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Objective:To investigate the preoperative ascending aorta diameter in patients with acute type A aortic dissection in the Chinese population, compares and analyze the differences in preoperative blood biomarkers, and evaluate the impact of the preoperative ascending aorta diameter in this part of patients on the short-term prognosis of patients.Methods:A collection of 641 patients with acute type A aortic dissection who were enrolled in the " Acute Aortic Syndrome High-Risk Early Warning and Intervention Study" project from January 2018 to January 2020 were collected. Divide the patients into two groups (group Ⅰ<55 mm, group Ⅱ≥55 mm) according to the preventive intervention value of ascending aorta diameter recommended by the guideline for studying preoperative ascending aorta diameter difference in blood biomarkers and the influence of ascending aorta diameter on the short-term prognosis of patients. All patients had CT scans to assess the diameter of the ascending aorta before operation.Results:In this study, all patients with acute type A aortic dissection had a mean preoperative ascending aorta diameter of (46.9±9.7)mm. The preoperative ascending aorta diameter of all patients was less than 55 mm, accounted for 84.1%. Male patients were more likely to have aortic dissection than females; most patients' age was less than 60 years old. The preoperative blood inflammatory index counts were higher in the ascending aorta diameter ≥55 mm group. However, the long-term prognosis of patients with different ascending aorta diameters before surgery was not apparent in this study. The preoperative survival rate and short-term survival rate of patients with ascending aorta diameter <55 mm were higher than those of other groups, but the difference was not statistically significant.Conclusion:In patients with acute type A aortic dissection, the diameter of the ascending aorta is usually less than 55 mm. Moreover, the blood inflammatory index counts are high in the preoperative ascending aorta diameter ≥55 mm group. Meanwhile, patients with smaller ascending aorta diameter have better survival rate and short-term prognosis.
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Objective To analyze the data on the pathogenic bacteria responsible for infected pan creatic necrosis (IPN) and drug resistance,and to study the impact on prognosis of patients.Methods The clinical data from 101 patients who were diagnosed to have IPN in the Xuanwu Hospital of the Capital Medical University,Beijing,from January 2011 to August 2017,were analyzed retrospectively.Logistic regression and statistical analysis were performed to evaluate the species composition and drug-resistance in the pathogens obtained from the pancreatic necrosis tissues or the drainage culture fluids from these IPN patients in the first,second or third surgery.Results Among the 101 patients,80 had bacteria-positive cultures,of which 97 were pathogenic bacteria:74.2％ were Gram-negative,22.7％ were Gram-positive,and 3.1％ were fungi.The commonest bacterial strains included Escherichia coli (n =20),Klebsiella pneumonia (n =17),Pseudomonas aeruginosa (n =13),Acinetobacter baumannii (n =11),and Enterococcus (hereafter called Ent.) faecium (n =11).Drug resistance analysis showed that the Gram-negative bacilli were susceptible to carbapenems.The resistance rates for all the antibiotic types in K.pneumoniae exceeded 50％.The use of enzyme inhibitors significantly improved bacterial sensitivity to the beta-lactams.The Gram-positive bacteria were sensitive to vancomycin and tigecycline.Drug-resistant fungi were not identified.The multidrug resistance rates for E.coli,K.pneumoniae,P.aeruginosa and A.baumannii Gram-negative bacilli were 35.0％ (7/20),76.5％ (13/17),53.9％ (7/13) and 63.6％ (7/11),respectively,while that for Gram-positive Ent.faecium was 75.0％ (9/12).Forty patients underwent three or more surgeries.Regression analysis showed that the proportion of patients with severe acute pancreatitis who underwent three or more surgeries was higher than that of the patients who underwent fewer surgeries.However,neither the number of overall infections,nor the number of infections with multiple drug-resistant pathogens,was associated with the number of operations.Conclusions Gram-negative bacilli was mainly involved in the primary infections of patients with IPN.E.coli was the most common microbe.Our clinical experience showed that enzyme penicillins or carbapenems were the preferred treatment options.
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Objective To observe the influence on the sensitivity of pancreatic cancer cell line BxPC-3 to gemcitabine of silencing PAUF gene.Methods BxPC-3 cells,which overexpress PAUF,was stably transfected with PAUF-shCtrl and PAUF-shRNA to establish BxPC-3_shCtrl and BxPC-3_shPAUF cells as control and experiment group.Then the mRNA and protein expression level of PAUF in these two cell lines were detected by RT-PCR and western blot,respectively.The growth inhibition rates of these two cell lines treated with different concentrations of gemcitabine (0,3.1,6.25,12.5,25,50,100,200 nmol/L) were detected by MTT.Apoptosis rates in the cells treated with different concentrations of gemcitabine (0,75,100 nmol/L) were then observed by flow cytometry.Results The relative PAUF mRNA expression level in BxPC-3_shCtrl and BxPC-3 cells were 1.00 ± 0.06 and 0.83 ± 0.07,which were significantly high er than that in BxPC-3_shPAUF cells (0.25 ± 0.02;both P ＜ 0.05).The relative PAUF protein expression level in BxPC-3_shCtrl and BxPC-3 cells were 0.89 ± 0.07 and 0.95 ± 0.04,which were significantly high er than that in BxPC-3_shPAUF cells (0.31 ± 0.03;both P ＜ 0.05).The IC50 value of gemcitabine to BxPC-3_shCtrl cell was (22.88 ± 2.43) nmol/L,which was significantly higher than that of BxPC-3_shPAUF cells [(1.06 ± 0.02) nmol/L;P ＜ 0.05];apoptosis rate of BxPC-3_shPAUF cells treated by gemcitabine increased faster than that of BxPC-3_shCtrl cells.Conclusion PAUF silencing could greatly enhance the sensitivity of BxPC-3 cells to gemcitabine.