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简介：AIM:Toinvestigatewhetherthesimultaneoustreatmentwithhumangrowthhormone(hGH)abolishesthenegativeeffectsofeverolimusonanastomotichealing.METHODS:Forty-eightmaleSprague-Dawley-ratswererandomizedtothreegroupsof16animalseach(Ⅰ:vehicle;Ⅱ:everolimus3mg/kgpo;Ⅲ:everolimus3mg/kgpo+hGH2.5mg/kgsc).AnimalswerepretreatedwithhGHand/oreverolimusdailyforsevendays.Thenastandardanastomosiswascreatedinthedescendingcolonandtreatmentwascontinuedforanothersevendays.Theanastomosiswasresectedintotoandtheburstingpressurewasassessedasamechanicalparameterofintestinalhealing.Moreover,biochemical(Hydroxyproline,PCNA,MPO,MMP-2andMMP-9)andhistological(celldensity,angiogenesis,amountofgranulationtissue)parametersofintestinalhealingwereassessed.RESULTS:AnastomoticburstingpressurewassignificantlyreducedbyeverolimusandasimultaneoustreatmentwithhGHresultedinconsiderablyhighervalues(Ⅰ:134±19mmHg,Ⅱ:85±25mmHg,Ⅲ:114±25mmHg;P<0.05,ⅠvsⅡ;P=0.09,ⅠvsⅢandⅡvsⅢ)HydroxyprolineconcentrationwassignificantlyincreasedbyhGHcomparedtoeverolimusalone(Ⅰ:14.9±2.5μg/mg,Ⅱ:8.9±3.6μg/mg,Ⅲ:11.9±2.8μg/mg;P<0.05,?ⅠvsⅡ/ⅢandⅡvsⅢ).ThenumberofMPO-positivecellswasreducedsignificantlybyhGHcomparedtoeverolimusalone(Ⅰ:10±1n/mm~2,Ⅱ:15±3n/mm~2,Ⅲ:9±2n/mm~2;P<0.05,ⅠvsⅡandⅡvsⅢ),whilethenumberofPCNA-positivecellswereincreasedbyhGH(Ⅰ:28±3/mm~2,Ⅱ:12±3/mm~2,Ⅲ:26±12/mm~2;P<0.05,?Ⅰ?vsⅡandⅡvsⅢ).Correspondingtothesebiochemicalfindings,HEhistologyrevealedsignificantlyincreasedamountofgranulationtissueinhGH-treatedanimals.CONCLUSION:InhibitionofintestinalwoundhealingbyeverolimusispartiallyneutralizedbysimultaeoustreatmentwithhGH.BothinflammationaswellascollagendepositionisinfluencedbyhGH.

简介：AIM:Toevaluateshort-termoutcomesfollowingintraoperativebiliarylavageforhepatolithiasis.METHODS:Atotalof932patientswhowereadmittedtotheWestChinaMedicalCenterofSichuanUniversitybetweenJanuary2010andJanuary2014andunderwentbileductexplorationandlithotomywereretrospectivelyincludedinourstudy.Thepatientsweredividedintothelavagegroupandthecontrolgroup.Relatedpre-,intra-,andpostoperativefactorswererecorded,analyzed,andcomparedbetweenthetwogroupsinordertoverifytheeffectsofbiliarylavageontheshort-termoutcomeofpatientswithhepatolithiasis.RESULTS:Amongstthepatientswhowereincluded,678patientswithhepatolithiasiswereincludedinthelavagegroup,andtheother254patientswereenrolledinthecontrolgroup.Dataanalysesrevealedthatpreoperativebaselineandrelatedintraoperativevariableswerenotsignificantlydifferent.However,patientswhounderwentintraoperativebiliarylavagehadprolongedpostoperativehospitalstays(6.67dvs7.82d,P=0.024),higherhospitalizationfees(RMB28437.1vsRMB32264.2,P=0.043),higherpositiveratesofbacterialculturesfromblood(13.3%vs25.8%,P=0.001)andbile(23.6%vs40.7%,P=0.001)samples,andincreasedusageofadvancedantibiotics(26.3%vs38.2%,P=0.001).Inaddition,inthelavagegroup,morepatientshadfever(>37.5℃,81.4%vs91.1%,P=0.001)andhyperthermia(>38.5℃,39.7%vs54.9%,P=0.001),andhigherwhitebloodcellcountswithin7daftertheoperationcomparedtothecontrolgroup.CONCLUSION:Intraoperativebiliarylavagemightincreasetheriskofpostoperativeinfection,whilenotsignificantlyincreasinggallstoneremovalrate.

简介：在华南的Dajiangbian形成是统治siliciclastic的沉积继任，低档变态在卡赛西亚·布洛克的西方的边缘上扔了，并且被glaciogenicdiamictite(Sizhoushan形成)盖住。Sizhoushanglaciogenic阶层能被归因于Jiangkou冰川(Sturtian冰川)他们在华南与Jiangkou阶层分享stratigraphic和lithological类似的事件。在整个Dajiangbian形成的上面的部分的一些碳酸盐，燧石和页岩单位为碳酸盐碳同位素被取样(13Ccarb)和器官的碳同位素(13Corg)分析。geochemical的一个范围索引包括氧同位素(18O)并且Mn/Sr(Fe/Sr)比率建议主要的碳同位素价值在上面的Dajiangbian形成被保存。上面的Dajiangbian形成表演13C向上减少向的-0.1,的carb到-5.4。我们建议否定13在Sizhoushandiamictite下面的C旅行是有Pre-SturtianIslay13Ccarb异例并且与全球Neoproterozoic同位素地层学允许关联。我们发现碳酸盐和上面的Dajiangbian形成的器官的碳同位素数据被联合，与13Ccarb-13C在多重大陆上观察的org模式。

简介：BackgroundSepticshockcausedbybacteremiaisalife-threateninginfectionwhoseprognosisishighlydependentonearlyrecognitionandappropriatetreatment.Procalcitonin(PCT)hasbeenshowntoaccuratelyandquicklydistinguishbacteremiafromnoninfectiousinflammatorystatesincriticallyseverepatients.However,theextentofPCTmagnitudeelevationaccordingtotheGramstainresultinelderlypatientswithcoronaryheartdisease(CHD)attheonsetofsepticshockcausedbybacteremiavaries,andhasnotbeenclearlyelucidated.MethodsThemedicalrecordsofadvancedage(non-neutropenic)patientwithCHDandsepticshockbetweenMar2013andJun2015whohadbacteremiacausedbyeitherGram-positive(GP)bacteriaorGram-negative(GN)bacteriawerereviewed,andthelevelsofPCT,C-reactive(CRP)proteinandwhitebloodcellscount(WBC)inbothgroupswereanalyzed.Results75episodesofeitherGNbacteremia(n=40)orGPbacteremia(n=35)wereenrolled.PCTlevelswerefoundtobemarkedlyhigherinpatientswithGNbacteremiathaninthosewithGPbacteremia[(8.93±17.58)vs.(64.42±58.56)ng/L(P<0.001)],whereastherewasnosignificantdifferenceinCRPandWBC(P>0.05).Moreover,ahighPCTlevelwasfoundtobeindependentlyassociatedwithGNbacteremiainthisstudypopulation.APCTlevelof19.69ng/mLyieldeda72.5%sensitivity,a91.4%specificity,an8.43positivelikelihoodratioanda0.30negativelikelihoodratioforGN-relatedbacteremiainthestudycohort[AUROCC=0.870(0.041),95%CI(0.790-0.949)].ConclusionInanelderlypatient(non-neutropenic)withCHDandsepticshock,GNbacteremiacouldbeassociatedwithhigherPCTvaluesthanthosefoundinGPbacteremia(PCT>19.69ng/mL).

简介：Objective:Apreviousstudydemonstratedthatnon-anthracycline-containingdocetaxelpluscyclophosphamide(TC)regimenwasinferiortodocetaxel,anthracyclineandcyclophosphamide(TAC)inneoadjuvanttreatmentoftriple-negativebreastcancer(TNBC)andhumanepidermalgrowthfactorreceptor-2-(HER2)-positivebreastcancerinashort-termfollow-up.Herein,long-termfollow-upsurvivaloutcomeshavebeeninvestigated.Methods:TNBCorHER2-positivepatientswererandomizedtoreceive6cyclesofTCorTACneoadjuvanttreatment.Theprimaryendpointwaspathologicalcompleteremission(pCR).Secondaryendpointsincludedclinicalresponserate,event-freesurvival(EFS),andoverallsurvival(OS).Results:Acohortof96patientsconsistedof45inTCand51inTACarm.Withamedianfollow-upperiodof53(range,8–76)months,thepatientsachievingpCRpostneoadjuvantchemotherapyexhibitedsuperiorEFSandOSthanpatientswithoutpCR(P<0.05).TACtreatmentresultedinconsistentlybetterEFSthanTCtreatment:theestimated5-yearEFSwas66.1%vs.29.8%(P=0.002).Moreover,theestimated5-yearOSwasalsoinfavorofTAC:88.4%vs.51.6%(P<0.001).Multivariableanalysisdemonstratedthatthetreatmentregimenwasanindependentprognosticfactor,andpatientstreatedwithTAChadasuperiorEFS[hazardratio(HR),0.48;95%confidenceinterval(95%CI),0.26–0.90;P=0.021]andOS(HR,0.20;95%CI,0.08–0.60;P=0.003).Conclusions:Theupdatedlong-termfollow-updatademonstratedasustainedbenefitinEFSandOSfromanthracycline-containingTACtreatment,indicatingthatanthracyclineisanessentialandeffectivedruginthisclinicaltrial.