Distribution and Drug Resistance of Pathogens in Oral Mucositis Associated with Chemotherapy in Patients with Malignant Hematopathy / 中国实验血液学杂志

OBJECTIVE@#To analyze the distribution and drug resistance of pathogens in oral mucositis associated with chemotherapy in hospitalized patients with malignant hematopathy, so as to provide scientific evidences for rational selection of antibiotics and infection prevention and control.@*METHODS@#From July 2020 to June 2022, 167 patients with malignant hematopathy were treated with chemical drugs in the Department of Hematology, Hainan Hospital, and secretions from oral mucosal infected wounds were collected. VITEK2 COMPECT automatic microbial identification system (BioMerieux, France) and bacterial susceptibility card (BioMerieux) were used for bacterial identification and drug susceptibility tests.@*RESULTS@#A total of 352 strains of pathogens were isolated from 167 patients, among which 220 strains of Gram-positive bacteria, 118 strains of Gram-negative bacteria and 14 strains of fungi, accounted for 62.50%, 33.52% and 3.98%, respectively. The Gram-positive bacteria was mainly Staphylococcus and Streptococcus, while Gram-negative bacteria was mainly Klebsiella and Proteus. The resistance of main Gram-positive bacteria to vancomycin, ciprofloxacin and gentamicin was low, and the resistance to penicillin, cefuroxime, ampicillin, cefotaxime, erythromycin and levofloxacin was high. The main Gram-negative bacteria had low resistance to gentamicin, imipenem and penicillin, but high resistance to levofloxacin, cefotaxime, cefuroxime, ampicillin and vancomycin. The clinical data of oral mucositis patients with oral ulcer (severe) and without oral ulcer (mild) were compared, and it was found that there were statistically significant differences in poor oral hygiene, diabetes, sleep duration less than 8 hours per night between two groups (P<0.05).@*CONCLUSION@#Gram-positive bacteria is the main pathogen of oral mucositis in patients with malignant hematopathy after chemotherapy. It is sensitive to glycopeptide antibiotics and aminoglycosides antibiotics. Poor oral hygiene, diabetes and sleep duration less than 8 hours per night are risk factors for oral mucositis with oral ulcer (severe).

Clinical treatment of diabetes mellitus complicated with chronic osteomyelitis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate treatment methods for diabetes complicated with chronic osteomyelitis.</p><p><b>METHODS</b>The clinical data of 39 diabetic patients with chronic osteomyelitis from 2000 to 2011 were studied. Among the patients, 23 patients were male and 16 patients were female,ranging in age from 21 to 81 years old,with a mean of 45 years old. All the patients had symptoms such as red,swelling,hot and pain to different degrees,and the duration of the disease lasted over more than 3 months,among which,25 patients had preoperative sinus formation. Routine preoperative drainage fluid culture, X-ray and CT examination were performed. Twenty-seven patients underwent debridement, one stage bone grafting and external fixation; 12 patients underwent debridement and antibiotic treatment. The examination results of ESR, CRP and blood routine before and after treatment were compared to evaluate clinical effects.</p><p><b>RESULTS</b>After treatment, the values of ESR(preoperative 35 patients with higher value, and postoperative 32 patients with normal value), blood routine (preoperative 25 patients with abnormal value,and postoperative 23 patients with normal value), and CRP(preoperative 36 patients with higher value, and postoperative 33 patients with normal value) all improved. The liquor puris cultures were negative after treatment. Among 39 patients, 33 patients had clinical cure; 6 patients recurred within 4 months to 4 years.</p><p><b>CONCLUSION</b>The treatment of diabetes should be paid attention when the chronic osteomyelitis was treated,and the combination treatment can significantly improve the cure rate of diabetes complicated with chronic osteomyelitis.</p>

Association of genetic variants in the IRAK-4 gene with susceptibility to severe sepsis / 世界急诊医学杂志（英文）

BACKGROUND: The association of genetic variation in the IRAK-1 gene with sepsis outcome has been proved. However, few studies have addressed the impact of the IRAK-4 gene variants on sepsis risk. This study aimed to determine whether the polymorphisms in the IRAK-4 gene are associated with susceptibility to and prognosis of severe sepsis in the Chinese Han ethnic population.METHODS: In this case-control study, 192 patients with severe sepsis hospitalized in the emergency department of Zhongshan Hospital from February 2006 to December 2009 and 192 healthy volunteers were enrolled. Exclusion criteria included metastatic tumors, autoimmune diseases, AIDS or treatment with immunosuppressive drugs. This study was approved by the ethical committee of Zhongshan Hospital, Fudan University. Sepsis patients were divided into a survival group (n=124) and a non-survival group (n=68) according to the 30-day mortality. Primer 3 software was used to design PCR and sequencing primers. Genomic DNA was extracted from peripheral blood mononuclear cells. Seven tagSNPs in IRAK-4 were selected according to the data of the Chinese Han population in Beijing from the Hapmap project and genotyped by direct sequencing. The chi-square test was used to evaluate the differences in genotype and allele frequencies between the two groups.RESULTS: The distributions of all tagSNPs were consistent with Hardy-Weinberg equilibrium. The allele and genotype frequencies of rs4251545 (G/A) were significantly different between the severe sepsis and healthy control groups (P=0.015, P=0.035, respectively). Carriers of the rs4251545A had a higher risk for severe sepsis compared with carriers of the rs4251545G (OR=1.69, 95％ CI: 1.10-2.58). The allele and genotype frequencies of all SNPs were not significantly different between the survival group and non-survival group.CONCLUSION: These findings indicate that the variants in IRAK-4 are significantly associated with susceptibility to severe sepsis in the Chinese Han ethnic population.

Investigation of articular cavity medicating for treatment of knee osteoarthritis / 中国骨伤

Osteoarthritis (OA) is a common chronic progressing disease in the elderly. In current there are many methods of drug treatment for knee osteoarthritis, the intra-articular injection belongs to local application, can direct effect on arthritis, is the most used and most effective methods in osteoarthritis treatment. A single medication may exist that anti-inflammatory effects produce a marked effect but articular cartilage injury is induced, or articular cartilage repairing are promoted but anti-inflammatory effects is not ideal. Therefore,the best method of treatment should be a comprehensive analysis of articular structure, function and possible pathogenic factor to understand the expectations of level of recovery and use in patients to design an individualized treatment plan.

Expression of hypoxia-inducible factor-1α and vascular endothelial growth factor in the synovium of patients with osteoarthritis / 南方医科大学学报

<p><b>OBJECTIVE</b>To detect the expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in patients with osteoarthritis and investigate their roles in the synovial lesions of osteoarthritis.</p><p><b>METHODS</b>The expressions of HIF-1α and VEGF in the synovium were detected by immunohistochemical staining in 30 osteoarthritis cases, 20 acute traumatic arthritis cases and 10 normal synovial biopsy samples. The correlation between HIF-1α and VEGF, and their relationships with osteoarthritis were analyzed.</p><p><b>RESULTS</b>The rates of positive expression of HIF-1α and VEGF in osteoarthritis cases were significantly higher than those in acute traumatic arthritis (86.7% vs 60% and 80% vs 48%, P<0.05). Normal human synovium showed no positive expressions of HIF-1α and VEGF. HIF-1α expression was positively correlated to VEGF expression in acute traumatic synovitis and osteoarthritis cases, with correlation coefficients of 0.666 and 0.678, respectively.</p><p><b>CONCLUSION</b>The expressions of HIF-1α and VEGF in the synovial tissue are significantly higher in osteoarthritis cases than in cases of acute traumatic arthritis. They have close relationship in the synovial lesions of osteoarthritis and both contribute to the development of osteoarthritis.</p>

Pullout test in expansive unilateral open-door laminoplasty of the cervical spine with OsteoMed M3 plate and screws: the screw orientation matters / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the impact of screw orientation on the pullout strength of OsteoMed M3 titanium screws in expansive unilateral open-door laminoplasty of the cervical spine.</p><p><b>METHODS</b>Six fresh human cervical spine specimens were randomly numbered and OsteoMed M3 plate and screws were used for an expansive unilateral open-door laminoplasty. The screws were inserted in the lateral mass at different extraversion angles (0°, 30° and 45°). The maximum pullout strength was tested on the ElectroForce material testing machine.</p><p><b>RESULTS</b>The maximum pullout strength was 81.60∓7.33 N, 150.05∓15.57 N, and 160.08∓17.77 N in extraversion angle 0°, 30°, and 45° groups, respectively. The maximum pullout strength was significantly less in extraversion angle 0° group than in 30° and 45° groups (P<0.05), but similar in the latter two groups.</p><p><b>CONCLUSION</b>The pullout strength of the screws inserted at an extraversion angle over 30° provides stronger fixation than an angle of 0° in the unilateral open-door laminoplasty using OsteoMed M3 titanium plate and screws.</p>

Interface shear stress between the artificial bones and injectable calcium phosphate glue: an experimental study in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of the composite bone material, fibrin glue (FG) combined with beta-tricalcium phosphate (beta-TCP)/monocalcium phosphate, in repairing bone defects and assess the feasibility of using this cement for artificial joint fixation.</p><p><b>METHODS</b>Bone defects were induced in 16 normal adult New Zealand white rabbits at the bilateral femoral lateral condyles where an 8-mm-deep hole (4 mm in diameter) was drilled on each side. The composite FG/calcium phosphate cement (CPC) (solution: power volume ratio of 0.3:1) was injected on one side of the bone defects (experimental group) and pressurized for 10 minutes, and CPC was injected on the other side (control). The rabbits were sacrificed at 2, 4, 8 or 12 weeks after the operation for gross observation and biomechanical tests.</p><p><b>RESULT</b>The composite material FG/CPC was more effective than CPC for bone defect repair, and biomechanical tests revealed significant differences between them (P<0.05). The shear stress of the artificial bone cement in the FG/CPC group was stronger than that in CPC group.</p><p><b>CONCLUSION</b>The FG/CPC composite possesses good biocompatibility and osteoconductivity and may serve as an ideal material for repairing bone defects.</p>

Detection of gene expression pattern in the early stage after spinal cord injury by gene chip / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the changes of the gene expression pattern of spinal cord tissues in the early stage after injury by DNA microarray (gene chip).</p><p><b>METHODS</b>The contusion model of rat spinal cord was established according to Allen's falling strike method and the gene expression patterns of normal and injured spinal cord tissues were studied by gene chip.</p><p><b>RESULTS</b>The expression of 45 genes was significantly changed in the early stage after spinal cord injury, in which 22 genes up-regulated and 23 genes down-regulated.</p><p><b>CONCLUSIONS</b>The expression of some genes changes significantly in the early stage after spinal cord injury, which indicates the complexity of secondary spinal cord injury.</p>