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Hypoxic preconditioning could improve the survival of mesenchymal stem cells (MSCs) in ischemic or hypoxic environments, but its exact mechanism remains to be further explored. This study aims to determine the role of lysine crotonylation (Kcr) in regulating the survival and proliferation of peripheral blood mesenchymal stem cells (PBMSCs) in the hypoxic culture. PBMSCs were isolated and cultured from rat peripheral blood mononuclear cells, and their surface markers were identified by flow cytometry. PBMSCs were first subjected to hypoxic/ normoxic preconditioning: hypoxic (1% O
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To evaluate the drug susceptibility of multidrug-resistant bacteria in elderly patients(≥65 years)with bloodstream infection, and to explore the influencing factors on generation of multidrug-resistant bacteria, so as to provide scientific basis for the early and accurate administration of antibiotics.Methods:The clinical data of the elderly patients diagnosed as bloodstream infection in Luhe Hospital from January 2016 to December 2018 was retrospective analyzed.Based on blood culture results, the isolated pathogens were divided into the multidrug-resistance group and the control group.Univariate analysis was performed by χ2 test, and the variables with statistical significance were included in the multivariate Logistic regression analysis to evaluate the influencing factors of multidrug-resistance bacteria’ infection. Results:Among 389 elderly patients with bloodstream infection, 221(56.81%)had multidrug-resistant bacteria infection.The top three bacteria detected were coagulase-negative staphylococcus(77.42%, 48/62), escherichia coli(56.80%, 71/125)and acinetobacter baumannii(55.88%, 19/34). Patients who had nosocomial acquired infections( OR=2.000, 95% CI: 1.160-3.447), used penicillins( OR=3.911, 95% CI: 1.835-8.336), used cephalosporins and quinolones within 3 months( OR=3.867, 95% CI: 1.956-7.646; OR=2.257, 95% CI: 1.087-4.688, respectively), or application of more than two antibiotics( OR=14.711, 95% CI: 1.861-116.258)had a significantly increased risk of multidrug-resistant infections. Conclusions:Taking effective preventive measures against nosocomial infections, rational use of penicillins, cephalosporins and quinolones, and careful combination use of antibiotics might be effective measures to reduce bloodstream infections caused by multidrug-resistant bacteria in the elderly.
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Objective To investigate the risk factors for drug resistance of urinary tract infections-causing Escherichia coli producing extended spectrum beta-Lactamases (ESBLs) in elderly people (≥65 years old),in order to provide evidence for rational use of antibiotics in clinic.Methods Clinical data of elderly patients diagnosed as urinary tract infections in Beijing Chao-Yang Hospital from January 2016 to December 2017 were retrospectively analyzed.According to whether ESBLs were produced by Escherichia coli isolated from urine samples,the patients were divided into the ESBLs-producing E.Coli group (ESBLs group) and the control group.Single factor analysis was performed by Chi-square test.Logistic regression analysis was used to analyze the risk factors for ESBLs-producing Escherichia coli infections in urinary tract on the basis of statistical significance.Results A total of 452 strains of Escherichia coli were isolated,including 253 strains (55.97％)producing ESBLs,and 199 strains (44.03％) not producing ESBLs.The ureteral calculi (OR =2.675,95％CI:1.129-6.341),urinary obstructive diseases (≥ 2 kinds) (OR =8.680,95％CI:2.508-30.040),indwelling catheters (OR =5.762,95％ CI:2.698-12.155),antibiotic treatment more than 2 weeks for urinary tract infections within one year (OR =3.461,95％CI:1.766-6.784)were independent risk factors for ESBLs-producing Escherichia coli urinary tract infections.The incidence rate of Escherichia coli resistance to various antibiotics was higher in elderly patients with urinary tract infection than in non-elderly patients.Conclusions Escherichia coli producing ESBLs can be easily isolated from elderly patients with urinary tract obstructive diseases,indwelling catheters and repeated long-term administration of broad-spectrum antibiotics.The proportion of ESBLs Escherichia coli-caused urinary tract infections is higher in elderly patients.Thereby,carbapenems or piperacillin/tazobactam is the reasonable antibiotics.Ampicillin,piperacillin,levofloxacin and ciprofloxacin should not be the first choice for the treatment of urinary tract infections in the elderly.
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Objective@#To investigate the risk factors for drug resistance of urinary tract infections-causing Escherichia coli producing extended spectrum beta-Lactamases (ESBLs) in elderly people (≥65 years old), in order to provide evidence for rational use of antibiotics in clinic.@*Methods@#Clinical data of elderly patients diagnosed as urinary tract infections in Beijing Chao-Yang Hospital from January 2016 to December 2017 were retrospectively analyzed. According to whether ESBLs were produced by Escherichia coli isolated from urine samples, the patients were divided into the ESBLs-producing E. Coli group (ESBLs group) and the control group. Single factor analysis was performed by Chi-square test.Logistic regression analysis was used to analyze the risk factors for ESBLs-producing Escherichia coli infections in urinary tract on the basis of statistical significance.@*Results@#A total of 452 strains of Escherichia coli were isolated, including 253 strains (55.97%) producing ESBLs, and 199 strains (44.03%) not producing ESBLs. The ureteral calculi (OR=2.675, 95%CI: 1.129-6.341), urinary obstructive diseases (≥ 2 kinds) (OR=8.680, 95%CI: 2.508-30.040), indwelling catheters (OR=5.762, 95%CI: 2.698-12.155), antibiotic treatment more than 2 weeks for urinary tract infections within one year (OR=3.461, 95%CI: 1.766-6.784) were independent risk factors for ESBLs-producing Escherichia coli urinary tract infections. The incidence rate of Escherichia coli resistance to various antibiotics was higher in elderly patients with urinary tract infection than in non-elderly patients.@*Conclusions@#Escherichia coli producing ESBLs can be easily isolated from elderly patients with urinary tract obstructive diseases, indwelling catheters and repeated long-term administration of broad-spectrum antibiotics. The proportion of ESBLs Escherichia coli-caused urinary tract infections is higher in elderly patients. Thereby, carbapenems or piperacillin/tazobactam is the reasonable antibiotics. Ampicillin, piperacillin, levofloxacin and ciprofloxacin should not be the first choice for the treatment of urinary tract infections in the elderly.
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Objective To observe the effect of paraformaldehyde fixation on viscoelastic properties of the vertebrae in rats, so as to find the best methods of preserving cancellous bone samples from the perspective of biomechanics. Methods Twenty 8-week-old healthy female Sprague-Dawley rats were selected, and their whole L4 and L5 vertebra were separated by surgery. The total 40 vertebrae were randomly and evenly divided into experimental group and control group. The experimental group was fixed with 4% paraformaldehyde for 72 h, and the control group was transferred to 5 mL EP tube and cryopreserved at -20 ℃. Ten vertebrae were randomly selected from each group for stress relaxation and creep experiments. After 7 200 s, the samples were collected and their micro-structure changes were analyzed by micro-CT. Results The relaxation creep curve of experimental group was smoother than that of control group, the time to reach steady state was shorter, and the total amount of relaxation creep at 500 s and 7 200 s was significantly decreased (P<0.01). Micro-CT results showed that relaxation and creep experiment could cause trabecular rupture, and trabecular damage was more severe in experimental group than that in control group. Conclusions Paraformaldehyde significantly reduce the viscoelasticity of rat vertebrae, and it is more easily to cause microstructure damage under mechanical stimulation, which is detrimental to cancellous bone preservation.
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Objective:To perform unilateral patellar resurfacing and contralateral patellar retention in bilateral total knee arthroplasty (TKA) randomly,and to compare the clinical effects of patellar retention with patellar resurfacing in TKA.Methods:In the study,14 bilateral knee osteoarthritis (OA) patients were randomized in the bilateral TKA to receive unilateral patellar resurfacing and contralateral patellar retention,including 28 knees,all were females,53 to 78 years old,with average (66.9 ± 7.8) years,and the BMI was (26.3 ± 1.8) kg/m2.All subjects were followed up from 3 to 12 months.The clinical effects were evaluated based on measurements of American Knee Society score (KSS),range of motion (ROM),anterior knee pain,patellar clunk,and patellar tilt angle (PTA).Results:All the wounds healed primarily without significant complications,such as infection,aseptic loosening,patellar fracture and so on.The preoperative KSS scores of patellar resurfacing group were 38.9 ± 22.2,and the scores changed to be 92.4 ± 6.7 after operation,which were added by 53.5 ± 20.3.While in the patellar retention group,the KSS scores were 38.4 ± 20.5 preoperatively,and after operation,which were added to be 92.1 ±4.2,and improved by 53.7 ±21.4.The differences in the changed KSS scores between TKA with and without patellar resurfacing were not statistically significant (Independent t-test,P =0.98).The ROM was changed from 95.4° ± 13.5° preoperatively to 120.4° ± 8.9° postoperatively in the patellar resurfacing group and from 92.9° ± 19.1 ° preoperatively to 120.4 ± 8.4° postoperatively in the patellar retention group.The ROM of the two group were increased by 25.0° ± 14.5° and 27.5° ± 19.4° re spectively.However,no remarkable differences were observed between the 2 groups in the knee ROM (Independent t-test,P =0.70).At the end of the latest follow-up,3 knees in the patellar resurfacing group and 2 knees in the patellar retention group had knee anterior pain,the incidences of anterior knee pain were 21.4％ and 14.3％ respectively.There was no obvious difference for the incidence of post operative anterior knee pain (Chi-square test,P =0.62).The incidences of post-operative patellar clunk in the 2 groups were all with 3 knees (21.4％),which had no significant difference in the 2 groups (Chi-square test,P =1.00).The post-operative PTA were 2.6° ± 2.6° in the patellar resurfacing group and 3.6° ± 2.9° in the patellar retention group,respectively.There was also no statistical difference between the 2 groups (Chi-square test,P =0.36).Conclusion:For knee OA patients with mild or moderate patellar cartilage damage,performing patellar resurfacing or not didn't significantly affect anterior knee pain,patellar clunk,functional outcomes or patellar tracking after TKA.So we suggest retain patella in TKA for OA patients with mild or moderate patellar cartilage damage.
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Prof. CHEN Quan-xin holds that proper application of reinforcing-reducing manipulation is the key for therapeutic effect of acupuncture. Clinically, he holds that the acupuncturist must carefully observe arrival of qi under the needle. In the present paper, Prof. CHEN's needling manipulation methods are preliminarily summarized, focusing a more systematic exposition on core manipulations of CHEN's needling manipulation, i. e. CHEN's Feizhen manipulation, CHEN's qi-inducing manipulation and CHEN's grading reinforcing-reducing manipulation. The author holds that only careful study, grasping the essentials and techniques of manipulation can attain very good clinical therapeutic effect in clinic.
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Humans , Acupuncture Therapy , Methods , China , History, 20th Century , History, 21st CenturyABSTRACT
Objective To investigate clinical outcomes and side effects of 103Pd seed brachytherapy for malignant tumors. Methods Twenty patients with residual or recurrent unresectable malignancies were treated with 103Pd seed implantation under the guidance of ultrasonigraphy or CT scans. Three patients were given a local anesthesia and 17 patients, general anesthesia. The match peripheral doses ranged from 97.3 Gy to 182.78 Gy (mean, 123 Gy). The activity of each seed ranged from 1.4 mCi to 1.8 mCi. The planning target volume (PTV) included a 1 cm isotropic expansion margin around the clinical target volume (CTV). The seeds were retrogradely placed with a Mick applicator. External beam radiation was required 3～4 weeks after seed implantation in 6 patients, with a total dose of 45～50 Gy and 2 Gy each fraction. All of the patients received CT scanning after implantation for quality evaluation and underwent routine chest X-ray examination at 24～48 hours for seed observation. Results A complete response was achieved in 5 patients and a partial response in 12 patients. Two patients were assessed as having stable disease. In 1 patient with prostatic cancer, the serum PSA level was decreased significantly. The local control rate was 90% (18/20). The 20 patients were followed for 2～25 months (median,11 months).Two patients were lost to follow-up at 6 and 12 months after operation, respectively. Twelve patients died and 6 patients survived.No severe complications were recorded postoperatively. Conclusions 103Pd brachytherapy for malignant tumors gives a high local control rate and satisfactory reliability.