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To investigate the carbapenemases distribution of carbapenem-resistant Klebsiella pneumoniae (CRKP) in the intensive care unit, and the clinical characteristics between carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) and carbapenem-resistant non-hypervirulent Klebsiella pneumoniae (CR-non-hvKP) were compared. A total of 53 non-repetitive CRKP strains isolated from 49 patients in the intensive care unit of the Second Affiliated Hospital of Xi'an Jiaotong University from May 2020 to March 2021 were retrospectively studied. The carbapenemase inhibitor enhancement test was used for screening carbapenemase-producing strains, and the string test was carried out to screen the hypermucoviscosity phenotype. Using PCR to detect five main carbapenemase genes (blaKPC-2, blaNDM, blaIMP , blaVIM and blaOXA-48-like), common serotype (K1 and K2) and virulence gene (rmpA and iutA). Treated the strains with both rmpA and iutA genes as hypervirulent Klebsiella pneumonia (hvKP), and the whole genome sequencing of CR-hvKP was completed. At the same time, the clinical data of 49 patients were sorted out, and the differences in clinical characteristics of CR-hvKP and CR-non-hvKP infected patients were compared using the independent sample t test, Mann-Whitney U test, chi-square test or Fisher's exact probability test. CRKP isolated from the intensive care unit were extensively drug resistance and still had a good sensitivity to polymyxin B and tigecycline. Producing carbapenemases were the main resistance mechanism of CRKP (52/53, 98.1%). Of the 53 CRKP strains, except for 1strain that did not detect carbapenemase, at least one carbapenemase resistance gene was detected in the remaining 52 CRKP strains, of which 45 strains carried an enzyme, including 36 blaKPC-2 (36/53, 67.9%), 8 blaNDM (8/53, 15.1%), 1 blaIMP (1/53, 1.9%), and 7 strains carried with both blaKPC-2 and blaNDM (7/53, 13.2%). String test and virulence gene showed that 7 CR-hvKP strains (13.2%) were detected in 53 CRKP strains, and two of which were hypermucoviscosity phenotype. Sequencing results revealed that CR-hvKP were mainly ST11 type. Almost all patients with CR-hvKP infection were over 60 years old (7/7), with invasive treatment (7/7), pulmonary infection with hypermucoviscosity phenotype (2/7) and high mortality (5/7); and the percentage of neutrophils in patients with CR-hvKP infection (86.44±4.70) % was higher than those patients with CR-non-hvKP infection (78.90±19.15) %, the difference was statistically significant (t=-2.225, P=0.032). The CR-hvKP strains in the intensive care unit mainly produced KPC-2 enzyme, with K2 capsular serotype and ST11 type. It is necessary to strengthen the monitoring and control of the CR-hvKP strain to prevent the co-evolution of drug-resistant and hypervirulent strains.
Subject(s)
Humans , Middle Aged , Anti-Bacterial Agents/therapeutic use , Carbapenems/pharmacology , Intensive Care Units , Klebsiella pneumoniae/genetics , Retrospective StudiesABSTRACT
In order to improve the laboratory identification ability of Lodderomyces elongisporus, we analyzed the main biological characteristics of Lodderomyces elongisporus isolated from peripheral venous blood and catheter blood of a brain stem infarction patient with a body temperature of 38.4 ℃, observed the colony color of the strain on CHROMagar Candida medium and the ascospores on Mcclary agar, identified the isolates with Vitek 2 compact, MALDI-TOF MS and sequence analysis, and tested the MICs with borth microdilution. The MICs of antifungal agents against Lodderomyces elongisporus are well below the normal values of these drugs. The central venous catheter was removed and antifungal drugs were used until two weeks after the last positive blood culture. During the medication perios, the blood culture was repeatedly negative, the patient had no fever and the infection index decreased to normal, which can be used for clinical reference.
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Objective:To explore the application of new teaching techniques and establish a new model for experimental teaching of Medical Statistics for undergraduate students of clinical medicine. Methods:We enrolled 2 classes of students from Xi'an Medical University as research objects, and they were randomized into study group ( n=62) and control group ( n=54). The study group received "traditional demonstration+ blended" learning, while the control group only received traditional teaching. On the premise of balanced comparability, the effects of the two teaching patterns were evaluated from such three aspects as satisfaction questionnaire, teacher's self-evaluation and achievement. SPSS 22.0 was performed for chi-square test, t test and rank sum test. Results:At the end of the semester, the value cognition of statistics in both groups was higher than before class, and the study group [93.5% (58/62)] was higher than that in the control group [68.5% (37/54)] ( χ2=12.20, P<0.001). The overall satisfaction ( Z=-7.05, P<0.001) and the satisfaction with teaching methods ( Z=-3.95, P<0.001) of the study group were significantly higher than those of the control group, with no statistical difference in satisfaction with teaching contents between the two groups ( Z=-0.27, P=0.784). More students in the study group thought that the experimental class deepened their understanding of statistical theory ( χ2=26.87, P<0.001). In the last four experimental classes, the post-test scores of both groups were higher than those of the pre-test, but the pre-test scores and post-test scores of the study group were higher than those of the control group. The performance of software operation in study group was higher than that in control group ( t=8.27 P<0.001). There was no statistical difference in the final test scores between the two groups ( t=0.29, P=0.773). Conclusion:The "traditional demonstration+ blended" learning is more in line with the students' learning pattern, and can better improve students' cognition and satisfaction of the statistics, especially can better cultivate students' team cooperation, expression and the SPSS analysis ability.
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It is a major public health task to promote the construction of modern disease prevention and control system in the prevention and control of the novel coronavirus pneumonia epidemic. In this study, we identified the current situation and challenges in the construction of disease prevention and control system in Shanghai, including the infrastructures, disciplines, human resources, information system, operational mechanism, and legalization. It is proposed that we should promote the construction of modern disease prevention and control system in Shanghai, which is aimed to improve the capacity in the disease prevention and control services, response to the major epidemics and public health emergencies, and scientific research in public health, in accordance with municipal functional orientation large-scale metropolitan public health security requirements in Shanghai. Moreover, we should promote policy-making, including upgrading infrastructures, facilitating discipline construction and scientific research innovation, optimizing development environment for human resources, accelerating comprehensive information construction, improving systems and mechanisms, and strengthening legal governance.
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To explore the mechanism of Hedyotis Diffusae Herba-Smilacis Glabrae Rhizoma(HDH-SGR) in treating lung adenocarcinoma based on big data bioinformatics combined with network pharmacology analysis and molecular docking technology. The chemical components and potential therapeutic targets of HDH-SGR were obtained from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP). Lung adenocarcinoma-related genes were obtained from The Cancer Genome Atlas(TCGA), Therapeutic Target Database(TTD), Pharmacogenetics and Pharmacogenomics Knowledge Base(PharmGKB), Online Mendelian Inheritance in Man(OMIM), DrugBank, and GeneCards. "Drug component-target" network was constructed using Cytoscape to screen out key compounds. STRING was used to build protein-protein interaction(PPI) network and core targets were screened out by Cytoscape-CytoNCA topology analysis. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) analyses of target genes were performed by R-clusterProfiler. Finally, key compounds were docked to core target genes using AutoDock. The results showed that 22 active compounds and 499 potential therapeutic targets were obtained from HDH-SGR. A total of 14 332 lung adenocarcinoma-related targets were screened out through six data platforms, including 182 common targets. Fifteen core targets were screened out from the PPI network. GO and KEGG analyses revealed significant enrichment of relevant target genes in various biological processes, cellular functions(e.g., response to lipopolysaccharide, nuclear receptor activity, and ligand-activated transcription factor activity) and close relationship between target genes and non-small cell lung cancer signaling pathways. Based on the results of molecular docking validation, diosgenin, quercetin, naringenin, taxifolin, 2-methoxy-3-methyl-9,10-anthraquinone, stigmasterol, and β-sitosterol were able to bind tightly to the core targets. HDH-SGR can intervene in lung adenocarcinoma through multiple targets and signaling pathways, such as non-small cell lung cancer signaling pathways. The binding of active components in Chinese medicine to key targets is presumedly one of the mechanisms that produce therapeutic effects.
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Humans , Adenocarcinoma of Lung/genetics , Carcinoma, Non-Small-Cell Lung , Drugs, Chinese Herbal , Hedyotis , Lung Neoplasms/genetics , Medicine, Chinese Traditional , Molecular Docking Simulation , Network PharmacologyABSTRACT
OBJECTIVE@#To detect the ectodysplasin A (EDA) gene mutation in patients with hypohidro-tic ectodermal dysplasia (HED), and to analyze the distribution pattern of missing permanent teeth and the systemic manifestation of HED patients with EDA gene mutation.@*METHODS@#Twelve HED families were enrolled from clinic for genetic history collection, systemic physical examination and oral examination. Peripheral blood or saliva samples were collected from the probands and the family members to extract genomic DNA. PCR amplification and Sanger sequencing were utilized to detect the EDA gene variations, which were compared with the normal sequence (NM_001399.5). The functional impact of EDA gene variants was then evaluated by functional prediction of mutation, conservation analysis and protein structure prediction. The pathogenicity of each EDA gene variation was assessed according to the stan-dards and guidelines of the American College of Medical Genetics and Genomics (ACMG). The systemic phenotype and missing permanent tooth sites of HED patients with EDA gene mutations were summarized, and the missing rate of each tooth position was analyzed and compared.@*RESULTS@#Eight out of twelve HED families were identified to carry EDA gene mutations, including: c.164T>C(p.Leu55Pro); c.457C>T (p.Arg153Cys); c.466C>T(p.Arg156Cys); c. 584G>A(p.Gly195Glu); c.619delG(p.Gly207Profs*73); c.673C>T(p.Pro225Ser); c.676C>T(p.Gln226*) and c.905T>G(p.Phe302Cys). Among them, c.164T>C(p.Leu55Pro); c.619delG(p.Gly207Profs*73); c.673C>T(p.Pro225Ser); c.676C>T(p.Gln226*) and c.905T>G(p.Phe302Cys) were novel mutations. The HED patients with EDA gene mutations in this study were all male. Our results showed that the average number of missing permanent teeth was 13.86±4.49, the average number of missing permanent teeth in the upper jaw was 13.14±5.76, the missing rate was 73.02%. And in the lower jaw, the average number of missing permanent teeth was 14.57±3.05, the missing rate was 80.95%. There was no significant difference in the number of missing teeth between the left and right sides of the permanent dentition (P>0.05). Specifi-cally, the maxillary lateral incisors, the maxillary second premolars and the mandibular lateral incisors were more likely to be missing, while the maxillary central incisors, the maxillary and mandibular first molars had higher possibility of persistence.@*CONCLUSION@#This study detected novel EDA gene pathogenic variants and summarized the distribution pattern of missing permanent teeth of HED patients, thus enriched the variation and phenotype spectrum of EDA gene, and provided new clinical evidence for genetic diagnosis and prenatal consultation.
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Humans , Male , Ectodermal Dysplasia , Ectodermal Dysplasia 1, Anhidrotic/genetics , Ectodysplasins/genetics , Mutation , Pedigree , PhenotypeABSTRACT
Objective:To investigate the effect of Clostridium perfringens combined with live bacteria therapy on intestinal flora, inflammation and immune indicators in children with pneumonia and antibiotic associated diarrhea.Methods:From December 2016 to October 2019, 44 neonates with pneumonia and antibiotic associated diarrhea diagnosed and treated in the Sixth People's Hospital of Datong were selected in the study, and they were divided into control group and observation group according to the random number table method, with 22 cases in each group.On the basis of routine symptomatic treatment, the control group was treated by oral administration of Saccharomyces boulardii, and the observation group was treated with Clostridium perfringens combined with live bacteria powder.The treatment course was two weeks.The intestinal flora, inflammatory factors and immune function of the two groups were compared.Results:There were no statistically significant differences in the levels of IL-2, IL-6 and TNF-α between the two groups before treatment(all P>0.05), and the levels of IL-2, IL-6 and TNF-α in the two groups after treatment were significantly improved(all P<0.05). The levels of IL-2[(34.20±8.55)ng/L vs.(40.13±10.32)ng/L], IL-6[(21.02±5.66)ng/L vs.(31.25±7.82)ng/L] and TNF-α[(30.10±6.20)ng/L vs.(43.55±9.52)ng/L] in the observation group were significantly lower than those in the control group( t=7.501, 6.885, 8.264, all P<0.05). There were no statistically significant differences in the number of Lactobacillus, Bifidobacterium and Eubacterium in the two groups before treatmentt(all P>0.05), and the number of Lactobacillus, Bifidobacterium and Eubacterium in the two groups after treatment increased significantly(all P<0.05). The number of Lactobacillus[(9.50±0.53)×10 8 CFU/mL vs.(8.95±0.44)×10 8 CFU/mL], Bifidobacterium[(10.60±0.53)×10 8 CFU/mL vs.(9.90±0.46)×10 8 CFU/mL] and Eubacterium[(8.93±0.68)×10 8 CFU/mL vs.(8.08±0.40)×10 8 CFU/mL] in the observation group were significantly higher than those in the control group( t=5.065, 6.547, 5.116, all P<0.05). There were no statistically significant differences in the levels of CD 3+ , CD 4+ , CD 8+ and CD 4+ /CD 8+ between the two groups before treatment(all P>0.05), and the levels of CD 3+ , CD 4+ , CD 8+ and CD 4+ /CD 8+ in the two groups after treatment were significantly improved(all P<0.05). The levels of CD 3+ [(62.55±5.06)% vs.(57.12±4.39)%], CD 4+ [(40.52±3.52)% vs.(36.43±2.55)%], CD 4+ /CD 8+ [(1.78±0.22) vs.(1.43±0.13)] in the observation group were significantly higher than those in the control group( t=7.504, 6.958, 5.452, all P<0.05). The level of CD 8+ [(21.22±2.05)% vs.(25.44±2.49)%] in the observation group was significantly lower than that in the control group( t=5.112, P<0.05). Conclusion:Clostridium perfringens combined with live bacteria in the treatment of neonatal pneumonia with antibiotic associated diarrhea can improve intestinal flora, reduce inflammatory response and improve immune function, and the effect is better.
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This paper described main practices and development status of transfusion medicine education at home and abroad. Transfusion medicine education in foreign counties is characterized by early development of discipline construction, complete system of transfusion medicine education, mature model for training transfusion specialists, complete certification system for vocational skills as well as flexible and diverse teaching of transfusion medicine. Our country should learn from the mature experience and practices of foreign countries and speed up the introduction of national policies related to transfusion medicine education; establish a reasonable training model for medical students in blood transfusion major; strengthen the in-service continuing education for blood transfusion practitioners.
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With the acceleration of industrialization, urbanization and population aging, the disease spectrum of the population has changed.Chronic diseases become the leading cause of death for residents.Health problems caused by poor lifestyles and behaviors are increasingly prominent.In order to promote the implementation of the healthy China strategy and effectively deal with the current prominent health problems, the state has formulated and issued the "Healthy China Action(2019-2030)".In accordance with the state′s deployment and strategic requirement, Shanghai has issued the "Healthy Shanghai Action(2019-2030)", which focuses on five aspects:comprehensive intervention in influencing factors of health, strengthening health services for key groups, prevention and control of major diseases, strengthening the construction of health service system, and promoting the improvement of the energy level of healthy Shanghai.By implementing a 10-year action on disease prevention and health promotion of entire people, Shanghai is to be promoted to become a globally influential center for health technology innovation and a model for a global health city.
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With the acceleration of industrialization, urbanization and population aging, the disease spectrum of the population has changed.Chronic diseases become the leading cause of death for residents.Health problems caused by poor lifestyles and behaviors are increasingly prominent.In order to promote the implementation of the healthy China strategy and effectively deal with the current prominent health problems, the state has formulated and issued the "Healthy China Action(2019-2030)".In accordance with the state′s deployment and strategic requirement, Shanghai has issued the "Healthy Shanghai Action(2019-2030)", which focuses on five aspects:comprehensive intervention in influencing factors of health, strengthening health services for key groups, prevention and control of major diseases, strengthening the construction of health service system, and promoting the improvement of the energy level of healthy Shanghai.By implementing a 10-year action on disease prevention and health promotion of entire people, Shanghai is to be promoted to become a globally influential center for health technology innovation and a model for a global health city.
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Objective To explore the causes, diagnosis and treatment of biliary tract hemorrhage after hepatic cancer thermal ablation. Methods The clinical data of 6 patients with biliary tract hemorrhage developed after hepatic cancer thermal ablation in our hospital from May 2013 to May 2018 were retrospectively analyzed. Endoscopic or digital subtraction angiography (DSA) was used to determine the bleeding points. After a definite diagnosis of biliary tract hemorrhage, selective hepatic artery embolization was performed. Hemoglobin, hepatic function and other indicators were detected after surgery to evaluate the treatment effect. Results Preoperative imaging diagnosis showed that 3 patients had mild dilatation of the intrahepatic bile duct. Endoscopy examination showed that there was persistent bleeding in the duodenal papilla with blood clot formation in all 6 patients. DSA examination showed that there were clear bleeding points in 4 patients, and no bleeding points in 2 patients. After embolization, the patients complained of biliary colic disappearance. Within 24 h after embolization, the patients still had hematochezia but the hemoglobin levels were stable. After 24 h operation, the hematochezia gradually disappeared. After selective hepatic artery embolization treatment, 6 patients obtained good hemostatic effects with the effective rate being 100%. All patients were discharged. No biliary bleeding reoccured in the 6-month follow-up. Conclusion Local expansion of intrahepatic bile duct is one of the main risk factors of biliary tract hemorrhage after hepatic cancer ablation. Triad of biliary bleeding is a typical symptom. Endoscopic detection rate is high. DSA examination diagnosis still need to be supported by clinical symptoms. Selective hepatic artery embolization is an effective treatment method. Selective hepatic artery embolization is also satisfactory in diagnostic treatment of patients without bleeding points on DSA examination.
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Objective@#To observe the long-term efficacy and safety of autologous hematopoietic stem cell transplantation (AHSCT) for systemic sclerosis (SSc) patients.@*Methods@#Between May 2007 and June 2009,4 patients with SSc were enrolled in the study. Peripheral blood stem cells were mobilized with cyclopho-sphamide (CTX) followed by granulocyte colony stimulating factor (G-CSF). Conditioning was performed with i.v. cyclophosphamide 50 mg·kg-1·d-1 for 4 days. The results of the modified Rodnan skin score (mRSS), thoracic high-resolution computer tomography and pulmonary function were collected after transplantation.@*Results@#There was an improvement in mRSS, lung function and HRCT in the six months after AHSCT. Within six month to one year after transplantation, one patient had sustained and two patients recurred. After active treatments two patients were improved again. During the follow-up of 8.7 (4.1-9.8) years, three patients were stable and one patient died. Infection and hepatic function injury were the major complications. There was not transplant-related mortality.@*Conclusion@#AHSCT with CTX as a pre-conditioning regimen is safe and effective for SSc. The efficacy for patients with short course, rapid progress and edema is significant. However, long-term efficacy is poor, and long-term maintenance treatment is needed.
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Objective To observe the long-term efficacy and safety of autologous hematopoietic stem cell transplantation (AHSCT) for systemic sclerosis (SSc) patients.Methods Between May 2007 and June 2009,4 patients with SSc were enrolled in the study.Peripheral blood stem cells were mobilized with cyclophosphamide (CTX) followed by granulocyte colony stimulating factor (G-CSF).Conditioning was performed with i.v.cyclophosphamide 50 mg ·kg-1 ·d-1 for 4 days.The results of the modified Rodnan skin score (mRSS),thoracic high-resolution computer tomography and pulmonary function were collected after transplantation.Results There was an improvement in mRSS,lung function and HRCT in the six months after AHSCT.Within six month to one year after transplantation,one patient had sustained and two patients recurred.After active treatments two patients were improved again.During the follow-up of 8.7 (4.1-9.8) years,three patients were stable and one patient died.Infection and hepatic function injury were the major complications.There was not transplant-related mortality.Conclusion AHSCT with CTX as a pre-conditioning regimen is safe and effective for SSc.The efficacy for patients with short course,rapid progress and edema is significant.However,long-term efficacy is poor,and long-term maintenance treatment is needed.
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Objective To investigate a suitable model for the teaching of medical statistics in postgraduates in general medicine. Methods A total of 225 postgraduates who majored in general medicine in the class of 2017 in Xi'an Medical College were enrolled and randomly divided into study group with 130 postgraduates and control group with 95 postgraduates. The postgraduates in the study group received blending learning (with the application of Wenjuanxing and Duifenyi), and those in the control group received traditional teaching. The two groups were compared in terms of teaching efficiency and degree of satisfaction. Results Compared with the control group, the study group had significantly higher score of objective questions (t=11.2, P<0.01), score of SPSS analysis (t=5.44, P<0.01), total score of exams (t=26.3, P<0.01), and degree of satisfaction (Z=-3.853, P<0.01). Conclusion Blending learning may have a better overall effect than traditional teaching and can help students to achieve stronger abilities of data analysis and SPSS operation. This is an important attempt to change the teaching mode of medical statistics in postgraduates and provides a feasible method for the training of general medical talents with innovative and scientific thinking.
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OBJECTIVE@#This study aims to compare the osteogenic differentiation capability of stem cells derived from human inflammatory periodontal ligament tissues (iPDLSCs) with those of stem cells derived from healthy periodontal ligament tissues (hPDLSCs). Both types of tissues were induced by stromal cell derived factor (SDF-1) in vitro.@*METHODS@#iPDLSCs and hPDLSCs were primarily cultured by tissue digestion method and purified by limited dilution cloning. The cells were passaged and identified by stem cell surface marker expression through flow cytometry. Then, we used thiazolyl blue tetrazolium bromide to detect and compare the proliferation capabilities of the iPDLSCs and hPDLSCs. Express of bone volumes were detected by alizarin red staining after SDF-1 was added to the cells. Using alkaline phosphatase, we evaluated the osteogenic differentiation capability of the cells induced by SDF-1. The expression levels of the osteogenesis-related genes of the cells induced by SDF-1 were determined by reverse transcription-polymerase chain reaction.@*RESULTS@#After purification, both iPDLSCs and hPDLSCs expressed stem cell markers. hPDLCSs had a higher proliferation capability than iPDLSCs. Osteogenesis-related genes had higher expression levels in the cells induced by SDF-1 than in those without induction (P<0.05). SDF-1 at 50 and 200 ng·mL⁻¹ concentration greatly affected the differen-tiation capabilities of iPDLSCs and hPDLSCs respectively.@*CONCLUSIONS@#iPDLSCs and hPDLSCs had osteogenic differentia-tion capability. The level of osteogenic differentiation in normal and inflamed periodontal ligament stem cells increases after SDF-1 induction.
Subject(s)
Humans , Cell Differentiation , Cell Proliferation , Cells, Cultured , Osteogenesis , Periodontal Ligament , Stem Cells , Stromal CellsABSTRACT
The clinical data and genetic results of a case of Xinjiang Kazakh adolescent Niemann-Pick disease type C (NPC) with neurological lesions as the first and main clinical manifestations were analyzed, and the literatures at home and abroad were reviewed and summarized. The main clinical manifestations of the patient were unstable walking, frequent falls, slow progression of the disease, difficulty in independent walking, and involuntary movements of the limbs and face, inability to concentrate and dysarthria. Skull MRI revealed abnormal signals in the posterior horn of bilateral lateral ventricles. Abdominal ultrasound splenomegaly was found. Niemann-Pick cells and navy tissue cells were seen in the bone marrow smear. The result of the patient gene sequencing showed that the exon 23 in NPC1 gene had a homozygous mutation c.3493G>A (p.V1165M), which was a missense mutation;the patient′s father and mother performed Sanger generation sequencing verification and were found that they all carried the disease-causing mutation. NPC is a rare autosomal recessive lysosomal storage disease with no specific clinical symptoms. For adolescents with ataxia, dystonia, or psychiatric symptoms, there is a high degree of suspicion of NPC when there is isolated splenomegaly and no liver disease.
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Objective To explore the clinical value and effect of neuronavigation-assisted neuroendoscopy for hypertensive lobar cerebral hemorrhage. Methods Clinical data of 35 cases treated with the neuroendoscopy (neuroendoscopy group) and 32 cases treated with the neuronavigation-assisted microscope (microscope group) were retrospectively analyzed. Data of the operative time, intraoperative blood loss and the clearance rate of hematoma, the postoperative complications (stress gastric ulcer, pulmonary infection, urinary tract infection and intracranial infection), the hospital stay, postoperative ability of daily life (ADL) in 6 months and fatality rates were observed and compared. Results The operative time and intraoperative blood loss were less in the neuroendoscopy group than those in the microscopy group, and the clearance rate of hematoma was higher in neuroendoscopy group than that in the microscopy group (P＜0.01). There was no significant difference in postoperative complications between the two groups (P＞0.05). The hospital stay was less in the neuroendoscopy group than that of the microscope group (P＜0.01). On the basis of ADL grading method, the prognosis of the endoscopy group was better than that of the craniotomy group (P＜0.05). There was no significant difference in the fatality rate between the neuroendoscopy group and the microscopy group (P＞0.05). Conclusion The neuronavigation-assisted neuroendoscopy is a safe and effective surgical method for hypertensive lobar cerebral hemorrhage, and which can improve the prognosis of patients with hypertensive intracerebral hemorrhage.
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Objective To study the effects of exchange transfusion on renal function, inflammatory factors and blood internal environment in children with hyperbilirubinemia. Methods Neonates with hyperbilirubinemia treated in neonatal intensive care unit of the hospital between February 2015 and March 2017 were selected as the research subjects and divided into two groups by random number table method. Combined group received exchange transfusion combined with blue ray irradiation, and control group received blue ray irradiation. The serum levels of bilirubin, renal function indexes, inflammatory response indexes and oxidative stress response indexes were measured 24 hours after the treatment. Results 24 hours after the treatment,serum TBIL,BUN,Cr,β2-MG, CysC, TRF, CRP, IL-6, TNF-α, MDA and AOPP levels of combined group were greatly lower than those of control group whereas SOD, CAT and GSH-Px contents were greatly higher than those of control group. Conclusion Exchange transfusion can improve the renal function and inhibit the inflammatory and oxidative stress response in children with hyperbilirubinemia.
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OBJECTIVE@#To explore the effect of oxidative stress on periprosthetic osteolysis induced by TCP wear particles in mouse calvaria and its mechanism.@*METHODS@#Thirty-six male ICR mice were randomly divided into three groups (=12):sham group, TCP wear particles (TCP) group and N-acetyl-L-cysteine (NAC) group. Aperiprosthetic osteolysis model in mouse was established by implanting 30 mg of TCP wear particles onto the surface of bilateral parietal bones following removal of the periosteum. On the 2nd day post-operation, NAC (1.0 mg/kg) was locally injected to the calvarium under the periosteum every other day for 2 weeks. Then, all the mice were sacrificed to obtain blood and the calvaria. Periprosthetic osteolysis in the mouse calvaria was observed by tartrate resistant acid phosphatase (TRAP) staining; serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), interleukin-6 (IL-6); total anti-oxidation capacity (T-AOC) and superoxide dismutase (SOD) activity were examined by ELISA and chemical colorimetry, respectively; protein levels of glucose-regulated protein 78 (GRP78), protein kinase R-like ER kinase (PERK), phospho-PERK (p-PERK), eukaryotic initiation factor 2α (eIF2α) and phospho-eIF2α (p-eIF2α) in periprosthetic bone tissue were detected by Western blot.@*RESULTS@#Compared with sham group, serum levels of TNF-α, IL-1β and IL-6, and osteolysis area were increased obviously in TCP group (<0.05), and serum level of T-AOC and SOD activity were decreased significantly in TCP group (<0.05), GRP78 expression, the ratio of p-PERK and PERK, p-eIF2α and eIF2α in the mouse calvaria of TCP group were up-regulated markedly. Compared with TCP group, serum levels of TNF-α, IL-1β and IL-6, and osteolysis area were decreased markedly in NAC group (<0.05), serum level of T-AOC and SOD activity were increased obviously in NAC group (<0.05), and GRP78 expression, the ratio of p-PERK/PERK and p-eIF2α/eIF2α were obviously down-regulated.@*CONCLUSIONS@#Inhibition of oxidative stress can prevent periprosthetic osteolysis induced by TCP wear particles, which may be mediated by inactivation of PERK/eIF2α signaling pathway.
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Animals , Male , Mice , Mice, Inbred ICR , Osteolysis , Oxidative Stress , Skull , Tumor Necrosis Factor-alphaABSTRACT
Objective To investigate the current status and features of the use of medical resources for emergency patients with medical insurance in China clarified by analysis of large numbers of data.Methods Using the database from China Medical Insurance Research Association's research group,the total amount and the average cost of emergency medicines for patients with medical insurance,as well as the proportion of emergency medicines in total medical resources used in the emergency department were statistically analyzed.Additional analyses were made based on cities and medical institutions of different levels.Results The data were collected from more than 63 million pieces of medication information,from which 260 thousand pieces of information involved in emergency medicine used within 100 sorts of emergency medicines.The use of emergency medicines for emergency cases accounted for a low proportion of over all medicine used in emergency department in our country,and the specifications of emergency medicine were limited in a few kinds of medicine such as tetanus antitoxin injectio (1500 U),50％ glucose solution in 20 ml water,and 50 g mannitol in 250 ml water frequently used as the leading essential agents.The sum of consumption of emergency medicines in tertiary hospitals was the highest among all levels of medical institutions,and the proportion of which in all medicine used in the emergency department also in the first place of the list.In the third-tier cities,although the sum of consumption of emergency medicines accounted for a small proportion of the whole country,the proportion of which in all kinds of medicine used in the emergency department was highest,while the situation of first-tier cities was just on the contrary.Except for only a few medicines,the ranking of the use of any emergency medicine else varied little in different cities and in various medical institutions.Conclusions On one hand,the current status and characteristics of the use of emergency medicines for emergency patients with medical insurance in China may be related to the characteristics of emergency departments and emergency cases,and on the other hand,they could also be influenced by medicines in clinical needs,clinical compliance,and shortages.This study showed the clinical application of emergency medicines in China in the past three years,which can provide some clinical data for the revision of emergency drug list in the future.