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OBJECTIVE： To provide reference for perioperative prophylactic use of antibiotics in urinary surgery department. METHODS： In response to irrational perioperative prophylactic use of antibiotics in urinary surgery department， taking type Ⅱ incision surgery and special diagnosis and treatment and preventive drug use as an example， the management and control mode for perioperative prophylactic use of antibiotics was established and intervened in urinary surgery department so as to intervene in antibiotics use through formulating surgical type risk classification system， forming perioperative medication clinical pathways such as type Ⅱ incision surgery and urinary calculi surgery with different infection risk， establishing tracking and supervision mechanism. The rationality indexes of perioperative prophylactic medication such as the rate of prophylactic antibiotics use were compared among related medical records collected from urinary surgery department within 3 months before and after intervention （186 records before intervention， 179 records after intervention）. Antibiotics use density （AUD） and amount of antibiotics in urinary surgery department were compared within 3 months before and after intervention to evaluate management and control effect. RESULTS： Among surveyed medical records， compared with before intervention， the rate of prophylactic antibiotics use was decreased from 97.3％ （181/186） to 91.6％ （164/179）； the rate of rational drug selection was increased from 17.7％ （32/181） to 71.3％ （117/164）； correct rate of medication timing was increased from 9.9％ （18/181） to 32.3％ （53/164）； the rate of rational post-operative prevention course was increased from 17.1％ （31/181） to 37.2％ （61/164）， with statistical significance （P＜0.05 or P＜0.01）. Average AUD was deceased from 83 DDD to 70 DDD within 3 months after intervention， and the amount of antibiotics was decreased from 689 669.23 yuan to 531 040.11 yuan. CONCLUSIONS： Established management and control mode for perioperative prophylactic use of antibiotics in type Ⅱ incision surgery and special diagnosis and treatment and preventive drug use can effectively reduce the rate of prophylactic antibiotics， AUD and amount of antibiotics in urinary surgery department， and promote rational use of antibiotics during perioperative period.
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Objective To investigate changes of functional connectivity between the right anterior insula and the frontal operculum in mild cognitive impairment(MCI).Methods Twenty-one MCI patients served as MCI group and twenty age-and gender-matched subjects with normal cognitive function served as a control group in this study.Resting-state fMRI was performed and functional connectivity to right anterior insula and the frontal operculum was obtained with a voxel-wise manner.The difference in functional connectivity between the two groups was obtained with two -sample t-test.Results The mini-mental state examination score was significantly lower in MCI group than in control group(25.8±0.6 vs 29.2±0.3,P＜0.01).In healthy elderly,a distributed set of regions,including bilateral inferior parietal lobule,right middle and posterior cingulated cortex,right middle frontal gyrus,right mediodorsal nucleus of thalamus,right supplementary motor area,left anterior insula and the frontal operculum,left superior temporal gyrus,left inferior frontal gyrus,left precentral gyrus and left olfactory cortex(orbital and vertical gyrus),showed functional connectivity to right anterior insula and the frontal operculum.While bilateral inferior parietal lobule,right inferior frontal gyrus(opercularis,orbitalis,triangularis),right middle frontal gyrus,right middle cingulated cortex,right thalamus,left anterior insula and the frontal operculum and ACC,showed functional connectivity to right anterior insula and the frontal operculum in MCI.Compared to healthy elderly,decreased functional connectivity to right anterior insula and the frontal operculum was identified in left olfactory cortex and left superior parietal lobule,while increased in right medial prefrontal lobe.At the same time,a tendency of decreased functional connectivity to left anterior insula and the frontal operculum was also observed in left olfactory cortex.Conclusion The changes of functional connectivity to right anterior insula and the frontal operculum can be a significant biomarker in the differential diagnosis of MCI.
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Alzheimer disease (AD) is the most common cause of dementia in the aging people.The early diagnosis is very important to slow down the progression and improve the prognosis of AD.At present,most researches focus on the subjective cognitive decline (SCD),which is considered as the preclinical stage of AD.The use of biological markers to predict whether the progress of SCD to AD is necessary.The progresses of imaging studies on SCD were reviewed in this article.
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Objective To examine the nonhuman primate(NHP)model of acute cerebral infarction thrombus-thrombolysis using multi-parameter high-field magnetic resonance imaging(MRI). Methods Altogether, 8 adult male rhesus monkeys aged 8.2(± 1.2)years old and weighing 9.4(± 1.0)kg were randomized into an infarction group(n=4)and thrombolysis group(n =4). Middle cerebral artery occlusion(MCAO)was induced with a clot in the M1 segment. Monkeys in the thrombolysis group were treated with the recombinant tissue plasminogen activator, rt-PA, while those in the infarction group were treated with 0.9% NaCl only. T2 weighted imaging(T2WI), T2-weighted-fluid-attenuated inversion recovery(T2-FLAIR), time-of-flight magnetic resonance angiography(TOF-MRA), and diffusion-weighted imaging(DWI)were used to examine all monkeys at 4 and 24 h after onset of ischemia. Results The rhesus monkey thrombus-thrombolysis model was successfully established. MRA showed that the middle cerebral artery(MCA) was not recanalized in the infarction group, but was recanalized in the thrombolysis group. T2WI sequence showed an increase in infarction volume(12 027 ± 5507 mm3)in the infarction group compared with the thrombolysis group(4910 ± 2764 mm3). DWI sequence showed an increase in infarction volume(9498 ± 5226 mm3)in the infarction group and thrombolysis group(4854 ± 1792 mm3). Both T2WI and DWI sequences showed no significant difference in infarction volume at 4 h between the two groups, while infarction volume in the thrombolysis group at 24 h was significantly lower compared with the infarction group. The increase in infarction volume was significantly lower in the thrombolysis group compared with the infarction group. Conclusions MRI sequences can be used to successfully evaluate recanalization and infarct changes in the thrombus-thrombolysis model in rhesus monkeys.
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Objective To investigate the effect of osthole on the proliferation and apoptosis of breast cancer cell line MCF-7 and its potential mechanisms.Methods Breast cancer cell line MCF-7 was treated by osthole 0,25,50,100,150 and 200 μmol/L respectively.MTT method was used to detect cell survival rate.HE staining was used to observe morphological changes,Annexin V-PI flow cytometry was used to analyze cell apoptosis,and RT-PCR and Western blot method were used to detect the mRNA and protein expression of peroxisome proliferator-activated receptor γ (PPARγ) and farnesoid X receptor (FXR),respectively.Results MTT assay showed that strong cytotoxicity of cell line MCF-7 was induced after administration of osthole for 72 h in a dose-dependent manner.Especially,the maximum inhibitory rate,73.0 ％ appeared in the 200 μmol/L group.HE staining showed that the number of MCF-7 cells decreased,hyperchromatic nuclei and apoptotic bodies appeared after treatment with osthole for 72 h in a significant dose-effect manner.Flow cytometric analysis revealed that osthole could induce extensive apoptosis in MCF-7 cultures after treatment for 72 h compared with normal group (P ＜ 0.05,P ＜ 0.01).In particular,when the concentration of osthole reached 50 μmol/L,the proportion of early apoptotic cells was significantly increased in a dose-dependent manner (P ＜ 0.01),especially.The maximum apoptosis rate (46.2±9.0) ％ appeared in the 200 μmol/L group,which was consistent with the results obtained from MTT assays.Moreover,osthole could significantly increased PPARγand FXR mRNA and protein expressions (P ＜ 0.01).Conclusion These data suggest that osthole could inhibit the proliferation of breast cancer MCF-7 cells and promote its apoptosis,which might be associated with the regulation of PPARγ and FXR-mediated target genes involved in cell growth and metabolism.
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Problem-based learning(PBL)brought many changes in the teaching model of medical education.This article explored the clinical application of PBL combined with picture archiving communicate system(PACS)in medical imaging education.Through comparing the results before and after periodic study,PBL was verified to motivate the students'learning interest.Enthusiasm of autonomic learning and problem analysis ability of students increased evidently,which provided a substantial basis for continued learning.
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Objective To study the MRI findings of HE and the pathological mechanism and to improve the diagnosis and differential diagnosis of HE. Methods Five patients of HE diagnosed by clinical and laboratory examination were examined with conventional MRI scan. Additional DWI, MRA and enhancement MRI scan were performed on 3 patients in which abnormal findings was detected on the conventional MRI. The distribution of lesions and signal characteristics were analyzed. The ADC values of the lesions and of the contralateral non-lesion area were measured. Moreover, the possible pathological mechanisms of HE were discussed on the basis of changes of clinical and imaging manifestations in the two cases with serial clinical and MRI data. Results Of 5 patients, brain abnormalities were found in 3 cases,which showed scattered spotted supratentorial white matter lesions of isointensity on T1 WI and DWI, and high signal intensity on T2WI and fluid-attenuated inversion recovery (FLAIR). Meanwhile, multiple plaque-like lesions involving both white matter and gray matter were found, mainly located at the basal ganglia nuclei, hippocampus and cingulate cortex. The lesions demonstrated iso-or hypo-intensity on T1 WI,and iso-or hyper-intensity on T2 WI, FIAIR and DWI at the initial stage. No enhancement was found in these lesions and MRA disclosed no remarkable findings. The ADC value of the lesions [ (0. 449 ± 0. 092) ×10-3 mm2/s] was decreased significantly compared with the contralateral noninvolved area [ (0. 838 ±0. 062) × 10-3 mm2/s] at the early onset. In 2 cases with glucocorticoid therapy, together with symptom relief, MRI follow-up scan demonstrated the reduction of lesion volume, the signal change to hyperintensity on T1 WI and hypo-intensity on DWL The ADC of the lesions increased significantly. Conclusion The MRI could be one of the effective tools for diagnosis, differential diagnosis, and judging the prognosis and therapeutic results of HE. Meanwhile, it may be a non-invasive method to study the pathological mechanism of HE.