Clinical characteristics and risk factors for concurrent infection in adult patients with hypopituitarism / 中国医师杂志

Objective:To explore the clinical characteristics and risk factors of concurrent infection in adult patients with hypopituitarism (HP).Methods:Clinical data of patients diagnosed with HP in Fuyang People′s Hospital from October 2016 to August 2020 were collected. Patients were divided into infected group and non-infected group according to whether they were co-infected, and the differences in clinical characteristics between the two groups were compared. The risk factors of infection in HP patients were analyzed by binary logistic regression.Results:The top three clinical manifestations of 64 HP patients were decreased libido; lack of energy, fear of cold, and poor appetite; hyponatremia. Etiological analysis of 64 HP patients: 23 cases of Sheehan′s syndrome, 14 cases of postoperative brain tumors (pituitary adenoma, craniopharyngioma, meningioma), 8 cases of idiopathic, 7 cases of pituitary adenoma, 8 cases of pituitary volume and morphology changes, and 4 cases of empty sella turcica. 40.32%(25/62) of patients with adrenal axis dysfunction received glucocorticoid replacement therapy, with 80%(20/25) receiving prednisone and 20%(5/25) receiving hydrocortisone. The replacement dose was 2.5-25(6.77±3.90)mg of prednisone equivalent dose. 37.70%(23/61) of patients with low thyroid axis function received thyroid hormone replacement therapy, of which 52.17%(12/23) free thyroxine (FT4) levels were still lower than the lower normal limit. 20%(2/10) of males ≤60 years old and 5.56%(1/18) of females≤50 years old received hormone replacement therapy for patients with hypogonadism of the gonadal axis. Among 64 HP patients included, 29 were co-infected (infected group) and 35 were not co-infected (non infected group). There was no significant difference between the infected group and the non infected group in gender, etiology, number of pituitary axis involved, glucocorticoid replacement therapy dose, thyroid hormone replacement therapy dose, and sex hormone replacement therapy rate (all P>0.05). Compared with the non infected group, the infected group was older, had a longer course of disease, lower diastolic blood pressure (DBP) and albumin levels, with statistically significant difference (all P<0.05), while the other indicators showed no statistically significant difference (all P>0.05). The results of binary logistic regression analysis showed that age, course of disease, occupation, and albumin level were the influencing factors of HP complicated infection (all P<0.05). Conclusions:The most common cause of pituitary dysfunction in adults is Sheehan′s syndrome; Adult HP patients who are older, have a longer course of disease, work as farmers, and have hypoalbuminemia are more likely to develop concurrent infections.

Association of bone resorption marker β-CTX with hypercalcemia in patients with Graves′ disease / 中国医师杂志

Objective:To explore the association of bone resorption marker β carboxyterminal peptide of collagen Ⅰ (β-CTX) with hypercalcemia in patients with Graves′ disease (GD).Methods:287 patients with GD who were hospitalized in the endocrinology department of Fuyang People′s Hospital from January 2021 to December 2021 were divided into control group ( n=251) and hypercalcemia group ( n=36) according to the corrected blood calcium level. The clinical data and serum β-CTX level of the two groups were compared. Logistic regression model was used to analyze the risk factors of hypercalcemia in GD patients. Pearson correlation was used to analyze the correlation between serum β-CTX level and other indexes. Results:Of the 287 GD patients, 36 were diagnosed as hypercalcemia, and the incidence of hypercalcemia was 12.54%. The levels of free triiodothyronine (FT3), free thyroxine (FT4), blood phosphorus (P) and β-CTX in hypercalcemia group were higher than those in control group, and the total parathyroid hormone (iPTH) in hypercalcemia group were lower than those in control group (all P<0.05). Multivariate Logistic regression analysis showed that FT3 ( OR=1.283, 95% CI: 1.049-1.570, P<0.05), iPTH ( OR=0.924, 95% CI: 0.863-0.989, P<0.05), β-CTX ( OR=2.488, 95% CI: 1.193-5.189, P<0.05) were the influencing factors for hypercalcemia in GD patients. Pearson correlation analysis showed that β-CTX was positively correlated with FT3, FT4, blood calcium, P, alkaline phosphatase (ALP), total procollagen type I amino end terminal peptide (PINP), N-bone-gamma-carboxyglutamic-acid-containing proteins (N-MID) and 25(OH)D, and negatively correlated with iPTH (all P<0.05). Conclusions:β-CTX is highly expressed in the serum of GD patients with hypercalcemia, which is a risk factor for the occurrence of hypercalcemia in GD patients.

Mechanism of polymyxin resistance related to lipopolysaccharide modification in carbapenem-resistant Klebsiella pneumoniae / 中华微生物学和免疫学杂志

Objective:To investigate the mechanism of polymyxin resistance related to lipopolysaccharide modification in carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods:Plasmid-mediated drug resistance genes in seven CRKP strains were detected by conjugation assay and mcr gene detection. The expression of polymyxin resistance-related genes was measured using quantitative real-time PCR. The complete genomes of CRKP strains were sequenced. Silver staining and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) were performed to analyze the changes in lipopolysaccharide (LPS). Results:The seven CRKP strains were negative for mcr genes and the results of conjugation assay were also negative. Moreover, no mobile genetic elements related to drug resistance were detected. Compared with wild-type strain, all seven CRKP strains that were resistant to polymyxin showed increased expression of pmrA, pmrB and pmrC genes at the transcriptional level; six showed increased expression of phoP/ phoQ genes; three showed decreased expression of crrA/ crrB genes; four showed decreased expression of mgrB gene. The missense mutation sites in drug-resistant strains were mainly in KPHS_09430, KPHS_35900, KPHS_39520 and KPHS_52420. IS Kpn14 insertion sequence was detected in CRKP-6 strain. MALDI-TOF-MS reveals the modification of natural lipid A with L-Ara4N in CRKP LPS. Conclusions:LPS modification induced by chromosome-mediated mutation in the two-component regulatory system was the main molecular mechanism of polymyxin resistance in CRKP isolates in this study. Effects of the mutation in the two-component system on polymyxin resistance varied in different strains.

Research progress in anti-reflux reconstructions and mechanism after proximal gastrectomy / 中华胃肠外科杂志

The electrophysiological activity of the gastrointestinal tract and the mechanical anti-reflux structure of the gastroesophageal junction are the basis of the anti-reflux function of the stomach. Proximal gastrectomy destroys the mechanical structure and normal electrophysiological channels of the anti-reflux. Therefore, the residual gastric function is disordered. Moreover, gastroesophageal reflux is one of the most serious complications. The emergence of various types of anti-reflux surgery through the mechanism of reconstructing mechanical anti-reflux barrier and establishing buffer zone, and the preservation of, the pacing area and vagus nerve of the stomach, the continuity of the jejunal bowel, the original gastroenteric electrophysiological activity of the gastrointestinal tract, and the physiological function of the pyloric sphincter, are all important measures for gastric conservative operations. There are many types of reconstructive approaches after proximal gastrectomy. The design based on the anti-reflux mechanism and the functional reconstruction of mechanical barrier, and the protection of gastrointestinal electrophysiological activities are important considerations for the selected of reconstructive approaches after proximal gastrectomy. In clinical practice, we should consider the principle of individualization and the safety of radical resection of tumor to select a rational reconstructive approaches after proximal gastrectomy.

Effect of individualized teaching method based on FMEA on operating room interns / 中华医学教育探索杂志

Objective:To explore the role of individualized teaching method based on failure mode and effect analysis (FMEA) in the teaching of rotation interns in operating room.Methods:Twenty-three operating room rotation interns received by Zhongnan Hospital, Wuhan University from February 2019 to September 2019 were selected as the control group, and another 23 operating room rotation interns received from October 2019 to May 2020 were selected as the research group. The control group adopted the conventional teaching method, while the research group adopted the individualized teaching method based on FMEA. The theoretical knowledge and practical operation examination results before and after teaching, self-directed learning ability before and after teaching and teaching satisfaction of interns after teaching were compared between the two groups. SPSS 25.0 was used for t test, chi-square test and rank sum test. Results:After teaching, the scores of theoretical knowledge [(91.13±6.35) vs. (84.26±5.94)] and practical operation [(89.39±5.45) vs. (79.78±5.65)], self-directed learning ability of each dimension and total scores [(280.63±23.39) vs. (248.17±20.68)] of the two groups were higher than those before teaching, and the scores of theoretical knowledge and practical operation, self-directed learning ability of each dimension and total score of the research group were higher than those of the control group ( P<0.05). After teaching, the satisfaction scores on the professional quality of the teachers, the rationality of the teaching mode and the effectiveness of the teaching mode of the interns in the research group were higher than those in the control group ( P<0.05). Conclusion:In the teaching of rotation interns in operating room, the individualized teaching method based on FMEA can not only improve the examination results of interns, enhance their self-directed learning ability, but also improve their teaching satisfaction.

The effect of siderophore virulence gene entB on the virulence of Carbapenem-resistant Klebsiella pneumoniae / 中华检验医学杂志

Objective:To study the effect of the siderophore virulence gene entB on the virulence of carbapenem-resistant Klebsiella pneumonia (CRKP). Methods:CRKP-27 was selected as the experimental strain from 30 CRKP strains collected from the First Affiliated Hospital of Kunming Medical University. The knockdown strain (Δ entB) and complementing strain (C-Δ entB) were constructed by the clustered regularly interspaced short palindromic repeat-Cas9 technology, and verified by polymerase chain reaction (PCR). In order to initially understand the effect of entB on CRKP colony morphology and virulence phenotype, the colony morphology of CRKP-27, Δ entB, and C-Δ entB strains were observed and string test were tested. Draw the growth curve of the strains and determine the effect of entB on the growth of the CRKP strains. The siderophores production ability of the strains were detected quantitatively using chrome azurol S (CAS) detection solution. Mice model of inflammation was established to observe the survival rate of mice and intuitively understand the effect of entB on CRKP virulence. Results:The PCR results showed that the Δ entB strain and C-Δ entB stranin were constructed successfully. The entB has no significant effect on the colony morphology, capsule and virulence phenotype of CRKP. The growth rate of Δ entB was significantly faster than that of CRKP-27( P=0.008) and C-Δ entB ( P=0.001), which showed that entB weakened the growth ability of CRKP. Compared with CRKP-27( P=0.001) and C-Δ entB( P=0.001), the siderophore production of Δ entB was significantly decreased by 11.739 3% and 11.964 2%, indicating that entB gene increased the capacity of CRKP to produce siderophpres. In animal experiments, compared with CRKP-27( P=0.023) and C-Δ entB( P=0.024), the survival rate of mice in the Δ entB group was significantly increased, indicating that the entB increased the virulence of the CRKP. Conclusion:The siderophore virulence gene entB significantly weakened the growth ability of the strain, but clearly enhanced the siderophore production capacity and virulence of CRKP.

Identification of coccoid forms of Helicobacter pylori and their clinical significance for eradication therapy / 中华传染病杂志

Objective:To investigate the factors associated with the occurrence of coccoid forms in clinical isolates of Helicobacter pylori ( H. pylori) and its relationship with the pathological changes of gastric mucosa. Methods:A total of 66 H. pylori-infected patients admitted to People′s Hospital of Ningxia Hui Autonomous Region from January 2020 to June 2021 were included.The clinical data of the patients were collected. Immunohistochemical staining was performed on gastric mucosal biopsy specimen to observe the occurrence of coccoid forms of H. pylori and pathological changes of gastric mucosa. Chi-square test was used for statistical analysis. Results:After immunohistochemical staining of 66 gastric mucosa biopsy specimens from H. pylori-infected patients, the co-existence of helical and coccoid forms of H. pylori was found in 26(39.39%) specimens, and no simple coccoid H. pylori change was found. Among them, the patients with a history of eradication therapy had a coccoid forms rate of 52.63%(20/38), and those without a history of eradication therapy had a coccoid forms rate of 21.43%(6/28), and the difference was statistically significant ( χ2=6.57, P=0.012). There were no significant differences in the coccoid forms rates between patients with different gender, ethnicity, age and gastric mucosal pathological changes (including atrophy, gastric intestinal metaplasia, inflammation, activity)(all P>0.050). Seventeen (73.9%) of the 23 patients whose endoscopy was more than one to three months from the last eradication therapy developed coccoid forms, while three of 15 patients whose endoscopy was more than three months from the last eradication therapy had coccoid forms, and the difference was statistically significant ( χ2=10.59, P=0.002). Conclusions:The transformation of H. pylori coccoid forms is related to the previous eradication therapy. The coccoid forms of H. pylori is equally pathogenic relative to the helical forms of H. pylori.

Analysis of renal glucose threshold and related factors in patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective:To investigate the value of renal glucose threshold and related factors in patients with type 2 diabetes mellitus.Methods:According to the cut-off point of normal renal glucose threshold(RT G 8.9-10 mmol/L), 107 patients with type 2 diabetes mellitus hospitalized in the Endocrinology Department of our hospital were divided into three groups: high RT G group(RT G>10 mmol/L), medium RT G group(8.9 mmol/L≤RT G≤10 mmol/L), and low RT G group(RT G<8.9 mmol/L). The clinical data and biochemical characteristics of each group were collected and analyzed. Results:The proportions of patients with high, medium, and low RT G of type 2 diabetes mellitus were 56%, 29%, and 15%, respectively. There were significant differences in RT G value, age, course of disease, body mass index(BMI), fasting plasma glucose(FPG), HbA 1C, total cholesterol(TC), serum creatinine, mean blood glucose(MBG), and 24-hour urine glucose between high and medium RT G groups. RT G, gender, BMI, FPG, HbA 1C, TC, and MBG in patients with high RT G group were different from those in low RT G group. Only RT G revealed a difference between medium and low RT G groups. Correlation analysis showed that RT G was positively correlated with gender, age, BMI, HbA 1C, TC, and low density lipoprotein-cholesterol(LDL-C). Regression analysis showed that BMI, HbA 1C, and LDL-C were the related factors affecting the RT G of patients with type 2 diabetes. Conclusion:There is a larger proportion of patients with high RT G in type 2 diabetes mellitus. Their BMI, HbA 1C, and LDL-C are associated with RT G in the patients with type 2 diabetes mellitus.

Influencing factors of obstructive sleep apnea hypopnea syndrome patients′ delay on health seeking behaviour: a literature review / 中国实用护理杂志

In order to provide scientific basis for health education and patient timely seeking behavior, this article summarizes the definition, the status quo and influencing factors of delayed on health seeking behavior of patients with obstructive sleep apnea hypopnea syndrome. Influencing factors mainly include clinical character, individual and environment.

Fusobacterium nucleatum promotes TNF-α-induced inflammatory changes in colorectal cancer HCT116 cell through NF-κB signaling pathway / 中华微生物学和免疫学杂志

Objective:To investigate the mechanism by which Fusobacterium nucleatum ( Fn) infection promotes TNF-α-induced inflammatory changes in colorectal cancer HCT116 cells. Methods:Fn-infected cells and TNF-α inflammation induction models were established and divided into 4 groups, namely uninfected control group, Fn-infected group, TNF-α induction group, and Fn+ TNF-α group. First, Fn was used to infect normal colonic epithelial cells hcoEPIC, colorectal cancer HCT116 and LoVo cells, the cell adhesion was detected 4 h later. Subsequently, HCT116 cells were induced with TNF-α for 3 h and then infected with Fn. After 24 h, the cell survival rate and cell damage were detected by CCK8 experiment and lactate dehydrogenase (LDH) viability assay. The ELISA method was further used to detect the expression of nuclear transcription factor NF-κB and cytokines IL-6, IL-8, and IL-1β in the cell and cell culture supernatant. Results:Fn has strong adhesion to colorectal cancer cells HCT116 and LoVo ( P<0.05), but basically does not show invasion. On the contrary, it has a higher invasion rate to normal colonic epithelial cells hcoEPIC after 24 h. Compared with the uninfected Fn group, the cell survival rate of the Fn-infected group was significantly reduced and the cell damage increased ( P<0.001). Three hours after TNF-α induction, Fn infection further promoted cell death and damage ( P<0.001). The expression of NF-κB in the Fn infection and TNF-α alone treatment group was significantly higher than that of the uninfected group ( P<0.001, P<0.05), and the NF-κB expression in the Fn+ TNF-α group was significantly higher than that of the control group and the single treatment group ( P<0.001). In the Fn infection and TNF-α treatment groups, the expressions of IL-6 and IL-8 were significantly higher than those in the uninfected group ( P<0.001), and IL-1β did not change significantly ( P>0.05). The expressions of IL-6, IL-8 and IL-1β in the Fn+ TNF-α group were significantly higher than those in the normal control group and the single treatment group ( P<0.05). Conclusions:Fusobacterium nucleatum can preferentially adhere to colorectal cancer cell HCT116, further promote TNF-α-induced cell damage and death, the expression and release of NF-κB and its downstream pro-inflammatory cytokines IL-6, IL-8, IL-1β.

Evaluation of unilateral and bilateral bimodal bone conduction hearing intervention in patients with bilateral microtia-atresia / 中华耳鼻咽喉头颈外科杂志

Objectives: To evaluate the therapeutic effects of unilateral/bilateral bone conduction hearing rehabilitation in patients with bilateral microtia accompanied with severe conductive hearing loss following staged auricle reconstruction and bonebridge implantation. Methods: Thirty-two patients, including 20 males and 12 females, with an average age of 11.8, who received surgical treatment in Peking Union Medical College Hospital (PUMCH) from March, 2016 to January, 2020 with bilateral microtia-atresia were included. Hearing thresholds, speech perception and high-resolution CT of the temporal bone were evaluated prior to surgery and individualized surgery plans (staged auricle reconstruction and bonebridge implantation) were made. Hearing thresholds and speech perception in quiet and noise (SNR = 5 dB) using unilateral Bonebridge were tested two weeks after the implantation surgery when the Bonebridge was activated and at 3th, 6th, 12th month after activation. Hearing thresholds and speech perception were also tested at least three months after the activation of the Bonebridge under three conditions: unaided, unilateral Bonebridge, and bilateral bone conduction hearing devices (Bonebridge plus contralateral ADHEAR). The international hearing aid assessment questionnaire (IOI-HA) and Glasgow children's benefit questionnaire were used to evaluate the subjective benefits of the patients. SPSS 21.0 software was used for statistical analysis. Results: Among these 32 patients, nine were conducted Bonebridge implantation surgery before auricle reconstruction, six were simultaneously with auricle reconstruction and 17 were implanted after auricle reconstruction surgery. Compared with unaided, the mean hearing thresholds (0.5, 1, 2, and 4 kHz) and speech perception following unilateral BCHD and bilateral BCHD attachment were improved significantly (P<0.05 each). The speech perceptin in noise of bilateral BCHD was better than unilateral (P<0.05 each). The modified questionnaire revealed high levels of patient satisfaction following use of both unilateral and bilateral devices. Conclusions: Individulized surgical procedures involving auricle reconstruction and Bonebridge implantation are safe and effective for patients with bilateral microtia-atresia, solving both appearance and hearing problems. Speech perception in noise is better following bilateral BCHD than unilateral BCHD attachment.

The sex- and age-specific association between resting heart rate and hypertension in rural adult residents of Henan province / 中华心血管病杂志

Objective: To investigate the sex- and age-specific association between resting heart rate and hypertension in rural adult residents of Henan province. Methods: At baseline, a total of 20 194 participants were randomly selected from Xin'an County of Henan province between July 2007 and August 2008. After excluding participants with hypertension or without resting heart rate data at baseline, and participants died or without hypertension outcome or diagnosed as gestational hypertension during follow-up between July 2013 and October 2014, 10 212 participants were finally included in this study. Multiple linear regression model was used to examine the association between resting heart rate and change of blood pressure. Logistic regression model was used to estimate the association between resting heart rate and risk of hypertension. Results: There were 2 059 new hypertensive cases (839 male) during the 6 years follow-up. After controlling for potential confounders, per 5 beats/minutes increases in resting heart rate was associated with 0.18 mmHg (1 mmHg=0.133 kPa) (95%CI 0.01-0.36 mmHg, P=0.046) absolute increase in systolic blood pressure and 7% higher risk of developing hypertension in women (95%CI 1.03-1.11, P<0.05). Compared with resting heart rate<70 beats/minutes, the adjusted RRs for 76-82 and>82 beats/minutes groups were 1.39 (95%CI 1.18-1.63, P<0.05) and 1.22 (95%CI 1.02-1.45, P<0.05), respectively. For both age groups, increased resting heart rate was positively associated with risk of hypertension in women(RR=1.05(95% CI 1.01-1.10), P<0.05 (the women those <60 years); RR=1.14(95% CI 1.04-1.25), P<0.05 (the women those≥60 years). However, no significant association was found between resting heart rate and hypertension in male residents. Conclusions: Increased resting heart rate is associated with high risk of hypertension in women who live in rural area, especially in elder women of this cohort.

Analysis of gut microbiota change in colorectal adenomatous polyps patients by 16S rRNA sequencing / 中华检验医学杂志

Objective:To explore the characteristics of gut microbiota change in colorectal adenomatous polyps (CAP), which has been considered as precancerous lesion for colorectal cancer.Methods:Thirty patients with colon adenomatous polyps (CAP group) and thirty healthy individuals without adenomatous polyps (HC group) who underwent colonoscopy at the First Affiliated Hospital of Kunming Medical University from November 2017 to April 2018 were randomly collected. The biopsy mucosae were collected by endoscopic electrocoagulation, and DNA was extracted to amplify 16S rRNA V3-V4 region, followed high-throughput sequencing with Illumina MiSeq platform. The experimental results were analyzed using Wilcoxon test.Results:The alpha diversity of CAP patients was higher than that of healthy controls (Chao & Ace P<0.01). A decreased abundance of Bacteroidetes (FC=0.38) was observed at phylum level( P<0.05). At genus level, the abundances of Bacteroides (FC=0.32) , Escherichia (FC=0.57) , Ruminococcus (FC=0.42) , Blautia (FC=0.27) , and Dorea (FC=0.57) were decreased ( P<0.05), but those of Pseudomonas(FC=2.43), Lactococcus(FC=2.84), Geobacillus(FC=2.07), and Acinetibacter(FC=2.36) were increased in CAP patients ( P<0.05). Conclusions:Compared with healthy volunteers, there are significant differences in the abundance and diversity of the adenoma tissue in CAP patients, indicating that there is an imbalance of gut microbiota in the adenomatous polyps. The imbalance of intestinal microenvironment may contribute to the occurrence and development of CAP.

Analysis of gut microbiota change in colorectal adenomatous polyps patients by 16S rRNA sequencing / 中华检验医学杂志

Objective@#To explore the characteristics of gut microbiota change in colorectal adenomatous polyps (CAP), which has been considered as precancerous lesion for colorectal cancer.@*Methods@#Thirty patients with colon adenomatous polyps (CAP group) and thirty healthy individuals without adenomatous polyps (HC group) who underwent colonoscopy at the First Affiliated Hospital of Kunming Medical University from November 2017 to April 2018 were randomly collected. The biopsy mucosae were collected by endoscopic electrocoagulation, and DNA was extracted to amplify 16S rRNA V3-V4 region, followed high-throughput sequencing with Illumina MiSeq platform. The experimental results were analyzed using Wilcoxon test.@*Results@#The alpha diversity of CAP patients was higher than that of healthy controls (Chao & Ace P<0.01). A decreased abundance of Bacteroidetes (FC=0.38) was observed at phylum level(P<0.05). At genus level, the abundances of Bacteroides (FC=0.32) , Escherichia (FC=0.57) , Ruminococcus (FC=0.42) , Blautia (FC=0.27) , and Dorea (FC=0.57) were decreased (P<0.05), but those of Pseudomonas(FC=2.43), Lactococcus(FC=2.84), Geobacillus(FC=2.07), and Acinetibacter(FC=2.36) were increased in CAP patients (P<0.05).@*Conclusions@#Compared with healthy volunteers, there are significant differences in the abundance and diversity of the adenoma tissue in CAP patients, indicating that there is an imbalance of gut microbiota in the adenomatous polyps. The imbalance of intestinal microenvironment may contribute to the occurrence and development of CAP.

Intrapartum electronic fetal heart rate monitoring / 中国实用妇科与产科杂志

Intrapartum fetal monitoring is of great importance to ensuring the safety of the fetus during labor,timely discovering the fetal hypoxia and reducing the incidence of short-term and long-term adverse outcomes of the newborn. Cardiotocography has been widely recommended for fetal monitoring during labor in the world.The clinical interpretation of it includes the definition of the basic waveform,the physiological and pathological significance of the waveform,and the management according to the cardiotocography classifications. This paper summarizes intrapartum cardiotocography based on the relevant guidelines at home and abroad in recent years.

Fluid management of amniotic fluid embolism / 中国实用妇科与产科杂志

The effective fluid resuscitation and management can not only save time for subsequent treatment measures but also lay the foundation for correcting blood loss and coagulation dysfunction,which helps avoid organ damage due to volume disorder during the treatment of amniotic fluid embolism(AFE).Amniotic fluid embolism management includes three parts:the phase of controlling volume load in right heart failure to avoid aggravation of pulmonary edema,maintain hemodynamic stability,the fluid resuscitationin cycle support phasea and restrictive fluid resuscitation in DIC phase.

Clinical analysis of different ways of extraction of the myomas in laparoscopic hysteromyomectomy / 中国实用妇科与产科杂志

OBJECTIVE: To investigate difference in the extraction of specimens between via the middle part incision of posterior vagina and via morcellation.METHODS: A retrospective analysis was performed in 70 cases of laparoscopic hystero myomectomy admitted to the gynecological ward from June 2017 to June 2018 in Shenyang Women and Children's Hospital;tissue extraction was accomplished in a specimen retrieval bag via middle part incision of posterior vagina in 36 cases,while 34 cases through morcellation.RESULTS: All the 70 patients with uterine fibroids underwent laparoscopic surgery successfully.The specimen was extracted via middle part incision of posterior vagina or through morcelation.The retrieval bags were not damaged and no complications occurred.The operation time and blood loss were compared between the two groups,and there was no significant difference[(106.58±10.24)min vs.(104.32±10.58)min,(88.89±41.60)mL vs.(88.82±46.76)mL,P>0.05].The vaginal incision healed well in follow-up.CONCLUSION: The middle part incision of posterior vagina took great advantage of the nature path.The way of the extraction is an efficacious and minimally morbid technique for removing the intact entrapped specimen after laparoscopic myomectomy.It is feasible and easy to grasp.

Expression and clinical significance of long non-coding RNA LINC00520 in laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

To investigate the expression of LINC00520 in laryngeal squamous cell carcinoma(LSCC),and analyze its relevance and roles in carcinogenesis and development of LSCC.The expression of LINC00520 in laryngeal squamous cell carcinoma tissue and paired adjacent normal tissue was determined by real-time PCR.The relationship between the expression of LINC00520 and the clinicopathological characteristics including clinical stage,pathological type,histological grade and lymph node metastasis of LSCC was analyzed.(1)The LINC00520 expression level was significantly upregulated in LSCC tissues compared to that of paired adjacent normal tissues(0.05).The LINC00520 expression level had no significant changes in poorly differentiated LSCC compared with that of well and moderately differentiated counterparts(>0.05).Moreover,the expression of LINC00520 had no significant difference between T1+T2 stage and T3+T4 stage LSCC tissues(>0.05).Interestingly,the LINC00520 level in LSCC with lymph node metastasis was significantly higher than that in patients without lymph node metastasis(<0.01).Upregulation of LINC00520 in LSCC may contribute to its metastasis.

Relationship of retinal thickness of macular region and glycosylated hemoglobin in patients with diabetes / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To investigate the correlation between retinal thickness (CSRT) in the macular region and glycosylated hemoglobin (HbA1c) of patients with type 2 diabetes mellitus.· METHODS:Totally 39 cases of patients with diabetes (77 eyes) who screened from May 2016 to March 2017 were selected,and were divided into two groups according to the levels of HbA1c,which the 24 cases (47 eyes) in the low HbA1c group (HbA1c＜8％) and 15 cases (30 eyes) in high HbA1c group (HbA1c≥8％).Other 22 cases of normal people (normal control group) and who for healthy physical examination were selected in the same period.Then,the correlation between HbA1c level and CSRT were analyzed by the Spearman correlation analysis.· RESULTS:In the high HbA1c group,HbA1c was (10.45±1.30)％,FBG was 10.67±1.64mmol/L and 2hPG was 15.98± 1.38mmol/L,which was higher than that in the low HbA1c group,and there was significant difference between the two groups (P＜ 0.05).The CSRT in the normal group was lower than the low HbA1c group and the high HbA1c group,and there was significant difference between the groups (P＜ 0.05).According to the analysis of the Spearman method,there was positive correlation between HbA1c and CSRT,macular volume,average macular thickness,FBG and those parameters,2hPG and them (P＜0.01).· CONCLUSION:The HbA1c level is associated with retinal thickening in the macular region of patients with diabetes,which could predict the severity of diabetic retinopathy and provide important guidance for prevention and treatment.

Study on plasmid-mediated blaNDM-1 gene in carbapenem-resistant Citrobacter freundii / 中国感染与化疗杂志

Objective To investigate the transmission of blaNDM-1 gene in carbapenem-resistant Citrobacter freundii. Methods A total of 18 strains of NDM-1-producing C. freundii were collected from the First Affiliated Hospital of Kunming Medical University during the period from June 2012 to October 2014. The isolates were identified and subjected to antimicrobial susceptibility testing with VITEK 2 System. Conjugation experiments, pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to determine the transferability of plasmids. Results The antibiotic susceptibility results showed that all the NDM-1-producing C. freundii isolates were resistant to penicillins, cephalosporins and carbapenems. All isolates exhibited different level resistance to other antibiotics. Conjugation experiments revealed that the plasmids harboring blaNDM-1 in 13 strains were transformed into E. coli 600, and exhibited carbapenem resistance. PFGE and Southern blot hybridization found that blaNDM-1 was located on a 33.3 kb plasmid in 16 isolates and on 33.3-54.7 kb plasmid in 2 isolates. Conclusions Our findings suggest that plasmids contribute to the horizontal dissemination of blaNDM-1 gene in carbapenemresistant C. freundii.