Correlation between body mass index and pulmonary function indexes in patients with bronchial asthma and suggestions for patient management / 中华健康管理学杂志

Objective:To analyze the correlation between body mass index (BMI) and lung function in patients with bronchial asthma (asthma).Methods:This study was a retrospective study. A total of 828 patients with asthma were included from March 2013 to November 2022 in the first affiliated Hospital of Guangxi Medical University, including 292 males and 536 females, aged 21-82 years, with a median age of 47 years. According to BMI, these asthma patients were divided into high BMI group (BMI≥24 kg/m 2), normal BMI group (18.5 kg/m 2≤BMI<24 kg/m 2) and low BMI group (BMI<18.5 kg/m 2). Forced vital capacity (FVC), forced expiratory volume in first second (FEV 1), FEV 1/FVC, maximum mid-expiratory flow (MMEF), forced expiratory flow at 25%, 50% and 75% of FVC (FEF 25%, FEF 50%, FEF 75%), peak expiratory flow (PEF), absolute increases in measured values of FVC and FEV 1 and percentage increases in FVC%pred (“%pred” represents the percentage of related indicators to expected value) and FEV 1%pred after inhalation of bronchodilator (salbutamol) were measured by pulmonary function meter. The correlation between BMI and the above indexes was analyzed. Results:In the high BMI group, FEV 1%pred, MMEF, FEF 25%, FEF 50% and FEF 75% were significantly lower than those in the normal BMI group and the low BMI group (all P<0.05), FVC% pred was significantly lower than those in the normal BMI group( P<0.05), and the percentage increase of FEV 1%pred was significantly lower than those in low BMI group ( P<0.05). FVC% pred in the normal BMI group was significantly higher than that in the low BMI group ( P<0.05). In male patients, BMI was negatively correlated with the absolute increase of FEV 1 ( r=-0.148, P<0.05); In female patients, BMI was negatively correlated with FEV 1%, FEV 1/FVC, MMEF, FEF 25%, FEF 50%, FEF 75% and the percentage increase of FEV 1%pred ( r=-0.124, -0.127, -0.165, -0.138, -0.156, -0.162, -0.106, all P<0.05). Conclusion:There is a significant correlation between BMI and lung function in patients with asthma, and the lung function in patients with high BMI is relatively worse; and in female patients, the effect of BMI on lung function is more significant; the increase of BMI can lead to the decrease of lung function and airway reversibility, suggesting that attention should be paid to the management of BMI in asthma management.

Research progress in autophagy and tumor angiogenesis / 国际生物医学工程杂志

Autophagy is a special cellular process, which can participate in regulating cell survival, growth, differentiation and homeostasis maintenance by transporting damaged organelles and macromolecular substances to lysosomes for degradation. Autophagy plays a very important role in all aspects of life process. Research results show that autophagy plays an important role in tumor occurrence, development and metastasis. The synergistic effect of autophagy and vascular endothelial growth factor promotes tumor angiogenesis and cell repair, and may play an important role in the development of tumor resistance to anti-vascular drug therapy. Targeted therapy with autophagy as the target may be a new direction for anti-tumor molecular targeted therapy in the future, aiming to provide multi-target collaborative therapy to benefit patients.

Corrigendum to "Cell Cycle Genes Are Potential Diagnostic and Prognostic Biomarkers in Hepatocellular Carcinoma".

[This corrects the article DOI: 10.1155/2020/6206157.].

Cell Cycle Genes Are Potential Diagnostic and Prognostic Biomarkers in Hepatocellular Carcinoma.

BACKGROUND: The cell cycle pathway genes are comprised of 113 members which are critical to the maintenance of cell cycle and survival of tumor cells. This study was performed to investigate the diagnostic and prognostic values of cell cycle gene expression in hepatocellular carcinoma (HCC) patients. METHODS: Clinical features and cell cycle pathway gene expression data were obtained from the Gene Expression Omnibus and The Cancer Genome Atlas databases. Differentially expressed genes (DEGs) were determined by the student t-test between HCC and noncancerous samples. Kaplan-Meier survival, univariate, and multivariate survival analyses and validation analysis were performed to characterize the associations between cell cycle gene expression and patients' overall survival and recurrence-free survival. RESULTS: 47 and 5 genes were significantly upregulated and downregulated genes in HCC samples, respectively. The high expression of BUB3, CDK1, and CHEK1 was associated with increased mortality (adjusted P value = 0.04, odds ratio (OR): 1.89 (95% confidence interval (CI): 1.04-3.46); adjusted P value = 0.02, OR: 2.06 (95% CI:1.15-3.75); and adjusted P value = 0.04, OR: 1.84 (%95 CI: 1.03-3.32), respectively). The expression of PTTG2 and RAD21 was significantly associated with cancer recurrence (adjusted P value = 0.01, OR: 2.17 (95% CI: 1.24-3.86); adjusted P value = 0.03, OR: 1.88[95% CI:1.08-3.28], respectively), while the low expression of MAD1L1 was associated with cancer recurrence (adjusted P value = 0.03, OR: 0.53 (%95 CI: 0.3-0.93)). CONCLUSIONS: The present study demonstrated that BUB3, CDK1, and CHEK1 may serve as a prognostic biomarker for HCC patients. PTTG2, RAD21, and MAD1L1 expression is a major factor affecting the recurrence of HCC patients.

Simultaneous Determination of the Contents of 12 Flavonoids in Quzhiqiao from Different Collection Places by HPLC / 中国药房

OBJECTIVE：To establish a method for the simultan eous determination of the contents of 12 flavonoids in Quzhiqiao. METHODS ：HPLC method was adopted. The determination was performed on Agilent Extend C 18 column with mobile phase consisted of 0.1％ formic acid-acetonitrile （gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was set at 35 ℃. The detection wavelength was set at 330 nm，and sample size was 10 μL. The contents of 12 components（such as eriocitrin，narirutin，naringin，naringenin，hesperidin，neohesperidin，hesperide hydrate ，luteolin，hesperide，nobiletin，hesperetin and hesperidolactone ）in 10 batches of Quzhiqiao from different collection places were determined. RESULTS ：The linear range of eriocitrin，narirutin，naringin，naringenin，hesperidin，neohesperidin，hesperide hydrate ，luteolin，hesperide，nobiletin，hesperetin and hesperidolactone were 1.65-16.51，4.50-45.02，35.41-354.12，4.11-41.12，2.29-22.86，34.96-349.56，1.42-14.15，1.50-15.04， 1.83-18.28，1.51-15.08，1.61-16.12，1.28-12.84 μg/mL，respectively（all r＞0.999 7）. The detection limits were 0.165 1，0.450 2， 3.541 2，0.411 2，0.228 6，3.495 6，0.141 5，0.150 4，0.182 8，0.150 8，0.161 2，0.128 4 μg/mL，respectively. The limits of quantitation were 0.547 8，1.487 4，11.663 3，1.360 3，0.758 3，11.594 9，0.466 3，0.497 1，0.601 2，0.499 9，0.532 3，0.424 6 μg/mL，respectively. RSDs of precision （n＝6），reproducibility（n＝6）and stability （24 h，n＝7）tests were all lower than 3％. The average recoveries were 99.50％，99.61％，98.18％，98.85％，98.48％，98.50％，98.25％，99.91％，103.13％，98.82％， 98.44％ ， 100.29％ （RSD＝1.49％ -2.38％ ， n＝6）. The contents of the above 12 components in 10 batches of samples from different collection places were 1.995 5-2.648 8，4.317 7- 5.005 1，33.215 5-34.054 6，3.140 4-3.471 5，3.221 2-3.748 8， 42.746 6-44.026 6，0.202 7-0.239 4，0.191 2-0.208 8，0.080 3- 0.097 9，0.291 9-0.307 1，0.119 9-0.149 1，0.082 7-0.089 8 mg/g. CONC LUSIONS：The method is accurate ，reliable，simple and efficient，which can be used to simultaneous determination of the contents of 12 flavonoids in Quzhiqiao ，and to provide reference for the establishment of quality control standards of Quzhiqiao.

Long non-coding RNA MACC1-AS1 promoted pancreatic carcinoma progression through activation of PAX8/NOTCH1 signaling pathway.

BACKGROUND: Accumulated evidences have demonstrated that long non-coding RNAs (lncRNAs) are dysregulated and correlate with the pathophysiological basis of malignant tumors. The objective of this research is to uncover the possible molecular mechanism of MACC1-AS1 regarding the regulation of pancreatic carcinoma (PC) metastasis. METHODS: lncRNA microarray and qRT-PCR were applied to identify differentially expressed lncRNA profile in PC. The function and role of MACC1-AS1 in PC were assessed via in vitro as well as in vivo assays. Luciferase analyses, RNA immunoprecipitation, and RNA pull-down were performed to determined the underlying MACC1-AS1 mechanisms. RESULTS: Numbers of differentially expressed lncRNAs in PC were identified via lncRNA microarrays, among which MACC1-AS1 was revealed as the most abundant lncRNA. The upregulation of MACC1-AS1 in PC was further confirmed in two expanded PC cohorts, which showed that MACC1-AS1 expression was upregulated in those PC patients with poor survival. Functionally, knockdown of MACC1-AS1 inhibited the proliferation as well as metastasis of PC cells. Meanwhile, MACC1-AS1 upregulated the expression of PAX8 protein, which promoted aerobic glycolysis and activated NOTCH1 signaling. Additionally, PAX8 was upregulated in PC tissues, which was correlated with the expression of MACC1-AS1 and the overall survival of PC patients. CONCLUSIONS: Together, our findings indicate a critical role of MACC1-AS1/PAX8/NOTCH1 signaling, which may be an alternative treatment target in PC therapy.

Analysis on risk factors for multidrug-resistant bacterial infections in patients in neurosurgical intensive care unit / 中国医师杂志

Objective To analyze the risk factors of multidrug-resistant bacteria (MDRO) infection in patients in Neurosurgical intensive care unit (NSICU),and to provide reference for clinical prevention and treatment.Methods 1 251 patients with NSICU in our hospital from January 2012 to March 2018 were selected as the study subjects.The bacterial specimens were extracted.380 patients with MDRO infection were the observation group,and 871 patients with non-MDRO infection in NSICU were the control group.The patients'medical records and clinical information were retrospectively analyzed,and multivariate logistic regression analysis was used to analyze the risk factors of MDRO infection in NSICU patients.Results There was no significant difference in the gender,age and body mass index (BMI) between the observation group and the control group (P ＞ 0.05).There was statistical significance in the proportion of hospitalization time,operation,use of urethra tube,mechanical ventilation,serious basic diseases and rational use of antibiotics between the observation group and the control group (P ＜ 0.05).According to the analysis on proportion of colony samples,the highest proportion in the observation group was sputum samples,accounted for 45.00％,followed by urine samples (21.58％),and the lowest proportion was other types of samples,accounted for 1.84％.The results of MDRO test showed that the highest proportion of pathogens was methicillin-resistant staphylococcus aureus (MRSA),accounted for 33.69％,followed by pseudomonas aeruginosa (PA),carbapenem-resistant acinetobacter baumannii (CR-AB),and the lowest proportion was stenotrophomonas maltophilia (SM),accounted for 1.58％.Logistic regression analysis showed that surgery,catheterization,mechanical ventilation,serious basic diseases and abuse of antibiotics were risk factors for MDRO infection in NSICU patients (P ＜ 0.05).Conclusions Invasive manipulation and antimicrobial abuse are the main risk factors for MDRO infection in NSICU patients,among which respiratory tract infection is the most serious and MRSA strain infection is the most common.The management of drugs and therapeutic devices should be scientific,rational and standardized in order to reduce the infection rate of MDRO.

Analysis on risk factors for multidrug-resistant bacterial infections in patients in neurosurgical intensive care unit / 中国医师杂志

Objective@#To analyze the risk factors of multidrug-resistant bacteria (MDRO) infection in patients in Neurosurgical intensive care unit (NSICU), and to provide reference for clinical prevention and treatment.@*Methods@#1 251 patients with NSICU in our hospital from January 2012 to March 2018 were selected as the study subjects. The bacterial specimens were extracted. 380 patients with MDRO infection were the observation group, and 871 patients with non-MDRO infection in NSICU were the control group. The patients' medical records and clinical information were retrospectively analyzed, and multivariate logistic regression analysis was used to analyze the risk factors of MDRO infection in NSICU patients.@*Results@#There was no significant difference in the gender, age and body mass index (BMI) between the observation group and the control group (P>0.05). There was statistical significance in the proportion of hospitalization time, operation, use of urethra tube, mechanical ventilation, serious basic diseases and rational use of antibiotics between the observation group and the control group (P<0.05). According to the analysis on proportion of colony samples, the highest proportion in the observation group was sputum samples, accounted for 45.00%, followed by urine samples (21.58%), and the lowest proportion was other types of samples, accounted for 1.84%. The results of MDRO test showed that the highest proportion of pathogens was methicillin-resistant staphylococcus aureus (MRSA), accounted for 33.69%, followed by pseudomonas aeruginosa (PA), carbapenem-resistant acinetobacter baumannii (CR-AB), and the lowest proportion was stenotrophomonas maltophilia (SM), accounted for 1.58%. Logistic regression analysis showed that surgery, catheterization, mechanical ventilation, serious basic diseases and abuse of antibiotics were risk factors for MDRO infection in NSICU patients (P<0.05).@*Conclusions@#Invasive manipulation and antimicrobial abuse are the main risk factors for MDRO infection in NSICU patients, among which respiratory tract infection is the most serious and MRSA strain infection is the most common. The management of drugs and therapeutic devices should be scientific, rational and standardized in order to reduce the infection rate of MDRO.

Clinical characteristics and antibiotic susceptibility features of different types of invasive infections caused by group B Streptococcus: a multicenter prospective study / 中华围产医学杂志

Objective To study the clinical manifestations and antibiotic sensitivity features of early-and late-onset invasive infections caused by group B Streptococcus (GBS). Methods A total of 96 infants with invasive GBS infections were enrolled prospectively from seven tertiary hospitals of GBS Infection Research Cooperative Group in southwest Fujian, such as Xiamen Maternal and Child Care Hospital, etc., from January 2016 to June 2018. According to the onset time of infection after birth, they were divided into early-onset GBS disease (GBS-EOD) group (<7 d, n=67) and the late-onset GBS disease (GBS-LOD) group (7-89 d, n=29). Clinical manifestations, disease spectrum, complications and outcomes of the two groups were compared. Drug sensitivity test was carried out using disk diffusion test. Chi-square or Fisher's exact test, two independent sample t-test or Mann-Whitney U tests were used for statistical analysis. Results (1) The average ages at onset in GBS-EOD and GBS-LOD groups were (15.8±6.7) h (0.5-142.0 h) and (25.0±8.1) d (9-89 d), respectively. The incidence of tachypnea, pallor, fever and convulsion were noted in 68.7% (46/67) vs 44.8% (13/29), 52.2% (35/67) vs 17.2% (5/29), 23.9% (16/67) vs 65.5% (19/29) and 7.5% (5/67) vs 48.3% (14/29) of GBS-EOD and GBS-LOD groups with χ2 values of 6.282, 10.199, 15.146 and 21.237 (all P<0.05). The main clinical manifestations of GBS-EOD were tachypnea and pallor, while most of the patients in the GBS-LOD group developed fever and convulsions. (2) The incidence of pneumonia, sepsis, meningitis, sepsis complicated by septic joints, pneumonia complicated by sepsis, sepsis complicated by meningitis and pneumonia complicated by sepsis and meningitis were noted in 43.3% (29/67) vs 20.7% (6/29), 9.0% (6/67) vs 17.2% (5/29), 0.0% (0/67) vs 3.4% (1/29), 0.0% (0/67) vs 6.9% (2/29), 31.3% (21/67) vs 13.8% (4/29), 6.0% (4/67) vs 31.0% (9/29) and 10.4% (7/67) vs 6.9% (2/29) of GBS-EOD and GBS-LOD groups. There was a statistically significant difference in the disease spectrum between the two groups (Fisher's exact test, all P<0.001). Compared with the GBS-LOD group, the GBS-EOD group had a higher incidence of pneumonia [85.1% (57/67) vs 41.4% (12/29), χ2=19.116, P<0.001] and a lower incidence of meningitis [16.4% (11/67) vs 41.4% (12/29), χ2=6.922, P=0.009]. Complications such as acute respiratory distress syndrome (ARDS), pulmonary hemorrhage, shock and persistent pulmonary hypertension of the newborn (PPHN) occurred much more in the GBS-EOD group than the GBS-LOD group [28.4% (19/67) vs 6.9% (2/29), 13.4% (9/67) vs 0.0% (0/29), 11.9% (8/67) vs 10.3% (3/29), 4.5% (3/67) vs 0.0% (0/29), χ2=13.683, P<0.001]. (3) Among the 96 patients, 23 (24.0%) had meningitis and 73 (76.0%) developed pneumonia and sepsis. Meningitis resulted in a higher fatality rate [17.4% (4/23) vs 4.1% (3/73), χ2=4.564, P=0.035] and longer average hospital stay [(37.2±12.6) vs (14.1±5.3) d, t=7.831, P<0.001] than pneumonia and sepsis. Seven out of the 19 meningitis survivors developed intracranial complications. (4) The overall fatality rate in this study was 7.3% (7/96) and no significant difference was found between GBS-EOD and GBS-LOD group [7.5% (5/67) vs 6.9% (2/29), χ2=0.010, P=0.982]. Among the 67 GBS-EOD infants, 58 (86.6%) occurred within 24 h and five of them died, but no death was reported in the other nine cases occurred after 24 h. (5) Totally 96 strains of GBS were isolated with 100% sensitivity to penicillin, ampicillin, cefazolin and meropenem, and 97% to vancomycin. Around 79.3%-91.0% of GBS isolates were resistant to clindamycin and erythromycin. Conclusions Clinial features vary greatly in GBS-LOD and GBS-EOD cases. Infants with meningitis have poor prognosis. The drug resistance rate of GBS to erythromycin and clindamycin are relatively high.

Influences of high-fat diet during pregnancy on sterol regulatory pathway and hepatic lipid deposition in male rat offspring / 中华围产医学杂志

Objective To analyze the influences of maternal high-fat diet on male rat offspring's blood lipid level and hepatic lipid deposition as well as on the expression of two key factors,sterol regulatory element binding protein-1 (SREBP-1) and SREBP cleavage acting protein (SCAP),involved in hepatic cholesterol regulatory cascade during childhood and adulthood.Methods Pregnant Wistar rats were randomly divided into two groups:high fat diet (HF) group and normal intake control (NC) group (both n=20).Rats in the HF group were fed with high-fat diet till delivery before changing to a normal-fat diet,while the NC group was given the normal-fat diet all through the study.Male offspring born appropriate for gestational age (AGA) in different feeding groups were randomly selected as experimental subjects.Physical development,serum lipid levels and hepatic lipid deposition at the age of 7 and 24 weeks were compared between offspring of the two groups.Expression of SCAP and SREBP-1 at protein level was detected with immunohistochemistry.T test or Chi-square test was used for statistical analysis.Results The average birth weight of HF group was higher than that of NC group [(6.95± 0.25) vs (6.79 ±0.78) g,t=2.088,P=0.038].Large for gestational age (LGA),AGA and small for gestational age (SGA) offspring accounted for 18.6％ (21/113),77.9％ (88/113)and 3.5％ (4/113) in HF group and 7.6％ (10/132),87.9％ (116/132) and 4.5％ (6/132) in NC group (x2=13.500,P=0.001).At the age of 7 weeks,the offspring's body weight in HF group was higher than that in NC group [(68.78±7.55) vs (66.61 ±3.92) g,t=2.303,P=0.023].At the age of 24 weeks,the body weight,body length and abdominal circumference of adult offspring in HF group were significantly higher than those in NC group [(251.74±24.04) vs (216.24±33.42) g,(22.60±0.79) vs (21.59± 1.34) cm,(17.93±0.59) vs (16.83±0.88) cm;t=2.220,2.379,2.927,all P＜0.05].At the age of 7 weeks,offspring's serum total cholesterol (TC) level in HF group was higher than that in NC group [(1.94±0.62) vs (1.23 +0.77) mmol/L,t=2.379,P＜0.05].At the age of 24 weeks,adult offspring's liver index,serum TC,triglyceride (TG),low density lipoprotein-cholesterol (LDL-C) and very low density lipoprotein-cholesterol (VLDL-C) levels were all higher in HF group than in NC group,while the high density lipoprotein-cholesterol (HDL-C) level was lower in HF group [(2.75±0.31)％ vs (2.46±0.39)％,(1.98±0.14) vs (1.45±0.27) mmol/L,(2.96±0.21) vs (2.71 ±0.29) mmol/L,(0.97±0.32) vs (0.71 ±0.21) mmol/L,(0.81 ±0.13) vs (0.52±0.17) mmol/L,(1.74±0.20) vs (1.59±0.29) mmol/L;t=2.264,2.333,2.359,2.088,5.336,1.994,all P＜0.05].Comparative analysis of nonalcoholic fatty liver disease activity scores (NAS) between the two groups showed that the liver lobular inflammation in HF group's offspring was more severe at both 7 and 24 weeks of age (2.29±0.49 vs 1.92±0.45,2.83±0.47 vs 2.22±0.55;t=2.157,3.251,all P＜0.05).At the age of 24 weeks,adult offspring in HF group also showed higher liver steatosis scores (2.81 ± 0.35 vs 2.25 ± 0.30,t=4.609,P＜0.05).Immunohistochemical detection showed that there was no significant difference in SCAP protein expressions in liver tissues of 7-week-old offspring between the two groups (P＞0.05),but higher expression of SREBP-1 protein was observed in HF group than in NC group [(34.16±5.08)％ vs (18.09±3.99)％,t=9.697,P＜0.05].At the age of 24 weeks,the expression levels of both SCAP and SREBP-1 proteins in liver tissues were higher in HF group than in NC group [(31.22±6.01)％ vs (17.98+7.89)％,(61.33± 16.25)％ vs (29.76± 11.21)％;t=2.303,2.274,both P＜0.05].Conclusions High-fat intake during pregnancy can increase offspring's birth weight and the risk for LGA offspring.Maternal high-fat diet even up-regulates the expression of SCAP and SREBP-1 in male offspring born AGA in childhood and this impact become more obvious when reaching adulthood,resulting in excessive increase of body weight,body length and abdominal circumference and elevated serum lipid level and liver lipid deposition.

Exploration and practice of "combination of general practice with specialties" model in community health service institutions / 中华全科医师杂志

Community health service is an important part of the health system reform in the new period in China,the community health service institutions play important roles in promoting the health reform and the development ofthe national medical and health service.Shanghai Fenglin Subdistrict Community Health Service Center has integrated general practice with specialist care for the patients in community health service,this article summarizes the exploration and practice of the "combination of general practice with specialties" model in the community health service in order to provide reference for relevant medical institutions.

Analysis on treatment of eight extremely severe burn patients in August 2nd Kunshan factory aluminum dust explosion accident / 中华烧伤杂志

Objective@#To summarize the measures and experience of treatment in mass extremely severe burn patients.@*Methods@#The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment.@*Results@#Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients.@*Conclusions@#Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.

Researches promote the institutional development of urban community health service centers / 中华全科医师杂志

Carrying out researches in urban community health service centers can effectively promote the improvement of management system, the cultivation of talents and the formation of characteristic service, leading to the institutional development.This paper summarizes the role and significance of researches in promoting the overall development of urban community health service center in order to provide reference for the relevant medical institutions based on the experiences in Shanghai Fenglin Community Health Service Center.

The analysis of pathogenic bacteria and its prevention of ICU patients with ventilator associated pneumonia in 80 cases / 中国基层医药

Objective To explore the treatment of the ICU ventilator associated pneumonia(VAP),and the prevention strategy.Methods Analyzed the clinical features and microbiological data of 80 ICU VAP patients. Results The main pathogenic bacterias of VAP were acinetobacter baumannii and pseudomonas aeruginosa,which were Gram negative bacteria.A total of 200 strains pathogenic bacteria were isolated,in which,Gram negative bacteria reached to 76.0%,which mainly including:acinetobacter baumannii strains,klebsiella pneumoniae,pseudomonas aeruginosa and so on.24.0% was Gram positive bacteria,including staphylococcus aureus accounted for 10.5%,and the epidermis staphylococcus,hemolysis staphylococcus and so on.Proportion of fungi was 11.0%.According to the results of microbiological data,the effective anti-microbial treatments were administered.After treatments for 10 days, the VAP infection parameters(including temperature,the white blood cell count and the number of strains)were grad-ually back to normal.Conclusion The main VAP pathogenic bacteria are Gram negative bacteria,patients commonly are infected by two or more bacterias,which lead to the multiple infection,the treatment should be fully based on mi-crobiology and clinical monitoring data,and the formulating personalization antibacterial treatment.

Guidance significance of NT-proBNP concentration change in middle and long term rational control of blood transfusion and fluid infusion volume in patients with severe burn / 国际检验医学杂志

Objective To explore the correlation of NT‐proBNP concentration and the fluid infusion volume in the patients with severe burn ,and to evaluate the significance of monitoring NT‐proBNP in severe burn patients .Methods Fifty cases of severe burn in 100 Hospital of PLA form September 2012 to September 2015 were selected ,without major disease history and genetic history before admission ,among them ,25 cases(group A) had the burned area 35% -50% TBSA or Ⅲ degree 10% -20% TBSA ,18 cases (group B) had the total burn area of >50% TBSA or Ⅲ degree >20% TBSA for group B and 10 cases(group C) had the total burn area>90% and were composite explosive injury .The NT‐proBNP concentrations were monitored on 1-30 d after admission for guiding blood transfusion and fluid infusion;contemporaneous age‐matched 53 patients with plastic surgery were selected as the control group .Compared with the calculation formula of the fluid volume ,the guiding advantage of NT‐proBNP was analyzed .Re‐sults The practical fluid volume in these burn patients were higher than that calculated by the common fluid replacement formula . The more severe burn ,the higher the NT‐proBNP concentration and the more blood products were demanded;the NT‐proBNP con‐centration ,fluid infusion volume ,MAP infusion volume and PLT transfusion volume had statistical difference between the group C and B and between the group B and A (P<0 .05) .Conclusion The NT‐proBNP concentration change may have a higher guidance and early warning significance for middle and long term rational control of blood transfusion and fluid infusion volume in the pa‐tients with severe burns .

Application value of narrow band imaging endoscopy without magnification in the diagnosis of malignant laryngeal neoplasms / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the value of narrow band imaging endoscopy without magnification in the diagnosis of malignant laryngeal lesions. METHODS A total of 425 patients diagnosed as laryngeal tumor from February 2013 to November 2014 were included in this study. All the cases were examined with electronic nasopharyngolaryngoscope equipped with NBI mode. The characteristics of mucosal morphology and superficial vessels of each lesion under NBI mode were evaluated for diagnosis and assessed by reference to histopathology. RESULTS The sensitivity, specificity, positive, predictive value and negative predictive value of NBI in diagnosis of malignant laryngeal lesions were 80.43%, 97.10%, 77.08% and 97.61%respectively. And NBI endoscopy is helpful to the detection of early cancer and precancerous lesions. CONCLUSION NBI endoscopy without magnification is a promising tool for improving the diagnosis of malignant laryngeal lesions.

Diagnosis value of ultrasound combined with CT in adrenal lesions / 重庆医学

Objective To evaluate the value of ultrasound and CT in the diagnosis of adrenal lesions .Methods A total of 70 pa‐tients of adrenal lesions were examined by ultrasound combined with CT .Pathologically confirmed 55 cases of adrenal tumors and 2 of cysts ,13 of hematoma with follow‐up .The results were analyzed and compared with ultrasound or CT individual inspection .Re‐sults The diagnosis accuracy of adrenal lesions by ultrasound with CT ,only ultrasound and CT ,were 88 .6% ,62 .8% and 72 .9% , 14 pheochromocytoma ,13 myelolipoma ,including 15 adenoma ,5 cortical carcinoma ,2 NHL ,6 metastalic tumor ,2 cysts ,13 hemato‐ma .There was a significant difference between two methods (P<0 .05) .Conclusion The combination of ultrasound and CT could improve accuracy greatly in diagnosis of adrenal lesions .

Research and analysis of present applications of anti-inflammatory and antidiabetic of pomegranate seed oil / 中国生化药物杂志

In recent years,the research of pomegranate seed oil has developed and deepened, which mainly includes the study of pomegranate seed oil anti-inflammatory,antidiabetic,anti-tumor and anti-oxidation and so on.This paper has reviewed the mechanisms of its anti-inflammatory and antidiabetic functions in order to facilitate the pomegranate seed oil a better exploitation and analyzes its applicable prospects .

The expression of Sp1 and CEA and the correlation between the two factors in colon cancer / 国际检验医学杂志

Objective To study the expression of transcription factor Sp1 and CEA and the correlation between the two tran‐scription factors in colorectal cancer .Methods To detect expression Sp1 and CEA mRNA by Real‐Time PCR in 60 colon cancer tis‐sues and corresponding normal tissues and the results were compared with the clinical features and pathological characters .The re‐lationship between the expression of Sp1 mRNA and CEA mRNA in 60 colon cancer tissues was determined .Results The expres‐sion rates of Sp1 and CEA mRNA was detectable to highly expressed rates in colon cancer tissues than the matched normal tissues (P0 .05) . Sp1 and CEA mRNA was detectable to highly expressed in the different histological grade and Dukes stages .In addition ,a positive correlation was found between the expression of Sp1 mRNA and CEA mRNA(r=0 .706 ,P<0 .01) ,(0< r<1) .Conclusion Sp1 and CEA was detectable to highly expressed in colon cancer .Positively correlation occurred in Sp1 mRNA and CEA mRNA indica‐ted that Sp1 and CEA provide the new clues of genetic diagnosis and treatment .