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Objective:To learn about the clustered regularly interspaced short palindromic repeats (CRISPR) genotyping of Yersinia pestis in Yushu Tibetan Autonomous Prefecture (Yushu for short), Qinghai Province, and to explore its genetic characteristics. Methods:In this study, 44 representative strains isolated from local natural plague focus in Yushu from 1963 to 2007 were selected as experimental objects to extract DNA. Primers targeting the three CRISPR loci (YPa, YPb, and YPc) were designed for PCR amplification. The amplified products were sequenced and analyzed to identify the CRISPR spacer, and to determine the CRISPR genotypes and clusters.Results:Twenty-three spacers including 14 of YPa, 6 of YPb and 3 of YPc were observed among 44 strains, of which 2 spacers (a106 and a107) were firstly identified. According to the spacer arrays, the strains were divided into 15 CRISPR genotypes and classified into 6 CRISPR clusters which were Cb4, Cc3', Ca7, Ca7', CaΔ5' and Ca35', respectively. Among them, Ca7 was the most epidemic dominant cluster (34 strains) in Yushu.Conclusion:The CRISPR loci of Yersinia pestis in Yushu have multiple genotypes, high genetic polymorphism, and complex population structure.
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Objective:To analyze the results of plague surveillance in Qinghai Province from 2011 to 2020, master the epidemic situation in recent years, and provide scientific basis for prevention and control of the plague in the future.Methods:The human plague epidemic data (from the human case database of Qinghai Institute for Endemic Disease Prevention and Control) and animal plague epidemic data (from plague monitoring data and plague focus survey data of Qinghai Province) from 2011 to 2020 were collected and analyzed with descriptive epidemiological methods, including human plague epidemic, animal plague epidemic regional distribution, host animal monitoring results, pathogenic monitoring results and serological monitoring results.Results:From 2011 to 2020, there was a human plague epidemic in Qinghai Province, which was infected due to the infection of a middle finger of the right hand that was accidentally scratched when peeling marmots, and Yersinia pestis was isolated from heart, liver, lung, lymph node puncture fluid, tracheal secretion and throat swab samples of the deceased. There were 16 animal plague epidemics and endemic areas were distributed in Haixi Prefecture, Yushu Prefecture and Haibei Prefecture, among which the animal plague epidemic was the most prevalent in Haixi Prefecture, with 13 outbreaks in recent 10 years. According to the monitoring of host animals, the main host animal was the Himalayan marmot, with an average density of 0.07/hm 2. Pathgenic monitoring showed that 31 strains of Yersinia pestis were isolated, of which 27 strains were isolated from Haixi Prefecture. The host animals of Yersinia pestis were mainly Himalayan marmot, accounting for 77.42% (24/31) of the total. Serological monitoring showed that 66 plague F1 antibody positive sera were detected, of which 43 were dog positive sera; the Himalayan marmot took the second place, 20. Conclusion:From 2011 to 2020, the animal plague in Qinghai Province has continued for many years, with some areas showing an active trend, and the overall situation of plague prevention and control is severe.
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Objective:To observe the efficacy of levofloxacin and moxifloxacin in the treatment of experimental plague in guinea pigs.Methods:A total of 70 SPF guinea pigs, female, weighing 250 to 300 g, were selected and randomly divided into 7 groups according to body weight by random number table. There were 10 guinea pigs in each group: levofloxacin 24, 48, 72 h groups, moxifloxacin 24, 48, 72 h groups (drug treatment was carried out after being infected with Yersinia pestis for 24, 48 and 72 h, respectively) and control group (without treatment). Experimentally infected plague model was established through guinea pigs subcutaneous injection of 141 strains of Yersinia pestis [1 × 10 7 colony forming unit (CFU)]; referring to the adult dose in the "National Pharmacopoeia of the People's Republic of China", the daily dose of guinea pigs was converted by Shi Xinyou's animal conversion coefficient method for treatment, the doses of levofloxacin and moxifloxacin in each guinea pig were 12.0 and 9.6 mg/d, respectively for 9 days. The guinea pigs were killed 9 days after drug withdrawal for bacteriological examination and pathological observation, and the cure rate was calculated. Results:The cure rates of levofloxacin 24, 48 and 72 h groups were 100.0% (10/10), 70.0% (7/10) and 6/6, respectively. The cure rates of moxifloxacin 24, 48 and 72 h groups were 100.0% (10/10), 100.0% (10/10) and 5/7, respectively, and the cure rate of animals in the control group was 0 (0/10). Compared with the control group, there were significant differences in the efficacy of moxifloxacin 24, 48 and 72 h groups and levofloxacin 24, 48 and 72 h groups ( P < 0.05). There was no significant difference between the two drugs at the same starting time ( P > 0.05). Conclusion:The effects of levofloxacin and moxifloxacin on animal plague infection are ideal and the two drugs can be used as a substitute for streptomycin in plague treatment under special circumstances.
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Objective:To analyze the pathogenic characteristics of Yersinia pestis in a plague natural foci in Qinghai-Tibet Plateau. Methods:In this study, 1 378 strains of Yersinia pestis isolated from different regions, hosts and vectors in Qinghai-Tibet Plateau from 1954 to 2016 were taken as the research objects. Phenotypic characteristics, plasmid spectrum and genotype of the strains were studied by using conventional techniques and molecular biological techniques. The etiology and geographical distribution of the plague were studied. Results:There were 6 biochemical types of Yersinia pestis in Qinghai-Tibet Plateau, namely Qinghai-Tibet Plateau, Qilian Mountain, Gangdis Mountain, Kunlun Mountain A, Kunlun Mountain B and Chuanqing Plateau. This study found that the Qinghai-Tibet Plateau type strain was not only distributed in north Tibet Plateau, but also distributed in south Tibet, and the distribution of Gangdis Mountain type strain extended to south Tibet. Four virulence factors (capsule antigen, yersinin, virulence antigen and pigmentation factor) were found in 79.97% (1 102/1 378) Yersinia pestis. The results also showed that there were 12 kinds of plasmids carried by Yersinia pestis strains in Qinghai-Tibet Plateau, which constituted 17 kinds of plasmid spectrum. There were 3 kinds of the largest plasmids with taxonomic properties, forming their respective relatively independent distribution areas. The study of different regions (DFR) type showed that 5, 8, 14, 19, 32 and 44 of 1 378 strains were the main genotypes, and the main genome types had obvious geographical distribution. Conclusions:All the tested strains have the characteristics of plague pathogen in Qinghai-Tibet Plateau. The polymorphism of the main hosts, vectors and the ecological landscape of plague geography in the plague foci in Qinghai-Tibet Plateau may lead to the diversity of biochemical characters, plasmid spectrum and geno types of Yersinia pestis.
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Objective:To investigate the effect of decompression of optic nerve canal for traumatic optic neuropathy (TON) via lateral supraorbital approach.Methods:A retrospective case series study was performed to analyze clinical data of 23 TON patients admitted to First People's Hospital of Huzhou from December 2013 to June 2019. There were 16 males and 7 females, aged 17-51 years [(34.3±2.2)years]. Degree of visual impairment included count fingers in 4 patients, hand motion in 4, light perception in 9 and loss of light perception in 6. Visual evoked potential examination (VEP) was performed in 15 patients before surgery. The amplitude of P100 completely disappeared in 5 patients, and the amplitude of P100 was lower than the lower limit of normal value and the latency prolonged in 10 patients. The time from injury to operation was 3 h-14 days [(3.3±0.6)days]. All patients underwent decompression of optic nerve canal via supralateral orbital approach, and dural repair was performed simultaneously in 11 patients with dural rupture. Intraoperative fractures and meningeal tears, duration of operation, blood loss, and hospitalization duration were recorded. Combined with the classical visual acuity improvement assessment method and the World Health Organization (WHO) low vision and blind grading standard, visual acuity was compared before operation, at 10 days and 3 months after operation. Glasgow Coma Scale (GCS) was used to evaluate patients' state of consciousness in the course of the disease. Glasgow Outcome Scale (GOS) was used to evaluate the prognosis. Incidence of complications was observed as well.Results:All patients were followed up for 12-16 weeks [(13.5±2.4)weeks]. Intraoperative microscopic exploration revealed that all patients had optic nerve canal fracture, 3 patients had frontal fracture with dural rupture, and 8 patients had ethmoid bone fragment with anterior skull base dural rupture. The duration of operation was 108.5-224.3 minutes [(151.8±30.2)minutes], including (32.5±8.4)minutes for craniotomy. The intraoperative blood loss was 90.5-165.3 ml [(121.3±15.5)ml]. The hospitalization was 14-26 days [(19.7±3.4)days]. The visual acuity of 13 patients (57%) improved and 5 patients (39%) relieved from blindness 10 days after operation, showing significant difference compared with the preoperation ( P<0.05). The visual acuity of 17 patients (74%) improved and 9 patients (39%) relieved from blindness at 3 months after operation. There was significant difference in visual acuity examined between 10 days and 3 months after operation ( P<0.05). Six patients were invalid, and 4 of them had no light perception before operation and the amplitude of VEP examination completely disappeared. All patients had GCS of 15 when left the hospital and GOS of 5 at 3 months after operation. One patient had cerebrospinal fluid rhinorrhea and healed after 7 days of supine position. No secondary hematoma, epilepsy or intracranial infection occurred during follow-up. Conclusion:Optic canal decompression via the lateral supraorbital approach can improve visual acuity in early stage and increase the rate of out of blindness, with low postoperative complications and satisfactory functional recovery, which is worthy of clinical application.
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Objective To observe the preventive effect of Taohong Siwu decoction on the formation of lower extremity deep vein thrombosis (DVT) in patients with cerebral hemorrhage.Methods Eighty patients with cerebral hemorrhage admitted to the Department of Neurosurgery in Huzhou First People's Hospital from November 2014 to January 2016 were enrolled, and they were divided into an observation group and a control group according to the difference in treatment methods, each group 40 cases. Both groups were given routine treatment and nursing care, the patients of observation group were additionally given Taohong Siwu decoction (composition:Radix Angelicae Sinensis (stir-fried with wine) 10 g,Radix Rehmanniae Preparata 10 g,Radix Paeoniae Alba10 g,Ligusticum Chuanxiong Hort 6 g,Semen Persicae 6 g,Carthami Flos 4 g), once a day for consecutive 2 weeks.Results The D-dimer level in the observation group was significantly lower than that in the control group (mg/L: 1.47±0.91 vs. 1.88±0.79,t = 1.991,P = 0.035); the incidence of DVT in the observation group was obviously lower than that in the control group [5.0% (2/40) vs. 20.0% (8/40), χ2 = 4.114,P = 0.043].Conclusion Taohong Siwu decoction can effectively reduce the incidence of DVT in patients with cerebral hemorrhage.
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Objective To evaluate the effects of different doses of oxycodone on renal ischemiareperfusion (I/R) injury in rats.Methods Forty adult male Sprague-Dawley rats, weighing 220-300 g, aged 10-13 weeks, were randomly divided into 5 groups (n =8 each) using a random number table: sham operation group (group S), group I/R, and low, medium and high doses of oxycodone groups (OL, OM and OH groups).After the rats underwent right nephrectomy, the renal I/R was induced by occlusion of the left renal artery and vein for 45 min with atraumatic microclips followed by 3 h reperfusion in I/R, OL, OM and OH groups.In group S, right nephrectomy was performed, and the left renal artery, vein and ureter were isolated without occluding blood flow.In OL, OM and OH groups, oxycodoue 2, 4, and 6 mg/kg were infused intravenously, respectively, immediately after onset of ischemia.At 3 h of reperfusion, blood samples were taken from the abdominal aorta to determine the concentrations of serum blood urea nitrogen (BUN) and creatiniue (Cr) concentrations.After blood sampling, the animals were sacrificed, and the left kidneys were removed for determination of tumor necrosis factor-alpha (TNF-α) , interleukin-6 (IL-6) and IL-8 and IL-10 contents (by using enzyme-linked immunosorbent assay), and malondialdehyde (MDA) content (by thiobarbituric acid method), and superoxide dismutase (SOD) activity (using xanthine oxidase method).Results Compared with group S, the serum BUN and Cr concentrations, and contents of TNF-α, IL-6, IL-8 and MDA in renal tissues were significantly increased, and the IL-10 content and SOD activity in renal tissues were decreased in the other four groups (P＜0.05).Compared with group I/R, the serum BUN and Cr concentrations, and contents of TNF-α, IL-6, IL-8 and MDA in renal tissues were significantly decreased, and the IL-10 content and SOD activity in renal tissues were increased in OL, OM and OH groups (P＜0.05).The serum BUN and Cr concentrations, and contents of TNF-α,IL-6, IL-8 and MDA in renal tissues were gradually decreased, and the IL-10 content and SOD activity in renal tissues were gradually increased with increasing dosage of oxycodone in OL, OM and OH groups (P＜ 0.05).Conclusion Oxycodone 2, 4, and 6 mg/kg can alleviate renal I/R injury in a dose-dependent manner in rats, and the mechanism is related to inhibition of inflammatory responses and oxidative stress response.
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Objective To summarize the clinical result of patients undergoing endoscopic vein harvest (EVH) technology to collect greater saphenous vein (GSV) in coronary artery bypass graft (CABG) operation, and to assess the operation outcome of EVH. Methods A total of 862 patients underwent primary CABG, among whom saphenous vein of 482 patients were taken using EVH, and the others by open vein harvesting (OVH) based on patients' willingness. The operation risk factors and complication were compared between the two groups. The 64 multi-slice computed tomography (64-MSCTA) was used to evaluate the vein grafts patency after surgery for 1 year. The vein patency between the two groups was compared. Results There was no significant difference in risk factors of incision complication between two groups ( P>0.05). But the incidence of various incision complication was significantly lower in EVH group (10.2%,49/482) compared with that in OVH group (35.0%,133/380) ( P0.05). After 1 year's follow-up, the vein graft patency were 86.0%(404/470) and 87.1%(324/372) in EVH group and OVH group, and there was no significant difference ( P>0.05). Conclusions The decrease in incision complication of EVH is unquestionably superior to those of OVH, especially for those patients with risk factors of incision complication. The EVH vein graft has good patency in short time.
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Objective To summarize the clinical treatment experience of blood culture-negative infective endocarditis,and to explore the surgery chance and therapeutic strategy of blood culture-negative endocarditis. Methods One hundred and sixty-six patients who were diagnosed blood culture-negative endocarditis in the Aisa Heart Hospital of Wuhan from Jul. 2008 to Dec. 2012 were recruited in the study. Broad-spectrum antibiotics including cefuroxime axetil and levofloxacin were used before the result of blood culture,and sensitive antibiotics were selected to control patient's condition when getting the result of blood culture. But broad-spectrum antibiotics were continuously used to the blood culture-negative endocarditis until stable condition. When the conditions were stable,active preparation before surgery should be carried out. Thoroughly clear the vegetation and protect the cardiorespiratory function during operating. Kata-step antibiotics were used to control patient's condition until normal temperature,as well as the number of leukocytes decreased,blood sedimentation normalized and C-reaction protein decreased. Then,the narrow-spectrum antibiotics were selected including cephalosporin until discharged from hospital,and continued treatment of antibiotics for 4 - 6 weeks. Results Five patients died after the operation,including 1 case died of low cardiac output syndrome,2 cases died of multiple organ failure,1 case died of septicemia and the 1 case died of cerebral embolism. All the other patients discharged from hospital successfully. Conclusion The patients with blood culture-negative IE should be controlled rapidly. The duration and dose of antibiotics should be enough. Active operative preparation should be taken and then surgery timely. Thus,the hospital mortality could decrease and prompt the long-term outcome.
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Objective To design a checklist (NICU-PoHC) for postoperative handover in the NICU (Neurosurgery Intensive Care Unit) in case of information omissions or task errors during the handover process,thus to improve patient safety.Methods Team discussion and literature review was conducted to compose the preliminary version of the NICU-PoHC.Then two rounds of panel review were conducted using the Delphi methods to revise the preliminary checklist and to calculate its Content Validity Index (CVI).Results The authority coefficient of experts was 0.86.Twenty experts proposed 7 suggestions for revision.The NICU-PoHC was developed,and its CVI was 0.88.Conclusions Our study developed the NICU-PoHC,which can be used as an assistant tool guiding the postoperative handover,preventing information omissions and task errors,and thus improving patient safety.
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Objective To explore the effect of improved local nerve block anesthesia in correction of nasal septum surgery.Methods One hundred and fifty-one cases of patients with simply received correction of nasal septum surgery were divided into two groups,72 cases with normal local nerve block (normal group),receiving sphenopalatine and anterior ethmoidal nerve block anesthesia; 79 cases with the improved local nerve block (improved group),receiving sphenopalatine,anterior ethmoidal and incisive canal nerve block anesthesia.Two groups of anesthesia success and anesthesia effect were compared.Results The anesthesia success rates of improved group and normal group who were performed correction of nasal septum surgery without removal of the nasal bottom ridge were 100.0％(41/41) and 97.3％ (36/37),there was no significant difference (P＞ 0.05).But for 73 cases who were performed correction of nasal septum surgery with removal of the nasal bottom ridge,the anesthesia success rate in improved group was higher than that in normal group [92.1％(35/38) vs.45.7％(16/35)],there was significant difference (x2 =18.623,P＜ 0.05).Conclusions Based on the distribution characteristics of sensory nerves of the nasal cavity,and combined with endoscopic techniques,the conventional sphenopalatine and anterior ethmoidal nerve block anesthesia is suitable for nasal septum surgery without removal of the nasal bottom ridge and the advanced sphenopalatine,anterior ethmoidal and incisive canal nerve block anesthesia is the first choice for nasal septum surgery with removal of the nasal bottom ridge.
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Objective To evaluate arch replacement in islet fashion combined with intraluminal-including technique.Methods From Aug.2011 to Mar.2012,19 patients with type A aortic dissection needed arch replacement were selected,whose cephalo-brachial artery and left common carotid artery were intact or left subclavicular artery alone was involved,Sixteen patients were male.Mean age was (49.6 ± 5.7) years.Urgent surgery and red surgery were completed in 13 cases,6 cases and 1 case,respectively.The arch replacement was performed in a modified islet fashion,remaining the adventitia and trimming intima,constituting a common opening with the proximate end of stented elephant trunk in side-to-side manner by using intraluminal anastomosis technique.This common opening was anastomosed with the distal end of the ascending aortic Dacron graft,completed the procedure of arch replacement.If left subclavicular artery was involved by dissection or it was displaced pathologically as to expose difficultly,it should be covered by the stented elephant trunk,and be transplanted to left common carotid artery in end-to-side manner.Finally,the entire Dacron graft was wrapped by remained adventitial coat using including technique,with a shunt connecting to right atrium.Results Mean duration of cardiac pulmonary bypass,aortic cross clamp and selective cerebral perfusion was (215 ±54),(93 ± 18) and (30 ±6) minutes,respectively.In one case with delayed sternum closure due to extensive bleeding,the mean chest tube output in first 24 hours was (926 ±322) mL,the mean duration of postoperative ICU was (78 ±21) hours; none of the patients was reopened for bleeding.Postoperative hypoxemia,transient neurologic dysfunction,and hematosepsis occurred in 3 cases,1 case and 1 case,respectively.One patient needed re-intubation attributing to pulmonary infection.There was no complication of permanent neurologic deficit or postoperative visceral mal-perfusion.All patients survived and were discharged from hospital.Severe complication was not observed at follow-up of 1 to 5 months.Conclusions The modified aortic arch replacement procedure,which adopt islet fashion combined with intraluminal inclusion technique,characterized by its feasibility,safety,reproduction and easy to control bleeding,may be considered as an alternative approach for managing arch disease.Its short-term outcomes were competitive and prospective was promising.
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Objective To discuss the effect of selenoprotein P (SeP) on occurring and developing of colorectal cancer and its clinical significance by detecting the expression of SeP in adjacent mucosa of colorectal cancer, and in the cancer, metastatic lymph node and metastasis hepatic tissues.Methods Tissue microarray was constructed, the expression of SeP in adjacent mucosa of colorectal cancer, and in the cancer, metastatic lymph node and metastasis hepatic tissues were detected by means of immunohistochemistry.Results The positive rate of SeP were 48.4%,69.5%,66.7% and 61.5% in adjacent mucosa, tumor cell, lymph node metastasis and hepatic metastasis. The expression of adjacent mucosa was significantly lower than that in other three sites(?2=16.53,P
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<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of interventional therapy in the treatment of hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Thirty-three patients with HCC were synthetically treated by systematic measures. Among them, percutaneous port-catheter system (PCS) implantation via the femoral artery was performed in 21 cases. Patients with haemorrhage were treated with prothrombin complex concentrate and fibroraas, and patients with hepatic encephalopathy by branched-chain amino acids and arginine.</p><p><b>RESULTS</b>All indwelling catheters of PCS were patent and no catheter tip dislocations were observed. Of 33 patients with advanced HCC, the mean survival rate was 20.1 months and 12 (36%) patients survived more than 2 years.</p><p><b>CONCLUSION</b>Patients with advanced HCC were treated by synthetic measures. Survival was prolonged, quality of life was improved significantly, and the effectiveness of interventional therapy was further improved.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Hepatocellular , Mortality , Therapeutics , Catheters, Indwelling , Liver Neoplasms , Mortality , Therapeutics , Survival RateABSTRACT
The myocardial cell respiration and the activity of pyruvic acid dehydrogenase system and glutathione peroxidase (GSH-px) in blood weredetermined in rats fed by deficient selenium (Se) diet, supplement Se dietand Xian diet. The absorbed oxygen value of myocardial cell respirationwas 52. 5 ? 3. 78, 69. 75 ? 5. 34, 77. 63 ? 4. 38 O ?l/40min/100mg myocardium(mean ? SE ) in deficient Se group, supplement group, and xian group, re-spectively. The difference between deficient Se group and supplement Segroup or Xian group was significant (P