ABSTRACT
Biliary stent has been widely used in the treatment of biliary stricture and obstruction, it can relieve the pain of patients effectively, but bacterial infection and stent obstruction are still troublesome after surgery. We introduce the mechanism of infection and stent blockage caused by bacterial invasion after biliary stent implantation, and expound the formation mechanism of bacterial biofilm and bile sludge in this review. Antibacterial biliary stent is an effective way to inhibit biliary tract infection, the literatures on antibacterial modification of biliary stent with different antibacterial methods in domestic and abroad are reviewed, and the research prospect of antibacterial biliary stent is summarized and prospected.
Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Bile , Biliary Tract , Cholestasis , StentsABSTRACT
Artificial conduits, including ureteral stents and catheters, are used widely as drainage tools in the urinary system. However, various bacteria in the urine and long duration of insertion can arouse the biofilm formation on the pipeline surface, which calls for effective antibacterial strategy. In this article, the mechanism of Catheter Associated Urinary Tract Infections (CAUTI) is explained from the perspective of etiology. Then, the biofilm formation conditions and the features of urine are analyzed, the antibacterial agents and approaches suitable for ureteral stents and catheters are introduced and their pros and cons are discussed respectively.
Subject(s)
Humans , Anti-Bacterial Agents , Catheters , Drainage , Stents , Urinary Catheterization , Urinary Tract InfectionsABSTRACT
Objective To compare the clinical effects of PFNA and ALP in the treatment of elder patients with femoral intertrochanteric fracture.Methods The clinical data of 52 elder patients with femoral intertrochanteric fracture in the Second People's Hospital of Huoqiu County from March 2011to November 2017 were retrospectively analyzed.According to the different operation method,the patients were divided into PFNA group(treated with PFNA) and ALP group(treated with ALP),with 26cases in each group.The operation time,the amount of bleeding,healing time of fracture,postoperative complications,the function of hip joint and incidence of adverse reactions were com-pared between the two groups.Results The operative Time[(80.1±6.3)min],intraoperative bleeding[(156.2 ± 4.7)mL],bed time[(20.3 ±2.9)d]and fracture healing time[(77.3 ±3.2)d]in the PFNA group were significantly lower than those in the ALP group,the differences were statistically significant(all P＜0.05).The Harris Assessment scores of the PFNA group was (87.30 ±6.18)points,the excellent rate of the PFNA group was 92.3%,while the Harris Assessment scores of the ALP group was (76.77 ±4.59 )points,the excellent rate of the ALP group was 80.77%,the difference was statistically significant in the excellent rate(χ2＝0.019,P＜0.05).The incidence of adverse reactions of the PFNA group was 0.00%,which was lower than 7.69%of the ALP group (P＜0.05 ). Conclusion The proximal femoral intramedullary nail (PFNA)is effective in the treatment of intertrochanteric fracture of the elderly,with better fixation strength,smaller operative trauma,faster fracture healing and lower adverse reaction rate.
ABSTRACT
Objective To investigate the influence of polyethylene glycol (PEG) on heparin release of heparinloaded polycaprolactone/polyethylene glycol (PCL/PEG) membranes used in artificial vascular peosthesis.Methods Heparin-loaded PCL/PEG membrane samples with different PEG mass contents of 0,0.5％,10％ and 15％ were prepared by blending method and freeze-drying technology.The influence of PEG on heparin release was experimental studied in vitro.The influence of PEG on the structural characteristics of the samples were investigated by X-ray diffraction,Fourier transform infrared spectrum and differential scanning calorimeter.Results The addition of PEG reduced the heparin release resistance.The results showed that the average release rate of heparin in the first day and the release amount for 34 d were improved.Both these parameters increased with the increase of PEG mass content.The X-ray diffraction,Fourier transform infrared spectroscopy and differential scanning calorimetry showed that the crystallinity of PCL membrane was slightly enhanced by the addition of heparin,but the overall effect was not significant.In addition,the addition of heparin could promote the crystalline grain growth of PEG,and a common distribution of heparin and PEG in the matrix was observed.Conclusions The heparin release control can be achieved by adjusting the PEG mass content in heparin-loading PCL/PEG membranes prepared by blending method and freeze-drying technology.The proposed samples may have anticoagulant effect,which can be expected to be used as small-diameter artificial vascular prosthesis material.
ABSTRACT
Objective To observe the effect of drug combinations on the blood flow after reduction of the testicular torsion in rabbits.Methods From October 2014 to June 2015,36 male rabbits (weighing 1.8-2.4 kg,10-14 months of age) were randomly divided into experimental group and control group,18 in each group.Produced by surgical testicular torsion model (720° counterclockwise rotation of the left side testicle),every rabbit was accepted surgery reset after 9 hours and found all twisted testicles were dark.After fomentation with warm salt water,all the testicles were observed no significant improvement in colors,and no fresh blood flow after opening tunica albuginea,then all the testicles were retained and fixed.Low molecular dextran(5 ml/kg,ear marginal vein injection,1/d),papaverine(1.5 mg/kg,intramuscular,3/d) and low molecular weight heparin sodium (200 IU/kg,subcutaneous,l/d) were applied to promote testicular revascularization for 5 days in experimental group,and penicillin (40 000 U/kg,intramuscular,1/d) for 7 days.Control group was only given penicillin (40 000 U/kg,intramuscular,1/d) to prevent wound infection.Then Color Doppler ultrasound was used to observe the testicular blood flow siganals that were divided into 0,1,2,3 classes.Class 2 and class 3 could be considered as testicular survival.After each scrotum was opened,according to color,texture of testicle and whether the fresh blood flowing out when tunica albuginea was opened,to determine whether the testicle was alive.The testicle was ruddy,flexible,and fresh blood was observed,which could prove testicular survival.Results In experimental group,the testicular blood flow siganals:0 class 4 cases,1 class 3 cases,2 class 4 cases,3 class 7 cases.In control group,the testicular blood flow siganals:0 class 9 cases,1 class 2 cases,2 class 4 cases,3 class 3 cases.Surgical exploration found 11 cases of testicular survival in experimental group and 7 cases in control group,which was significantly difference (P ＜ 0.05).Conclusions The combined application of low molecular dextran,papaverine,low molecular weight heparin sodium can promote the recovery of testicular blood after reduction of testicular torsion,and improve testicular survival rate.
ABSTRACT
Objective To investigate the influencing factors involved in the long-term effect after interventional treatment of diabetic lower extremity vascular disease.Methods The data of 358 diabetic patients with lower extremity vascular disease were collected retrospectively.The ankle-brachial index (ABI) values at the 6th, 12th and 24th month after interventional treatment were documented and the factors may influence ABI value werc analyzed.Results Single factor analysis showed that after 24 months treatment, the proportion of ABI＜0.5 (severe ischemia) in the patients combined with obesity, smoking, older age were 15.0％ (31/206), 18.4％ (25/136) , 12.1％(19/157) ,7.5％(15/200) ,while non obesity,younger age,no smoking,no hypertension were 6.6％ (10/152), 14.8％ (33/222), 6.5％ (13/201), 1.9％ (3/158), and the differences were significant (P ＜0.05).Logistic regression analysis showed that old age (OR =1.341,95％ CI: 1.281-1.496, P =0.045), smoking(OR=2.301,95％ CI: 1.903-4.844,P=0.028) and obesity(OR=1.299,95％ CI: 1.270-1.588,P =0.038) were the independent factors influence the long-term therapeutic effects on diabetic lower extremity vascular disease.Conclusion Obesity, smoking, old age are the main factors influence the long-term therapeutic effects on diabetic lower extremity vascular disease.
ABSTRACT
Objective:To observe the changes of blood glucose,insulin and dipeptidyl peptidase-Ⅳ(DPP-Ⅳ/CD26)on type 2 diabetes mellitus in rabbits after HUCBSC( human umbilical cord blood stem cells) transplantation. Methods:18 rabbits were randomly divided into normal control group (6 rats,Group C) and diabetic model group (12 rats). After preparation model of type 2 diabetes,and 6 rats of them were treated with HUCBSC ( CD45+,CD34-) transplantation by ear vein transfusion ( Group A) ,and 6 rats were treated with PBS(Group B). All three groups of rabbits were fed for 4 weeks,and the blood glucose was monitored every day,and the level of blood insulin and DPP-IV/CD26 were measured every week. Results:The negative expression rate of CD34 in HUCBSC was 96. 5%. The positive expression rate of CD45 in HUCBSC was 100%. Compared with non transplantation group,the blood glucose and DPP-IV/CD26 in the umbilical cord blood stem cell transplantation group were gradually decreased,and insulin level was gradually increased, the difference was statistically significant (P<0. 01). Conclusion:HUCBSC were round or oval,with adherent growth,HUCBSC trans-plantation can significantly reduce blood glucose, increase insulin secretion, reduce the level of DPP-IV/CD26, the immunological phenotype of HUCBSC was CD45+,CD34-,thus providing a new theoretical basis for the clinical treatment of diabetes and its complica-tions.
ABSTRACT
@#To investigate the related substances of tenofovir, 3 related substances were synthesized. RP-HPLC analytical method was developed using Agilent ZORBAX SB-C18 column. The mobile phase composed of methanol and 0. 02 mol/L potassium dihydrogen phosphate. Linear gradient elution was used and the detection wavelength was 260 nm. 3 impurities were found in tenofovir. The established method was accurate and reproducible, and it can be applied for the related substances test in tenofovir.
ABSTRACT
BACKGROUND:In recent years, interventional therapy because of its high success rate, good curative effect, little trauma has been widely recognized, but vascular intimal injury due to interventional therapy stil has no effective treatment, resulting in long-term postoperative severe restenosis. Stem cel transplantation has brought a new drawn for the repair of impaired endothelial function, reendothelialization and aided restoration of the blood supply to ischemic tissues. OBJECTIVE: To summarize the recent progress in umbilical cord blood stem cels transplantation and endovascular treatment for treatment of diabetic lower limb ischemic disease. METHODS: A computer-based search of PubMed and CNKI was performed for relevant articles published from January 2000 to March 2015 using the keywords of “umbilical cord blood stem cel transplantation, percutaneous transluminal angioplasty, diabetic lower limb ischemia, restenosis” in English and Chinese. Totaly 216 relevant literatures were initialy obtained, and 44 articles were ultimately included. RESULTS AND CONCLUSION:By comparing the therapeutic efficacy and long-term prognosis of umbilical cord blood stem cel transplantation and endovascular treatment, it is concluded that umbilical cord blood stem cel transplantation combined with endovascular treatment is better than either of them alone, which can promote the establishment of colateral circulation, improve the impaired endothelial function and reduce the occurrence of restenosis after interventional therapy.
ABSTRACT
Objective To evaluate the characteristics of the testicular torsion patients with the first symptom of acute abdominal pain.Methods From October 1998 to May 2014, 8 adolescent or boys with testicular torsion presenting acute abdominal pain instead of scrotal pain as their primary symptom were retrospectively reviewed.The average age was 12 (3-16) years.An acute abdominal pain presented firstly in all cases, which accompanied by nausea and vomiting in 4 cases, groin pain in 2 cases, fever in 1 case. In genital examination, the scrotum skin was red and swollen, while the testis was in transverse position and tenderness.The testicular and homolateral abdominal pain got worse when we pulled the involved testis. Doppler ultrasound examination revealed that the blood supply of the involved testis decreased or disappeared.Results In the 8 cases, 5 cases were not examined their testicles or scrotum during the first evaluation, which were found the testicular necrosis during the following exploratory surgery, and orchidectomy was performed. In the other 3 cases, external genital were examined during the first evaluation, and the scrotal and testicular abnormalities were detected.Doppler ultrasonography showed abnormality in testicular blood supply.Testicular torsion was proved during the emergent operation, and the 3 testes were salvaged.The mean duration time from symptom onset to operation was 4 h in the salvaged group, while the average time was 28 h in the orchiectomy group.The mean follow-up time was 18 ( 10-36) months.In the 3 cases whose testis was saved, 1 affected testis was atrophied, and the blood supply of the other two was good.No severe complications occurred in the other 5 cases.Conclusions Testicular torsion should be considered in adolescents and boys with acute lower abdominal pain.The routine external genital examination should be performed when a boy or adolescent complains of abdominal pain.
ABSTRACT
Objective To observe the changes of serum superoxide dismutase (SOD) levels in typeⅡdiabetic patients with peripheral arterial disease (PAD) before and after interventional therapy, and to investigate the effects of oxidative stress level and interventional treatment on serum SOD level. Methods During the period from July 2011 to December 2012 at authors’ hospital, a total of 40 patients with type Ⅱ angiography together with balloon dilation and/or stenting was carried out in 24 patients (group B, with Fontaine stage of Ⅱb - Ⅲ). Of the 24 patients in group B, lower limb arterial angiography together with balloon dilation was employed in 16 (group B1) and lower limb arterial angiography together with balloon dilation and stenting was adopted in 8 (group B2). Twenty healthy clinical subjects were used as control group (group C). Before interventional treatment, elbow venous blood samples of patients in group A and B were collected to determine serum lipid, HbA1c and SOD levels. The same tests were also carried out in the subjects of group C. During percutaneous lower extremity arterial intervention , through arterial sheath 3 ml arterial blood specimen was collected in all patients of both group A and B before intervention started. Twenty-four hours after the treatment, venous blood specimen was also collected in all patients to determine serum SOD levels. The results were statistically analyzed. Results Lower limb arterial angiography showed that no obvious arterial stenosis was seen in the patients of group A. The interventional procedures were all successfully completed in all patients of group B. SOD levels of group A, B and C were (46.1 ± 3.13)U/ml, (35.37 ± 3.58)U/ml and (60.50 ± 6.99)U/ml respectively. SOD levels of both group A and B were significantly lower than that of group C (t = 8.420, P < 0.01; t = 14.324, P < 0.01). The level of SOD in group A was significantly higher than that in group B (t = 10.092, P < 0.01). The ankle-brachium indexes (ABI) of group A, B and C were (0.70 ± 0.12), (0.58 ± 0.13) and (1.15 ± 0.07) respectively. ABI of group A and B was significantly lower than that of group C (t = 14.324, P < 0.01; t = 17.392, P < 0.01). ABI of group B was significantly lower than that of group A (t=3.027, P<0.05). SOD level bore a negative correlation with HbA1c level (r=-0.541, P<0.01). In both group A and group B, no significant difference in SOD level existed between the venous blood and arterial blood. The preoperative arterial SOD levels in group B1 and group B2 were (35.70 ± 3.04)U/ml, and (36.07 ± 2.14)U/ml respectively, and the difference between the two groups was not statistically significant. The preoperative SOD levels in the ischemic arterial region in group B1 and group B2 were (32.95 ± 3.52)U/ml and (33.59 ± 2.64)U/ml respectively, and the difference between the two groups was not statistically significant although these levels were significantly lower than the preoperative arterial SOD levels(t=2.741, P<0.05; t=2.704, P<0.05). After the interventional treatment, the SOD levels in the ischemic arterial region in group B1 and group B2 were (29.40 ± 5.49)U/ml and (26.68 ± 2.31)U/ml respectively, and the difference between the two groups was not statistically significant although these levels were significantly lower than the preoperative SOD levels in the ischemic arterial region (t = 2.536, P < 0.05; t = 5.005, P < 0.01). No statistically significant differences in SOD levels at each corresponding site existed between group B1 and group B2. Conclusion No significant difference in SOD level exists between the venous blood and the arterial blood. Serum SOD level carries a negative linear correlation with HbA1c level. Before interventional treatment , the SOD level in ischemic region is low, which becomes lower after the interventional procedure, which may be caused by the enhanced oxidative stress reaction that is resulted from the damage of the vascular wall due to interventional manipulations. The enhanced oxidative stress reaction may play an important role in the occurrence of restenosis.
ABSTRACT
Objective: To determine the national norm of Chinese questionnaire of quality of life in Chinese patients with cardiovascular diseases (CQQC) according patients with hypertension, coronary artery disease（CAD）, and congestive heart failure（CHF）and to analyze the influence factors. Methods: The quality of life was estimated by CQQC to evaluate 7937 persons normal and with cardiovascular diseases（contain with hypertension, CAD, and CHF ） in 28 hospitals of 19 cities across China. The data were compared in gender, age, exercise, psychologic condition, education, number of family member and medical cost. Results: 1、The mean scores（national norms）of normal persons were （95.74±23.21）; 2、The scores of hypertension patients were （73.75±23.62）, the scores of hypertension stage 3 group （69.06±21.78）were least compared with other stages（P<0.01）; 3、The scores of CAD patients were（64.67±20.59）, the scores of unstable angina group（55.37±18.62）were least compared with other types in CAD patients（P<0.01）; 4、The scores of CHF patients were （40.36±17.24）, it was least compared with those of hypertension and CAD patients （P<0.01）; 5、Influence factor: （1）Sex, age: The mean scores were （71.41±27.8）for 7937 persons, the scores of male persons were significantly higher than those of female (P=0.000). In normal persons, along with age increased, the scores decreased （P<0.05） ; except ≥70 ages group, the scores of male persons were higher than those of female（P<0.05） ; （2）Exercise: The scores of patients participating exercise were significantly higher than those of no participating exercise [（72.64±21.87）vs.（66.91±23.13）, P=0.000]; （3）Psychological condition: The scores of patients with healthy psychological condition were significantly higher than those of with psychologic disorder [（70.13±25.66）vs.（68.91±20.44）, P=0.001]; （4）Other: patients with better education, more than 1 family members and medical insurance or public expense had more scores (P<0.05～0.001). Conclusions： The sample size is large and the datum is reliable for Chinese questionnaire of quality of life in Chinese patients with cardiovascular diseases. It can reflect influence of age, sex, exercise, psychologic condition, family, education background, medical condition and disease, its item is brief, clear, and operation is easy, so it may well be spread.
ABSTRACT
Heparinase III is an enzyme that specifically cleaves certain sequences of heparan sulfate. Previous reports showed that this enzyme expressed in Escherichia coli was highly prone to aggregation in inclusion bodies and lacks detectable biological activity. In this paper, we fused a glutathione-S-transferase (GST) tag to the N-terminus of heparinase III gene and expressed the fusion protein in Escherichia coli to develop an expression system of soluble heparinase III. As a result, approximately 80% of the fusion protein was soluble. The protein was then purified to near homogeneity via one-step affinity chromatography. A 199.4-fold purification was achieved and the purified enzyme had a specific activity of 101.7 IU/mg protein. This represented 32.3% recovery of the total activity of recombinant GST-heparinase III. The maximum enzyme production was achieved when bacteria were induced with 0.5 mmol/L isopropyl-beta-D-thiogalactoside at 15 degrees C for 12 h. The enzyme showed maximum activity at 30 degrees C and pH 7.5. And the enzyme activity was stimulated by 1 mmol/L Ca2+ and 150 mmol/L NaCl.
Subject(s)
Escherichia coli , Genetics , Metabolism , Flavobacterium , Genetics , Glutathione Transferase , Genetics , Heparin Lyase , Genetics , Recombinant Fusion Proteins , GeneticsABSTRACT
OBJECTIVE To investigate the optimal surgical approach and compatible material for large nasal septal perforation.METHODS Operations were underwent via labiogingival groove approach under endoscope.Double layer of flaps were perichondrium of nasal septal cartilage,base of nasal cavity and inferior nasal meatus on the left and acellular dermal matrix (ADM) on the right and the two flaps were adhered with ear-cerebral glue (EC).RESULTS All of 36 cases were successfully repaired and no reperforation occurred after following-up for 3 months to 2 years.CONCLUSION Large mucosal flaps with wide pedicel and abundant blood supply and ADM of good biocompatibility provide a higher survival rate of the flaps.This method has the advantages of wide field of vision,less damage of the donated area and short time of operation.It is an optimal and practical method for repair of the large nasal septal perforation.
ABSTRACT
Objective To Study the antiarrhythmic effects of oryzanol.Methods Twenty rats were randomly divided into two groups:oryzanol group and control group,ten rats in each.The rats in the oryzanol group were fed with oryzanol which was mixed into normal diet at a dose of 60mg?kg -1 ?d -1 for 4 days.The rats in the control group were fed with normal diet.Results The responses to noise interference and adrenaline in the oryzanol group and control group were as follows:⑴the heart rates were 299?72 beats/min,351?68 beats/min(P