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Objective: To understand the characteristics of bacterial meningitis after pediatric neurosurgical procedures. Methods: This was a retrospective observational study. From January 2016 to December 2022, 64 children diagnosed with post-neurosurgical bacterial meningitis based on positive cerebrospinal fluid (CSF) culture in Department of Neurosurgery of Shanghai Children's Medical Center were selected as the study population. The clinical characteristics, onset time, routine biochemical indexes of cerebrospinal fluid before anti infection treatment, bacteriology characteristics and sensitivity to antibiotics of bacteria cultured from cerebrospinal fluid were analyzed. Based on the CSF culture results, the patients were divided into the Gram-positive bacteria infection group and the Gram-negative bacteria infection group. The clinical characteristics of the two groups were compared using t-tests or Wilcoxon rank-sum tests, and chi-square tests. Results: There were 64 children,42 boys and 22 girls, with onset age of 0.83 (0.50, 1.75) years. Seventy cases of post-neurosurgical bacterial meningitis occurred in the 64 children, of which 15 cases (21%) in spring, 23 cases (33%) in summer, 19 cases (27%) in autumn, and 13 cases (19%) in winter. The time of onset was 3.5 (1.0, 10.0) months after surgery; 15 cases (21%) occurred within the first month after the surgery, and 55 cases (79%) occurred after the first month. There were 38 cases (59%) showing obvious abnormal clinical manifestations, fever 36 cases (56%), vomiting 11 cases (17%). Forty-eight cases (69%) were caused by Gram-positive bacteria, with Staphylococcus epidermidis 24 cases; 22 cases (31%) were caused by Gram-negative bacteria, with Acinetobacter baumannii the prominent pathogen 7 cases. The Gram-positive bacterial infection was more common in summer than the Gram-negative bacterial infection (20 cases (42%) vs. 3 cases (14%), χ2=5.37, P=0.020), while the Gram-negative bacterial infection was more in autumn and within the first month after surgery than the Gram-positive bacterial infection (11 cases (50%) vs. 8 cases (17%), 15 cases (67%) vs. 5 cases (33%), χ2=8.48, 9.02; P=0.004, 0.003). Gram-positive bacteria resistant to vancomycin and Acinetobacter baumannii resistant to polymyxin were not found. However, Acinetobacter baumannii showed only 45% (10/22) susceptibility to carbapenem antibiotics. Conclusions: The clinical presentation of post-neurosurgical bacterial meningitis in children is atypical. Gram-positive bacteria are the main pathogens causing post-neurosurgical bacterial meningitis; Gram-negative bacterial meningitis are more likely to occur in autumn and within the first month after surgery. Acinetobacter baumannii has a high resistance rate to carbapenem antibiotics, which should be taken seriously.
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Male , Female , Humans , Child , China/epidemiology , Anti-Bacterial Agents/pharmacology , Meningitis, Bacterial/diagnosis , Gram-Negative Bacterial Infections/drug therapy , Gram-Positive Bacteria , Gram-Positive Bacterial Infections/drug therapy , Carbapenems , Retrospective Studies , Microbial Sensitivity Tests , Drug Resistance, BacterialABSTRACT
Benign prostatic hyperplasia （BPH）， a common disease in urology and andrology， is mainly manifested as enlarged prostate glands， bladder outlet obstruction， and lower urinary tract symptoms（LUTS）， which seriously affects the quality of life of middle-aged and elderly men. This disease falls into the categories of "retention of urine" and "prostatic hypertrophy" in traditional Chinese medicine （TCM）. In recent years，many doctors have put forward their understandings of BPH based on academic classics and their clinical experience. Clinical research on the treatment of BPH with TCM has become increasingly abundant. The basic pathogenesis of BPH lies in the disturbance of Qi transformation in the bladder and poor blood circulation due to kidney Qi deficiency in the aged. The disease is located in the kidney and the bladder and is related to the dysfunction of the lung and the kidney. It is basically characterized by deficiency in origin and excess in superficiality. A large number of clinical research reports have proved that TCM is efficient in alleviating the clinical symptoms of BPH patients， improving their quality of life， reducing the volume of the prostate， and decreasing postoperative complications. In addition， the external treatment methods of TCM， such as acupuncture therapy， moxibustion， hot water bathing， acupoint application， anal suppository， and enema therapy， are also widely used in clinical practice， demonstrating the diverse ways of TCM in treating BPH. TCM and western medicine complement each other's advantages in the treatment of BPH， thus enhancing the clinical efficacy and reducing the occurrence of long-term complications. This study reviewed the etiology， pathogenesis， and treatment progress of BPH with TCM in recent years， and summarized the current research status. From three aspects of producing high-quality clinical research， standardizing the clinical diagnosis and treatment of TCM， and combining cutting-edge research to explore the mechanism of TCM， it provided suggestions for clinical research on the treatment of BPH with TCM to promote the development and application of TCM in the treatment of this disease.
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Benign prostatic hyperplasia （BPH） model， as a carrier of BPH， is vital for exploring the pathogenesis of the disease and evaluating the efficacy of corresponding drugs. This paper reviewed the in vivo and in vitro models of BPH， the modeling principles and methods， and evaluation indicators， and analyzed the advantages and disadvantages of different types of models. At present， the BPH model is getting closer to the clinical characteristics of human BPH， providing powerful support for the evaluation of drug efficacy. Furthermore， the model has been developed towards cytology to allow further research on the pathogenesis of BPH. The relevant testing indicators reflect the core pathological changes of BPH from different levels， providing a guarantee for further exploring the pathogenesis of BPH and the development of prevention and control drugs. However， no model can fully simulate the natural development process of human BPH， and each model and evaluation criterion has its unique advantages and limitations. In terms of model evaluation， most BPH models are assessed based on benign prostate enlargement （BPE）， and there is still a lack of reliable models to simulate BPH progression and combine with bladder dysfunction. In terms of indicator evaluation， symptom-reflected behavioral indicators are absent in the replication of BPH models in animals. The study of the BPH model in traditional Chinese medicine （TCM） only focuses on the replication and investigation of the "disease" model， rather than the "syndromes" and "signs"， which cannot simulate the syndrome differentiation and treatment under the guidance of the TCM theory. In view of the above deficiencies， we should further improve the modeling method based on clinical characteristics， explore the multifactor composite models， especially those of disease-syndrome combination suitable for basic research of TCM， replicate the model closing to disease development， and optimize the evaluation indicators， which is of great theoretical and practical significance to develop drugs for effective prevention and control of BPH.
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China Association of Chinese Medicine organized specialists in andrology of Chinese and western medicine to explore the population and treatment stage of benign prostatic hyperplasia （BPH） with Chinese medicine as the leading therapy. Chinese medicine has great advantages in the treatment of benign prostatic hyperplasia. However， it is necessary to make clear the stage when Chinese medicine or modern medical treatment can be used as the leading therapy， and the conditions under which Chinese and western medicine can be combined to achieve the best treatment efficacy. The specialists agreed Chinese medicine as the leading therapy for the treatment of BPH in the following populations or conditions： the elderly and weak patients with basic diseases， BPH symptoms， and cannot tolerate anesthesia and surgery， the patients with BPH symptoms and cannot tolerate the adverse reactions or the possible adverse reactions of western medicine； the patients with mild ［international prostatic symptom score （IPSS） ≤ 7］ or moderate lower urinary tract symptoms （IPSS ≥ 8） and the quality of life not significantly affected， the patients with bladder detrusor hypofunction， bladder dysfunction and cannot be treated surgically， or with incomplete bladder emptying after surgical treatment； the BPH patients with prostatitis as the main clinical manifestation， the patients with non-acute complications after operation. BPH is one of the dominant diseases in urology and andrology of Chinese medicine， and the symptoms， complications， and prognosis of BPH patients need to be fully considered during the clinical treatment. When Chinese medicine is taken as the leading therapy， it is essential to regularly review the serum level of prostate-specific antigen to exclude the possibility of prostate cancer， and apply Chinese medicine for full treatment course and cycle. At the same time， Chinese and western medicine can be combined to achieve the most effective， convenient， economical， and satisfactory treatment， which can carry forward the advantages of Chinese medicine in treating this disease.
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In recent years， the incidence rate of andrological diseases has shown a significant growth trend. Considering the unavailability of a perfect theoretical system for andrology in traditional Chinese medicine （TCM） and the complex pathogenesis despite of the limited types of andrological diseases， it is necessary to improve the clinical efficacy of andrological diseases so as to satisfy the needs of patients. Therefore， the China Association of Chinese Medicine （CACM） organized the andrologists of TCM and western medicine and the outstanding young clinicians to discuss the andrological diseases responding specifically to TCM or integrated TCM and western medicine， such as chronic prostatitis， male infertility， benign prostatic hyperplasia， erectile dysfunction， and premature ejaculation， determine their diagnostic criteria in western medicine， and standardize the specifications for TCM diagnosis and treatment based on syndrome differentiation， thus formulating recognized and integrated diagnosis and treatment protocols. Apart from proposing suggestions on the treatment of such andrological diseases with TCM and western medicine， the experts have also figured out the andrological diseases responding specifically to TCM， the optimal intervention time of TCM and western medicine， and the suitable measures including surgery. The resulting consensus helps to better guide the formulation of accurate， personalized， and optimized treatment plans in clinical practice and improve the diagnosis and treatment effects of andrological diseases by giving full play to the advantages of TCM， which will in turn contribute to further innovation and development of TCM.
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Objective: To study the therapeutic effect of Huoxue Tongluo Decoction (HXTLD) on erectile dysfunction caused by ischemic stroke and identify the mechanisms involved. Methods: Network pharmacology was used to predict the key active ingredients and targets of HXTLD. Surgical methods were used to create a rat model of ischemic stroke. The rats were then given a suspension of HXTLD by ig administration. Erectile function was evaluated by Apomorphine (APO) induction. Real-time fluorescence quantitative reverse transcription-polymerase chain reaction (Real-time PCR) and Western blotting were used to detect the expression of related mRNAs and proteins in rat penile corpus cavernous tissue and brain tissue. Hematoxylin & Eosin (HE) staining was used to investigate structural changes in the penile cavernous tissue. Results: Network pharmacology showed that tumor necrosis factor (TNF), nitric oxide synthase 3 (eNOS), and vascular endothelial growth factor (VEGF) were the key targets of HXTLD in the treatment of erectile dysfunction caused by ischemic stroke. Experimental studies showed that HXTLD improved erectile dysfunction caused by ischemic stroke. HE results showed that HXTLD improved the structure of the corpus cavernosa. HXTLD also inhibited the expression of TNF and VEGF proteins in penile tissue (P < 0.05) and enhanced the expression of eNOS protein in penile tissue (P < 0.05). Conclusion: HXTLD improved the erectile function of rats with erectile dysfunction caused by ischemic stroke by regulating the mRNA and protein levels of TNF, eNOS and VEGF.
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OBJECTIVE@#To evaluate the clinical therapeutic effect of electroacupuncture (EA) at @*METHODS@#The data of 318 patients undergoing anal fistula surgery were analyzed retrospectively. In accordance with whether accepted the combined treatment with EA at bilateral @*RESULTS@#For VAS score, there was an interaction between therapeutic method and treatment duration (@*CONCLUSION@#Electroacupuncture at
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Humans , Acupuncture Points , Acupuncture, Ear , Electroacupuncture , Rectal Fistula/therapy , Retrospective StudiesABSTRACT
Objective To mastered the distribution characteristics of Haemaphysalis longicornis in the Tumen River basin along the border between Russia, Korea and Northeast China, and understand the status of Haemaphysalis longicornis carrying the virus of fever with thrombocytopenia syndrome (SFTS), then, isolate the virus and analyze its genetic characteristics. Method Ticks were collected from Hunchun, Tumen, Helong and Longjing cities in the Tumen River basin of Jilin Province from April to September, 2017. Haemaphysalis longicornis was selected and grouped. SFTS virus was detected by real-time quantitative polymerase chain reaction (RT-qPCR). Virus isolation was carried out in Vero cells, besides, S,M,L gene segments were amplified . The homology of S, M and L gene segments was compared, phylogenetic tree was established, and their gene characteristics were analyzed. Result Haemaphysalis longicornis mainly distributed in Hunchun and Tumen City in the lower reaches of Tumen River. It was the dominant species in the two counties, reaching 71.85% and 87.62% respectively. A virus named YBHC-TICK2-2017/CHINA was isolated from Haemaphysalis longicornis collected in Hunchun. The sequences of S segment (1 746 bp), M segment (3 336 bp) and L segment (6 376 bp) of the virus were 98.00%-99.00%, homologous to those of SFTS virus isolates from China and Korea recorded in National Center for Biotechnology Information (NCBI) Gen Bank. Phylogenetic tree analysis showed that the S segment gene sequence of the virus strain was divided into a cluster with Jilin strain (KT890282) in China, and M segment and L segment gene sequence with Jiangsu strain (KR230781) in China. Conclusions Haemaphysalis longicornis are widely distributed in the lower reaches of the Tumen river. It was the first time that SFTS virus was isolated from Haemaphysalis longicornis in this area, suggesting that this area is important for SFTS prevention.
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OBJECTIVE： To investigate and analyze the channels by which doctors obtain related information of diagnosis and treatment about diseases， and to provide reference for management institutions to understand related information and execute continue education. METHODS： 14 public general hospitals （12 were second grade class A， 2 were third grade class A） with grade Ⅱ and above in Tangshan were selected， and a self-designed questionnaire was used to conduct a one-to-one paper questionnaire survey on the doctors on duty. The content of the survey focused on the channels to obtain related information of diagnosis and treatment （including internal communication platform for medical experts， professional Chinese medical journals， professional medical network media， professional medical training classes/courses and professional medical academic conferences）. The channels to access relevant information on diagnosis and treatment were analyzed from the hospital level， department， professional title， education backgrounds and medical years. RESULTS： A total of 2 536 questionnaires were sent out， and 2 105 questionnaires were recovered （recovery rate of 83.0％）， among which there were 2 047 valid questionnaires （effective rate of 97.2％）. Doctors in third grade hospitals obtain more relevant information through “professional Chinese medical journals” “professional medical network media” “professional medical training classes/courses” “professional medical academic conferences” and than doctors in second grade hospitals （P＜0.05 or P＜0.01）； there was no statistical significance among different departments （P＞0.05）. Doctors with deputy chief physician or above title chose “internal communication platform for medical experts” “professional Chinese medical journals” and “professional medical academic conference” more than doctors with attending physician or below title （P＜0.05 or P＜0.01）. The proportion of doctors with master’s degree or above choosing “professional Chinese medical journals” “professional medical network media” and “professional medical academic conferences” were significantly higher than that of doctors with bachelor’s degree or below （P＜0.05 or P＜0.01）. The proportion of doctors who had been in medicine experience for 11 years or more choosing “professional Chinese medical journals” and “professional medical training classes/courses” were higher than that of doctors who had been in medicine experience for 10 years or less （P＜0.05 or P＜0.01）. Overall， the doctors who choosing “internal communication platform for medical experts” and “professional medical network media” was significantly higher than that of doctors choosing “professional Chinese medical journals” “professional medical training classes/courses” and “professional medical academic conferences” （P＜0.001）. CONCLUSIONS： Doctors are more likely to choose “internal communication platform for medical experts” and “professional medical network media” channels to obtain disease diagnosis and treatment information. Medical experts’ inner exchange platforms and professional medical network media can be effectively used as an important way for medical staff to conduct continue education and improve the level of disease diagnosis and treatment.
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TAR DNA/RNA -binding domain protein 43 (TDP-43) is a highly conserved and widely expressed nuclear protein. TDP-43 is recognized as a pathological marker protein of amyotrophic lateral sclerosis (ALS),frontotemporal lobar degeneration (FTLD) and alzheimer disease (AD).This article discusses the structure and the function ofTDP-43 and the relationship of its expression in neurodegenerative disease.Meanwhile, this article emphatically probes into the specific expression andfunction of TDP-43 in acute and chronic brain injury based on the knowledge of its biological characteristics,aiming to explore the feasibility for determining the cause of death and the injury and disability situations by TDP-43 in forensic pathology.
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Objective To detect the long term effect of pure and multiple concussions on spatial cognitive of rats.Methods One hundred and eighty 7-week-old Spragne-Dawley male rats with weight of 280 ± 30g were chosen and randomly divided into a control group and a concussion group.The cerebral concussion was induced in the rats using a metallic pendulum striker concussive device.After the first strike,the brain injury group was randomly divided into a pure cerebral concussion(PCC)group and a multiple cerebral concussion(MCC) group.After the second strike,the MCC group was randomly divided into two-fold cerebral concussion(2MCC) group and three-fold cerebral concussion(3MCC) group.The striking interval was 24h.One,3 and 6 months after trauma,their cognitive function was tested using Morris water maze.Results One month later after injury,there was no significant difference in the escape latency between the control group and PCC group.Significant differences in the measurement were observed between the control/PCC group and 2MCC group on the 7th day after the injury,also between the control/PCC and 3MCC groups on the 6th and 7th day.And there were significant differences between the 2MCC and 3MCC groups on the 6th and 7th days.The non-platform test did not observe any significant differences among the four groups.Three months after injury,there was still no significant difference between the control group and PCC group,PCC and 2MCC groups,as well as 2MCC and 3MCC groups in the escape latency.However,there was significant difference between the control group and 2MCC group on the 5th,6th and 7th days,between the control group and 3MCC group on the 4th,5th,6th and 7th days,as well as between PCC group and 3MCC group on the 6th and 7th days.In the non-platform test,there was no significant difference between the control group and PCC group,between PCC group and 2MCC group,as well as between 2MCC group and 3MCC group.However,2MCC and 3MCC groups spent significantly less time in the former platform quadrant,when compared with the control group and 3MCC group spent significantly less time than PCC group.Six months after injury,significant differences in the escape latency were observed between the control group and PCC group on the 6th and 7th days,and 2MCC group on the 5th,6th and 7th days,also and 3MCC groups on the 2nd,3rd,4th,5th,6th and 7th days,still between PCC group and 2MCC group on the 6th and 7th days,as well as between PCC group and 3MCC group on the 4th,5th,6th and 7th days.Moreover,there was significant difference between 2MCC and 3MCC groups only on the 7th day.In the non-platform test,PCC group,2MCC group and 3MCC group spent significantly less time in the former platform quadrant compared with the control group.Moreover,in this test significant differences were found between PCC group and 2MCC/3MCC group,but not between 2MCC group and 3MCC group.Conclusion With the increase of cerebral concussion times,earlier and more serious damage of spatial cognition will appear,with a significant cumulative effect in rats.Such rat model can be used to study the pathological changes of cognitive impairment in chronic traumatic encephalopathy.
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Objective-To assess the clinical value of the computer-assisted three-dimensional reconstruction technique design and evaluate the climcal experience of manufacture artificial bone precision to repair the mandibular defect.Methods· From 2001 to 2016,163 computer-assisted reconstruction surgeries had been performed in Craniofacial Department,Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine.During six months followup,the measurement data was conducted and compared with three-dimensional CT result.Random measurement of the three key anatomical points pre-and post-operative carried out with statistical error was used to evaluate the accuracy of computer-assisted three-dimensional reconstruction in mandibular defects repairation and to investigate the clinical application value of the operation time and postoperative complication rate.Results· From July 2001 to July 2016,a total of 163 patients underwent computer-assisted three-dimensional reconstruction of artificial bone repair for mandibular defects;149 patients met the statistical criteria in which preoperative design and postoperative actual effect's average distance error (1.27±0.15) mm,operation time (2.5±1.2) h.Conclusion· Threedimensional design of artificial bone to repair the mandibular defect is a valuable technology,by relying on quantitative design and preoperative simulation to simplify the difficulty and improve the accuracy of surgery.The patients showed high satisfaction rate with low surgical complications and long-term efficacy.
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Objective To analyze the incidence of gallbladder cancer in Qidong City from 1993 to 2012 . Methods The clinical data of gallbladder cancer from January 1993 to December 2012 for patients with census registration in Qidong were sorted out from the cancer registration center in Qidong . Annual percent change ( APC ) models were applied to describe the annual percent changes of disease incidence and the standardized incidence trend over time.The incidence was standardized with the age structure of standard population from a national census taken in 2000 . Results A total of 493 new cases were diagnosed from 1993 to 2012 , occupying 0 .81%of new-onset malignant tumors for the same period . The crude incidence rate of gallbladder cancer was 2 .41/100 000 population and the standardized incidence thereof was 1 .42/100 000 population .Both the crude incidence and the standardized incidence thereof increased on a yearly basis from 1993 to 2012 ( APC=12 .83; APC =12 .04 ) while the annual crude incidence thereof for females increased faster than that for males ( APC=14 .51; APC=10 .60 ) . Old people aged 65 years and above were a high-risk group for gallbladder cancer , occupying 63 .49%of the incidence thereof for all ages . Conclusion The incidence of gallbladder cancer increases in Qidong , Jiangsu province of China on a yearly basis from 1993 to 2012 , with the incidence thereof for females increasing faster than that for males .
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Objective@#To investigate the relationship of erectile dysfunction (ED) with psychological factors in male patients with infertility.@*METHODS@#We conducted a questionnaire investigation among 252 male patients with infertility, which involved the general condition, results of semen routine examination, sexual life, and scores in IIEF-5, self-reported 9-item patient health questionnaire (PHQ-9) and 7-item generalized anxiety disorder scale (GAD-7). We analyzed the prevalence of ED, depression, and anxiety and their correlations among the patients in comparison with 100 fertile male controls.@*RESULTS@#In 245 of the infertility patients, the most common symptoms of depression and anxiety were "feeling tired or no vitality" and "easily getting worried or impatient", 20.4% of them with depression disorder and 42.9% with anxiety disorder. The PHQ-9 and GAD-7 scores were significantly higher in the infertile males than in the normal fertile controls (P <0.05), and so was the incidence of ED (28.6% vs 12.4%, P <0.05), while the IIEF-5 scores were markedly lower in the former than in the latter group (P <0.01), and so were sex frequency and sexual satisfaction (P <0.05). The PHQ-9 and GAD-7 scores were remarkably higher in the infertility patients with ED than in those without (P <0.01). Logistic regression analysis showed that the level of libido and results of semen routine examination were the risk factors for depression disorder, while age, education level, disease course and experience of assisted reproduction were those for anxiety disorder.@*CONCLUSIONS@#Male infertility patients have a poorer mental health and a higher incidence of ED than normal fertile men, and there is some interaction between psychological status and ED prevalence.
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Humans , Male , Anxiety , Epidemiology , Depression , Epidemiology , Erectile Dysfunction , Epidemiology , Psychology , Infertility, Male , Psychology , Libido , Patient Health Questionnaire , Prevalence , Risk Factors , Semen Analysis , Sexual BehaviorABSTRACT
Objective@#To evaluate the clinical efficacy and safety of Qilin Pills in the treatment of oligoasthenospermia in infertile men.@*METHODS@#This multi-centered randomized double-blind controlled clinical trial included 216 infertile males with oligoasthenospermia, 108 in the trial group and the other 108 in the control, the former treated with Qilin Pills at the dose of 6 g tid while the latter with Wuziyanzong Pills at 6 g bid, both for 12 weeks. We examined the total sperm count, sperm motility and the count of progressively motile sperm of the patients before and at 4, 8 and 12 weeks after medication and evaluated the safety of the drug based on the adverse events and the laboratory results of blood and urine routine examinations and liver and kidney function tests.@*RESULTS@#Compared with the baseline, the patients in the trial group showed a significant time-dependent improvement after 4, 8 and 12 weeks of medication in sperm motility (21.75% vs 27.54%, 29.04% and 32.95%, P <0.05), total sperm count (156.27 ×106 vs 177.33, 188.18 and 205.44 ×106, P <0.05), and the count of progressively motile sperm (32.08 ×10⁶/ml vs 46.33, 50.98 and 61.10 ×10⁶/ml, P <0.05). The three parameters above were also improved in the controls, but more significantly in the trial group (P <0.05).@*CONCLUSIONS@#Qilin Pills can evidently improve the semen quality of oligoasthenospermia patients with no obvious adverse events.
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Humans , Male , Asthenozoospermia , Drug Therapy , Capsules , Double-Blind Method , Drugs, Chinese Herbal , Therapeutic Uses , Infertility, Male , Drug Therapy , Oligospermia , Drug Therapy , Semen Analysis , Sperm Count , Sperm Motility , Treatment OutcomeABSTRACT
Objective To understand effect of application of disposable shoe covers on the culture result of air-borne bacteria in intensive care unit (ICU).Methods According to Hygienic standards for disinfection in hospi-tals (GB 15982-2012)and Technical standards for disinfection in medical institutions (WS/T 367-2012),the col-ony forming units of bacteria in ICU air were detected for 15 consecutive days when disposable shoe covers were used and unused,bacterial culture results were analyzed.Results The number of patients,number of visitors, temperature,and humidity in ICU when disposable shoe covers were used and unused were not significantly differ-ent (all P >0.05).The total number of bacterial colonies in ICU air when using disposable shoe covers was (median ± interquartile range:[1.20±2.20]CFU/15 min.·Φ9 cm.plate),which was significantly higher than air when disposable shoe covers were not used(median ± interquartile range:[0.60±1.10]CFU/15 min.·Φ9 cm.plate), difference was statistically significant(P <0.05).The qualified rate of bacterial culture result of air when disposable shoe covers were not used was higher than that when disposable shoe covers were used (96.67% vs 86.67%,P <0.05).Conclusion The use of disposable shoe covers can not improve ICU air quality.
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Objective To compare the clinical efficacies of 3D and 2D laparoscopic partial nephrectomy for renal tumors and to investigate the pros and cons of 3D laparoscopic partial nephrectomy. Methods We retrospectively analyzed the clinical data of 134 patients with renal tumors; they underwent laparoscopic partial nephrectomy between Aug. 2013 and Mar. 2016 by the same surgical group in Changhai Hospital and Changzheng Hospital, Second Military Medical University. Fifty-three cases were included in the 3D laparoscopic partial nephrectomy group and 81 cases in the 2D laparoscopic partial nephrectomy group. The perioperative and follow-up data subjected to comparison and analysis included operative time, estimated blood loss, intraoperative transfusion, warm ischemic time, recovery time of bowel function, length of hospitalization, perioperative complications, and pre- and post-operative glomerular filtration rate (GFR). Results All operation procedures of this study were completed uneventfully without conversion to open surgery or radical nephrectomy, and surgical margins were negative in all cases. The operative time ([193.40±45.14] vs [217.00±59.19] min, P = 0.015), warm ischemic time ([23.70±6.96] vs [26.60±8.10] min, P = 0.032) and decrease of GFR of the operated kidney ([12.70 + 6.49] vs [15. 10 + 6. 45] mL • min-1 • 1. 73 m2, P = 0. 036) in the 3D group were significantly improved compared with those in the 2D group. However, the estimated blood loss, intraoperative transfusion, recovery time of bowtt function, length of hospitalization and perioperative complications were not significantly different between the two groups (P>0. 05). Att the patients with complications were discharged from the hospitat after conservative therapy. During a follow-up of 1-32 months, no patients had acute or chronic renat failure, local recurrence or distant metastasis, and there was no death case. Conclusion Compared with 2D laparoscopic partial nephrectomy, 3D laparoscopic technology can reduce operative time and warm ischemic time, which can help to better conserve renal function.
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Objective To understand effect of application of disposable shoe covers on the culture result of air-borne bacteria in intensive care unit (ICU).Methods According to Hygienic standards for disinfection in hospi-tals (GB 15982-2012)and Technical standards for disinfection in medical institutions (WS/T 367-2012),the col-ony forming units of bacteria in ICU air were detected for 15 consecutive days when disposable shoe covers were used and unused,bacterial culture results were analyzed.Results The number of patients,number of visitors, temperature,and humidity in ICU when disposable shoe covers were used and unused were not significantly differ-ent (all P >0.05).The total number of bacterial colonies in ICU air when using disposable shoe covers was (median ± interquartile range:[1.20±2.20]CFU/15 min.·Φ9 cm.plate),which was significantly higher than air when disposable shoe covers were not used(median ± interquartile range:[0.60±1.10]CFU/15 min.·Φ9 cm.plate), difference was statistically significant(P <0.05).The qualified rate of bacterial culture result of air when disposable shoe covers were not used was higher than that when disposable shoe covers were used (96.67% vs 86.67%,P <0.05).Conclusion The use of disposable shoe covers can not improve ICU air quality.
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<p><b>BACKGROUND</b>Thalidomide is an immunomodulatory and anti-angiogenic drug that has shown promise in patients with myeloma. Trials comparing efficacy of standard melphalan and prednisone (MP) therapy with MP plus thalidomide (MPT) in transplant-ineligible or elderly patients with multiple myeloma (MM) have provided conflicting evidence. This meta-analysis aimed to determine the efficacy and toxicity of thalidomide in previously untreated elderly patients with myeloma.</p><p><b>METHODS</b>Medline, the Cochrane Controlled Trials register, conference proceedings of the American Society of Hematology (1995-2014), the American Society of Clinical Oncology (1995-2014), and CBM, VIP, and CNKI databases were searched for randomized control trials with the use of the medical subject headings "MM " and "thalidomide ". Trials were assessed by two reviewers for eligibility. Meta-analysis was conducted using a fixed effects model. Sensitivity analysis was performed to test the robustness of the findings.</p><p><b>RESULTS</b>Overall, seven trials were identified, covering a total of 1821 subjects. The summary hazard ratio (thalidomide vs. control) was 0.82 (95% confidence interval [CI]: 0.72-0.94) for overall survival (OS), and 0.65 (95% CI: 0.58-0.73) for progression-free survival, in favor of thalidomide treated group. The risk ratio of complete response with induction thalidomide was 3.48 (95% CI: 2.24-5.41). A higher rate of III/IV adverse events were observed in MPT arm compared with the MP arm. However, analysis of sub-groups administering anticoagulation as venous thromboembolism prophylaxis suggested no difference in relative risk of thrombotic events between two arms (RR = 1.47, 95% CI: 0.43-5.07, P = 0.54). Further analysis of trials on the treatment effects of MPT versus MP on adverse events-related mortality showed no statistical difference between two arms (RR = 1.24, 95% CI: [0.95-1.63], P = 0.120).</p><p><b>CONCLUSION</b>Thalidomide appears to improve the OS of elderly and/or transplant-ineligible patients with MM when it is added to standard MP therapy.</p>
Subject(s)
Humans , Disease-Free Survival , Immunosuppressive Agents , Therapeutic Uses , Melphalan , Therapeutic Uses , Multiple Myeloma , Drug Therapy , Mortality , Prednisone , Therapeutic Uses , Thalidomide , Therapeutic UsesABSTRACT
The ubiquitin-proteasome system plays a pivotal role in breast tumorigenesis by controlling transcription factors, thus promoting cell cycle growth, and degradation of tumor suppressor proteins. However, breast cancer patients have failed to benefit from proteasome inhibitor treatment partially due to proteasome heterogeneity, which is poorly understood in malignant breast neoplasm. Chemical crosslinking is an increasingly important tool for mapping protein three-dimensional structures and proteinprotein interactions. In the present study, two cross-linkers, bis (sulfosuccinimidyl) suberate (BS(3)) and its water-insoluble analog disuccinimidyl suberate (DSS), were used to map the subunit-subunit interactions in 20S proteasome core particle (CP) from MDA-MB-231 cells. Different types of gel electrophoresis technologies were used. In combination with chemical cross-linking and mass spectrometry, we applied these gel electrophoresis technologies to the study of the noncovalent interactions among 20S proteasome subunits. Firstly, the CP subunit isoforms were profiled. Subsequently, using native/SDSPAGE, it was observed that 0.5 mmol/L BS(3) was a relatively optimal cross-linking concentration for CP subunit-subunit interaction study. 2-DE analysis of the cross-linked CP revealed that α1 might preinteract with α2, and α3 might pre-interact with α4. Moreover, there were different subtypes of α1α2 and α3α4 due to proteasome heterogeneity. There was no significant difference in cross-linking pattern for CP subunits between BS(3) and DSS. Taken together, the gel-based characterization in combination with chemical cross-linking could serve as a tool for the study of subunit interactions within a multi-subunit protein complex. The heterogeneity of 20S proteasome subunit observed in breast cancer cells may provide some key information for proteasome inhibition strategy.