province from 2010 to 2019 were collected through the Occupational Disease and Occupational Disease Health Information Monitoring Subsystem in the China Disease Prevention and Control Information System, and a retrospective analysis was conducted. RESULTS: From 2010 to 2019, there were 4 450 new cases of pneumoconiosis in Jiangxi Province. Among these cases, the main disease types were coal workers′ pneumoconiosis and silicosis, accounting for 98.5%. The number of new cases of pneumoconiosis showed a decreasing trend with the increase of years for the last ten years(P<0.05). The median age and the 0 th-100 th percentile [M(P_0-P_(100))] of new-onset pneumoconiosis diagnosis was 56.6(34.0-97.0) years old. The service length M(P_0-P_(100)) with dust-exposure was 12.0(1.0-48.0) years. The main industry of the new pneumoconiosis cases was concentrated in the coal mining and washing industry(63.4%). The distribution of economic types of enterprises with new pneumoconiosis cases was mainly state-owned enterprises(70.0%). The enterprise scale was medium-sized and small enterprises(65.9% in total). The types of work were mainly coal blenders, rock drillers, and coal miners, accounting for 56.5%. CONCLUSION: The incidence of occupational pneumoconiosis in Jiangxi Province is not optimistic. It is necessary to strengthen the prevention and control of occupational diseases on workers exposed to dust in key industries, enterprises and types of work.
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OBJECTIVE: Neoadjuvant chemotherapy (NACT) for the treatment of epithelial ovarian cancer (EOC) has remained controversial. This meta-analysis was performed to systematically assess the efficacy and safety of NACT versus primary debulking surgery (PDS) in patients with EOC.METHODS: PubMed, Embase, ClinicalTrials.gov, and Cochrane Library were queried to assess the therapeutic value of NACT versus PDS in EOC. Electronic databases were queried by using the keywords “ovarian cancer/neoplasms”, “primary debulking surgery”, and “neoadjuvant chemotherapy”.RESULTS: The available trials were pooled, and hazard ratios (HRs), relative risk ratios (RRs) and associated 95% confidence intervals (95% CIs) were determined. Sixteen trials involving 57,450 participants with EOC (NACT, 9,475; PDS, 47,975) were evaluated. We found that NACT resulted in markedly decreased overall survival than PDS in patients with EOC (HR=1.30; 95% CI=1.13–1.49; heterogeneity: p<0.001, ²=82.7%). Furthermore, our results demonstrated that the NACT group displayed increased completeness of debulking removal (RR=1.69, 95% CI=1.32–2.17; heterogeneity: p<0.001, ²=81.9%), and reduced risk of postsurgical death (RR=0.18, 95% CI=0.06–0.51; heterogeneity: p=0.698, ²=0%) and major infection (RR=0.29, 95% CI=0.17–0.51; heterogeneity: p=0.777, ²=0%) compared with patients administered PDS.CONCLUSIONS: This meta-analysis indicated that NACT results in increased completeness of debulking removal, and reduced risk of postsurgical death and major infection compared with PDS, while PDS is associated with improved survival in comparison with NACT in EOC patients.TRIAL REGISTRATION: PROSPERO Identifier: CRD42019120625
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Humanos , Procedimentos Cirúrgicos de Citorredução , Tratamento Farmacológico , Terapia Neoadjuvante , Razão de Chances , Neoplasias Ovarianas , Características da PopulaçãoRESUMO
OBJECTIVE@#Neoadjuvant chemotherapy (NACT) for the treatment of epithelial ovarian cancer (EOC) has remained controversial. This meta-analysis was performed to systematically assess the efficacy and safety of NACT versus primary debulking surgery (PDS) in patients with EOC.@*METHODS@#PubMed, Embase, ClinicalTrials.gov, and Cochrane Library were queried to assess the therapeutic value of NACT versus PDS in EOC. Electronic databases were queried by using the keywords “ovarian cancereoplasmsâ€, “primary debulking surgeryâ€, and “neoadjuvant chemotherapyâ€.@*RESULTS@#The available trials were pooled, and hazard ratios (HRs), relative risk ratios (RRs) and associated 95% confidence intervals (95% CIs) were determined. Sixteen trials involving 57,450 participants with EOC (NACT, 9,475; PDS, 47,975) were evaluated. We found that NACT resulted in markedly decreased overall survival than PDS in patients with EOC (HR=1.30; 95% CI=1.13–1.49; heterogeneity: p<0.001, ²=82.7%). Furthermore, our results demonstrated that the NACT group displayed increased completeness of debulking removal (RR=1.69, 95% CI=1.32–2.17; heterogeneity: p<0.001, ²=81.9%), and reduced risk of postsurgical death (RR=0.18, 95% CI=0.06–0.51; heterogeneity: p=0.698, ²=0%) and major infection (RR=0.29, 95% CI=0.17–0.51; heterogeneity: p=0.777, ²=0%) compared with patients administered PDS.@*CONCLUSIONS@#This meta-analysis indicated that NACT results in increased completeness of debulking removal, and reduced risk of postsurgical death and major infection compared with PDS, while PDS is associated with improved survival in comparison with NACT in EOC patients.TRIAL REGISTRATION: PROSPERO Identifier: CRD42019120625
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Objective:To compare the similarities and differences of four telemedicine diagnostic projects, for providing evidence-based policy-making advice for the development of telemedicine diagnostic projects in China.Methods:Four projects led by the government, close medical alliances, loose medical alliances and companies were selected from November 2018 to June 2019. Through semi-structured interviews with different leaders, the authors analyzed the characteristics, problems and difficulties of different projects from three dimensions of organizational system, working conditions and operational effects.Results:A total of 18 people were interviewed. Projects were different from each other in leaders, connection mechanism and effectiveness, participants and timeliness as well. The projects led by the government and close medical alliances had limited local participants with strong connection, clear but limited sources of diagnostic doctors and relatively large workload. While the projects led by loose medical alliances and companies had a wide range of participants, relatively weak connection efficiency and long response time.Conclusions:Different types of telemedicine diagnostic projects have supplemented the manpower shortage of diagnosis physicians at primary medical institutions, introduced new service participants, as well as improved the medical service system.
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Objective@#To compare the similarities and differences of four telemedicine diagnostic projects, for providing evidence-based policy-making advice for the development of telemedicine diagnostic projects in China.@*Methods@#Four projects led by the government, close medical alliances, loose medical alliances and companies were selected from November 2018 to June 2019. Through semi-structured interviews with different leaders, the authors analyzed the characteristics, problems and difficulties of different projects from three dimensions of organizational system, working conditions and operational effects.@*Results@#A total of 18 people were interviewed. Projects were different from each other in leaders, connection mechanism and effectiveness, participants and timeliness as well. The projects led by the government and close medical alliances had limited local participants with strong connection, clear but limited sources of diagnostic doctors and relatively large workload. While the projects led by loose medical alliances and companies had a wide range of participants, relatively weak connection efficiency and long response time.@*Conclusions@#Different types of telemedicine diagnostic projects have supplemented the manpower shortage of diagnosis physicians at primary medical institutions, introduced new service participants, as well as improved the medical service system.
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Objective To observe HRCT features of cochlear aqueduct (CA) in normal infants,and to explore the differences of CA diameters between sensorineural hearing loss (SNHL) infants and normal infants.Methods Totally temporal bone HRCT data of 129 infants without abnormal hearing (258 ears) were taken as control group,while temporal bone CT data of 58 infants (116 ears) diagnosed as sensorineural hearing loss (SNHL) with normal inner ear structure were collected as SNHL group.Infants in both 2 groups were divided into 1-year,2-year and 3-year subgroups.The width of external aperture and length of CA were measured,and the results were statistically analyzed.Results In normal group,CA diameters and the width of external aperture had no statistical differences between sides and genders (both P＞0.05).There was no statistical difference of CA diameters between the same subgroup in 2 groups (t=0.160,0.979,0.432,all P＞0.05),but the width of CA external aperture in subgroups of SNHL group was smaller than those of normal group (t=3.722,3.101,3.336,all P＜0.01).Conclusion The length of CA and width of external aperture increase with age,and there may be relationship between smaller width of CA external aperture and SNHL.
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Objective To analyze the diagnostic value of parameters derived from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and dynamic contrast-enhanced MRI (DCE-MRI) in cervical cancer and to explore the correlation of parameters between DCE-MRI and IVIM-DWI.Methods MRI data of 30 patients with cervical cancer confirmed by surgical pathology and 26 patients with normal cervix confirmed by clinical or MRI examination were analyzed retrospectively.All patients underwent IVIM-DWI and DCE-MRI.The IVIM-DWI was performed to calculate the values of ADC,D,D* and f.The values of Ktrans,Kep and Ve were measured on DCE-MRI.All parameters between cervical cancer and normal cervix were compared by two independent sample t-test.Diagnostic efficacy of these parameters in cervical cancer group was evaluated by using area under curve(AUC).The correlation of these parameters between IVIM-DWI and DCE-MRI was analyzed by Pearson correlation.Results The D*,f,Ktrans,Kep and Ve in cervical cancer were significantly higher than those in normal cervix.The ADC and D in cervical cancer were significantly lower than those in normal cervix.The differences of these parameters between the two groups were statistically significant (P ＜0.05).The AUC of Ktrans was the maximum (0.958),with diagnostic sensitivity of 86.7％ and specificity of 100％.F and K were positively correlated (r=0.446,P＜0.05).F and Kep were positively correlated (r=0.400,P＜0.05).Conclusion IVIM-DWI and DCE-MRI can improve the diagnostic value of cervical cancer.DCE-MRI has better diagnostic performance than IVIM-DWI.Significantly positive correlations were found between perfusion paramenters from IVIM-DWI and quantitative perfusion paramenters from DCE-MRI.
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Aim To observe the effect of thioesterase superfamily member 4 ( THEM4 ) expression on extra-cellular matrix ( ECM ) accumulation in the kidney of diabetic mice .Methods For in vivo vector delivery experiment , male CD1 mice were randomly divided in-to four groups: normal control mice ( Control group ) , diabetic mice ( DM group ) , diabetic mice receiving pYr-ads-4-THEM4 vector ( DM+THEM4 vector ) and diabetic mice receiving pYr-adshuttle-4 vector ( DM+V vector ) .pYr-ads-4-THEM4 vector or pYr-adshuttle-4 vector ( 1 mg · kg -1 ) were mixed with TransIT-EE Hydrodynamic Delivery Solution from Mirus Co .and injected into tail vein once a week for four weeks after STZ injection.Four weeks later, mice were sacrificed and Western blot , immunohistochemistry and real-time PCR were used to detect the expression of phospho-Akt(Ser 473), THEM4, TGF-β1, α-SMA, Col Ⅲ, FN proteins and THEM4 mRNA in kidneys respectively . Results THEM4 decreased in kidney of diabetes mel-litus accompanied with increased phospho-Akt ( Ser 473), TGF-β1, α-SMA and ECM.The delivery of pYr-ads-4-THEM4 vector increased THEM4 expression and decreased phospho-Akt (Ser 473), TGF-β1, α-SMA and ECM deposit in kidneys of diabetic mice . Conclusion The up-regulation of THEM4 may pre-vent ECM deposit by inhibiting the phosphorylation of Akt and down-regulating the expression of TGF-β1 andα-SMA in kidneys of diabetic mice .
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Aim To investigate the effect of thioester-ase superfamily member 4(THEM4)expression on col-lagen secretion in human renal proximal tubular epithe-lial cells (HKC)treated with high glucose. Methods In order to examine the direct effect of THEM4 ex-pression vector on PI3K/ Akt pathway and collagen se-cretion,pYr-ads-4-THEM4 expression vector was con-structed and transfected into the HKC with lipo-fectamine 2000 in vitro. HKC cells were randomly di-vided into four groups:normal glucose group (Con-trol),high glucose group (HG),high glucose plus pYr-ads-4-THEM4 vector group (HG + THEM4 vec-tor) and high glucose plus pYr-adshuttle-4 vector group (HG + V vector). After 48 h with HG stimula-tion,the cells were collected for extraction of protein and phospho-Akt (Ser 473),THEM4,TGF-β1 andα-SMA protein expression were examined by Western blot and immunofluorescence staining respectively. Col Ⅰ and Col Ⅲ were detected using the competitive sandwich ELISA kit according to the manufacturer's instructions. Results High glucose inhibited THEM4 expression,and induced increased phospho-Akt (Ser 473),TGF-β1,α-SMA and secreted ColⅠand secre-ted Col Ⅲ in HKC cells. Up-regulation of THEM4 re-versed high glucose-induced decreased THEM4,in-creased phospho-Akt (Ser 473),TGF-β1,α-SMA, secreted Col Ⅰ and secreted Col Ⅲ in HKC cells. Conclusion The up-regulation of THEM4 may de-crease Col Ⅰ and Col Ⅲ secretion by inhibiting the phosphorylation of Akt and down-regulating the expres-sion of TGF-β1 and α-SMA in high glucose-induced HKC cells.
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This article introduced the application of the standard operating procedures(SOP) in the logistics outsourcing projects of a hospital. By means of enforcing SOPs and implementation, all aspects of hospital logistics outsourcing projects are managed by sections over the entire process. These SOPs constitute a task chain that is closely linked and efficient,enhancing working efficiency and reducing risk exposure of hospital logistics outsourcing projects.
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Objective To explore the application of diffusion tensor imaging(DTI) in neonates with hypoxic ischemic encephalopathy(HIE).Methods 37 cases of full-term neonates diagnosed as HIE by pediatricians and 12 normal neonates were selected.All subjects underwent MRI and DTI at 3.0 Tesla.The correlation of FA value in posterior limb of internal capsule and neonatal NBNA score was examined.Results The FA values in posterior limb of internal capsule, splenium had significant difference between the HIE group (mild group, moderate group, severe group) and control group (P0.05).The FA in posterior limb of internal capsule and NBNA score(12-14 d;26-28 d)showed significant correlation (r=0.96,P<0.05),as well as the sequelae shape (r=0.87,P<0.05).Conclusion DTI is promising for early diagnosis of anisotropic index changes to evaluate HIE brain damage and prognosis.
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Objective To discuss the role of MRI in diagnosis and for the placenta previa and implantation presented negative in ultrasound.Methods Patients of placenta previa without placenta implantation confirmed by ultrasound were analyzed retrospectively.The patients were divided into A and B groups according to different treatment stages.A group underwent uterine segment cesarean section directly without MRI.B group underwent MRI scan first.And the MRI positive patients (B1 group) got abdominal aortic balloon temporarily block technique combined with the lower uterine segment cesarean section,if necessary,uterine artery embolization.The negative ones (B2 group) got uterine segment cesarean section directly.The placenta implantation was diagnosed by operation and (or) pathology.The maternal blood loss and hysterectomy rate between A and B group were compared.Results The sensitivity and specificity of MRI scan in placenta implantation was 0.75 and 0.916.The blood loss showed significant difference (P＜0.001).Hysterectomy rates presented no significant difference (P＞0.05).Conclusion When the ultrasound only showed placenta previa without implantation,the further test of MRI scan could detect the placenta implantation patients.After diagnosed by MRI,obstetrics and gynecology jointly intervene could effectively reduce the blood loss,or reduce the rate of hysterectomy.
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Two new compounds, (22E)-25-carboxy-8β,14β-epoxy-4α,5α-dihydroxyergosta-2,22-dien-7-one (1) and fusidione (3), along with two known compounds, 5α,8α-epidioxy ergosta-6,22-diene-3β-ol (2) and microperfuranone (4), were isolated from the fermentation products of the marine-sourced fungus Acremonium fusidioides RZ01. The structures of compounds 1 and 3 were elucidated by extensive spectroscopic methods, especially 2D NMR, and their absolute configurations were suggested on the basis of the circular dichroism spectral analysis and the NOESY data. Both new compounds showed inhibitory activity against HL-60 cells with IC values being16.6 and 44.9 μmol·L, respectively.
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Humanos , Acremonium , Química , Classificação , Metabolismo , Antineoplásicos , Química , Farmacologia , Proliferação de Células , Fermentação , Células HL-60 , Espectroscopia de Ressonância Magnética , Estrutura Molecular , Água do Mar , MicrobiologiaRESUMO
BACKGROUND:The tourniquet is usualy fuly used or bilateraly used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time. OBJECTIVE:To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty. METHODS:80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), al knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh sweling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups. RESULTS AND CONCLUSION:There were no statisticaly significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in control group (P 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty wil aleviate pain and sweling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.
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Background Sustained abnormal tear secretion in dry eye patients may lead to ocular surface and lacrimal glands in the state of long-term inflammatory cell infiltration.Lacrimal gland suffers immune attack by lymphoproliferative,and inflammation interferes normal gland secretion,in which chemokines and their receptors on lymphocytes play a key role.Objective This study was to investigate the inflammation mechanism of delayed allergy induced by Th1 cell in the development of dry eye.Methods Sixty eyes of 30 patients with dry eye and matched 30 healthy volunteers were enrolled in Affiliated First Hospital of Xinjiang Medical University from June to December in 2012.Schirmer Ⅰ test (S Ⅰ t),break up time (BUT) of tear and corneal fluorescence stain (FLS) were performed on the subjects,and conjunctiva epithelial cells were obtained using cytological method of conjunctiva imprinting.Positive cell rates of CC chemokine receptor 5 (CCR5) and CXC chemokine receptor 3 (CXCR3) were detected by flow cytology,and the relative expression levels of regulated upon activation of normal T cells exp ressed and secreted (RANTES),macrophage inflammatory protein (MIP)-lα and MIP-1β,monokine induced by interferon-γ (IFN-γ) (MIG),interferon-γ inducible protein 10 (IP10) and interferon-inducible T-cell α chemoattractant (I-TAC) mRNA were quantitatively assayed by real-time PCR.Differences of the positive rates of CCR5,CXCR3 and lignds were compared between dry eye group and normal control group.Relationship between the positive rates of CCR5,CXCR3 and BUT,S Ⅰ t,FLS scores was analyzed.Results The values of BUT,S Ⅰ t were (2.90±1.37) seconds and (4.00±2.49) mm/5 minutes in the dry eye group,which were significantly lower than (8.56±4.69) seconds and (11.31 ±5.23) mm/5 minutes in the normal control group (t =3.172,2.186,both at P＜0.05).FLS scores,positive rates of CCR5 and CXCR3 were0.90±0.57,(3.38±0.66) ％ and (2.64±0.47)％ in the dry eye group,showing significant elevations in comparison with 0.14±0.06,(2.12±0.21) ％ and (1.12±0.11) ％ in the normal control group (t=2.297,3.151,5.454,all at P＜0.05).In the dry eye group,the masculine rate of CCR5 was negatively correlated with BUT and S Ⅰ t (r=-0.473,-0.385,both at P＜0.05).The masculine rate of CXCR3 was negatively correlated with BUT and S Ⅰ t (r =-0.753,-0.684,both at P＜0.05).No considerable correlations between the positive rate of CCR5 with the positive rate of CXCR3 or FLS scores (r =0.231,0.336,both at P＜0.05).The relative expression levels of RANTES,MIP-1α,MIG and IP10 mRNA in the dry eye group were significantly higher than those in the normal control group (t =3.091,2.894,2.688,2.245,all at P＜0.05),but there were no significant differences in the relative expression levels of MIP-1β and I-TAC mRNA between the two groups (t =0.512,1.979,both at P＞0.05).The positive correlations were seen between the masculine rate of CCR5 with the relative expression of RANTES or MIP-1α mRNA (r=0.473,0.285,both at P＜0.05),but there was no obvious correlation between the masculine rate of CCR5 and the MIP-1 β mRNA expression(r=0.214,P＞0.05).In addition,the masculine rate of CXCR3 was positive correlated with the expressions of MIG and IP10 mRNA (r=0.553,0.314,both at P＜0.05),whereas the masculine rate of CXCR3 was not related to the expression of I-TAC mRNA (r=0.364,P＞0.05).Conclusions Dry eye is probably along with the long-term infiltration of inflammatory cells.The delayed allergy induced by Th1 cells and the nature killed cells is probably the primary cause to xerophthalmia.CCR5,CXCR3 and their ligands might be the regulative targets in the inflammation mechanism of dry eye.
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<p><b>OBJECTIVE</b>To examine the expression of secretoglobin family 2A member 2 (SCGB2A2) (mammaglobin A, MGB1) in oral lichen planus (OLP) lesions.</p><p><b>METHODS</b>Sixteen OLP patients and 10 healthy controls were included in this study. The real time reverse transcription-PCR (RT-PCR), Western blotting and immunohistochemistry (IHC) were used to determine the mRNA and protein of SCGB2A2.</p><p><b>RESULTS</b>Compared with healthy controls (0.48 ± 0.09), the expression of SCGB2A2 protein in OLP lesions significantly increased (1.02 ± 0.11) (P < 0.05).However, the mRNA level of SCGB2A2 in lesions was significantly lower than that in controls (P < 0.05).</p><p><b>CONCLUSIONS</b>These results suggest that SCGB2A2 may be involved in pathogenesis of OLP.</p>