A multicenter survey of antibiotic use in very and extremely low birth weight infants in Hunan Province / 中国当代儿科杂志

OBJECTIVE@#To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province.@*METHODS@#The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017.@*RESULTS@#The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01).@*CONCLUSIONS@#Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.

Strategy of the Causes of Death of Dependents / 法医学杂志

Objective To discuss the methods and strategies to identify the causes of dependents' deaths, as well as provide the experiences that can be used for reference and scientific basis for the forensic identification of the potentially growing deaths of the same kind in the future. Methods The 13 cases concerning death of dependents accepted by Sun Yat-sen University Forensic Center were collected, and the basic information of the dependents were statistically described. The nutritional status, environmental condition and medical care condition were evaluated according to dietary energy, living space, environment and medical treatment condition. Results Among the 13 dependents, there were 11 males and 2 females, with the oldest 74 and the youngest 9 and dwelling time was from 0.4 to 5.6 years. Forensic pathological examination showed that 13 dependents had infectious diseases and 11 were severely dystrophic. There were no fatal mechanical injuries or poisoning in dependents. Molecular pathological screening of 4 cases revealed no pathogenic variants of sudden death susceptible genes. The poor status of the diet, nutrition, living environment and medical care of these dependents were discovered. The direct cause of death of all 13 dependents was identified to be disease. The lack of nutrition, poor living environment and lack of medical care were thought to play a dominant role in causing the deaths of 12 dependants. Conclusion The death identification should follow the judicial procedure. In identification of the causes of death and analysis of the proportion of the affecting factors resulting in death, all factors, including nutrition,environment, medical care, injury and diseases, need to be considered.

Clinical observation of selective posterior rhizotomy for improving spasticity and gross movement in patients with cerebral palsy / 中国骨伤

OBJECTIVE@#To explore the effect of selective lumbosacral posterior rhizotomy(SPR) on lower limb spasticity and gross motor function in patients with cerebral palsy.@*METHODS@#From January 2018 to October 2018, 47 patients with cerebral palsy were treated with rehabilitation alone and SPR combined with rehabilitation. According to whether SPR was performed, the patients were divided into group A and group B. Group A was treated with rehabilitation combined with SPR at lumbosacral level, and group B was treated with rehabilitation alone. There were 23 cases in group A, including 15 males and 8 females, with an average age of (7.30±3.25) years old; 24 cases in group B, 13 males and 11 females, with an average age of (7.00±3.09) years old. Forty-seven patients were assessed with modified Ashworth(MAS) and Gross Motor Function Scale(GMFM-88 items) before and after treatment. The changes of MAS and GMFM-88 scores before and after treatment were compared to evaluate the degree of spasm and the improvement of gross motor function in the two groups.@*RESULTS@#All 47 patients were followed up. At 6 months after treatment, the MAS classification of the two groups was significantly improved(<0.05), and the improvement of group A was more obvious than that of group B(<0.05). Six months after treatment, the D, E and total scores of GMFM-88 between two groups were significantly improved compared with those before operation(<0.05). The improvement of D and total scores in group A was more obvious than that in group B. There was no significant difference in the improvement of area E between two groups.@*CONCLUSIONS@#Selective posterior rhizotomy combined with rehabilitation can significantly improve the spastic state and gross motor function of lower limbs in children with cerebral palsy, and can effectively promote the reconstruction and recovery of motor function of lower limbs in children with cerebral palsy.

Analysis of curative effect of traditional Chinese bone setting manipulation for the treatment of femoral neck fracture / 中国骨伤

<p><b>OBJECTIVE</b>To analysis the outcome of modified closure bone setting manipulation for the treatment of femoral neck fracture.</p><p><b>METHODS</b>From January 2012 to December 2012, 47 cases of femoral neck fracture were treated and included 25 males and 22 females with an average age of (44.58±10.32) years old ranging from 23 to 61 years old. All patients had a history of trauma, hip pain and movement limited, limb shortening extorsion deformity, X-ray showed fracture between femoral head and femoral neck basic. Among them, 32 cases were Garden type III and 15 cases were type IV. Patients were performed surgical treatment at 2 to 5 days after admission with 45 degrees abduction and extension position, internal rotation reduction, and 3 guide pins were inverted in a equilateral triangular structure of upside down arrangement. The postoperative recovery quality, fracture healing, femoral head necrosis and hip function were observed.</p><p><b>RESULTS</b>Operation time was 40 to 70 min, intraoperative bleeding was 20 to 50 ml. All patients received good reposition, and the intraoperative perspective was 12 to 25 times. Forty-five patients were followed up for 24 to 36 months, and 2 cases were lost. Fracture of 45 cases were got bony healing, 3 cases with partial necrosis of femoral head, both in the ARCO stage II. Twenty-four months after operation, Harris hip function score was 43.24±2.74 in pain, 42.82±1.95 in function, 3.72±0.45 in deformity, 2.77±0.52 in activity, 92.56±4.42 in total;the outcome was excellent in 39 cases, good in 4 cases, fair in 2 cases, without unbroken nails, infection, deep venous thrombosis, fracture and other complications.</p><p><b>CONCLUSIONS</b>Treatment of femoral neck fracture with the modified bone setting manipulation has an advantages of good effect, postoperative hip function recovery, curative effect.</p>

Effect of fracture of lower limbs with hemorrhage on myocardial injury and its mechanism in rats / 中国应用生理学杂志

OBJECTIVES@#To test whether myocardial apoptosis can be induced by traumatic fracture of lower limbs with hemorrhage, in order to lay a foundation of myocardial injury after traumatic fracture for the follow-up study.@*METHODS@#Twenty SD rats were randomly divided into two groups, i. e. control group and trauma group(=10). A rat model of traumatic hemorrhage was establish, and a traumatic model of the original generation of myocardial cell culture was constructed . The level of interleukin-2(IL-2),IL-6,IL-10 and tumor necrosis factor-α(TNF-α) in rat serum was detected by ELISA at 0, 1, 2, 4, 8, 12, 16, 24 and 48 hour to find the most significant point. The pathological cardiac injury in rats was observed by HE staining under a microscope, and the apoptosis of cultured cardiomyocyte was detected by TUNEL methods. The expressions of apoptosis gene,(Bcl-2) and Bax, in myocardium of rat and cultured cardiomyocyte were detected by Western blot and RT-PCR.@*RESULTS@#At the 4 hour after trauma, IL-6 and IL-10 in the serum of rats reached its highest, IL-2 reached its lowest at the 8th hour after trauma, and TNF-αreached its highest at 1 hour after trauma, then all recovered to their normol level gradually. Myocardial HE staining indicated that cardiomyocyte was swelling, disordered derangement, inflammatory cell infiltrated; a large number of myocardial cell nuclei was dyedbrown in TUNEL test which proved that the apoptosis index increased (<0.05). Western blot and RT-PCR results showed that the expression of pro-apoptotic gene Bax was up-regulated (<0. 05), while expression of anti apoptosis gene Bcl-2 down-regulated (<0.05).@*CONCLUSIONS@#The myocardial apoptosis can be induced by traumatic fracture of lower limbs with hemorrhage in rats, and then lead to myocardial injury.

Two different methods for acute angle-closure glaucoma with cataract / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To investigate the clinical efficacy of phacoemulsification (Phaco) and intraocular lens (IOL) implantation combined with goniosychialysis in the treatment of acute primary angle-closure glaucoma (APACG) with cataract.· METHODS:In this prospective randomized clinical trial,60 eyes of 60 patients with APACG and coexisting cataract were randomized to the control group (30 patients,30 eyes) or the study group (30 patients,30 eyes) and completed the trial.All the two groups were treated with phacoemulsification and intraocular lens implantation,and the control group (30 patients,30 eyes) was combined with trabeculectomy,while the study group (30 patients,30 eyes) was treated with the goniosychialysis.All patients were followed up for 2mo.The preoperative and postoperative best corrected visual acuity (BCVA),intraocular pressure (IOP),anterior chamber depth (ACD),anterior chamber angle(ACA) and complications were compared.· RESULTS:There were no statistically significant differences between the 2 groups in BCVA,IOP,ACD,ACA before surgery(P＞ 0.05).The postoperative BCVA,lOP,ACD and re-opening anterior chamber angle (ACA) in two groups were all improved,and the differences had statistical significance (P ＜ 0.001).BCVA,ACD,re-opening ACA of research group were significantly better than those of the control group (P＜0.05).The decreased IOP of the study group were more than the control group and the complications of the control group were more than the study group,but there was no statistical difference in the postoperative IOP and complications between two groups (P＞0.05).· CONCLUSION:The phacoemulsification and IOL implantation combined with goniosychialysis can improve the vision of patients,decrease IOP,increase ACD,and re-opening anterior chamber angle (ACA) in patients with APACG combined with cataract.It has a positive clinical effect.

Drug-target network of taxanes revealed by data mining

Taxanes, mainly group paclitaxel and docetaxel, are amongst the most promising anticancer agents that are widely used for a variety of tumor types. It is a great challenge to gain a quick overview of the molecular mechanisms of taxanes, owning to the massive amounts of data have been produced. Network pharmacology will be a powerful tool to uncover the drug-targets network of taxanes. In this study, drug-targets network of paclitaxel and docetaxel were constructed via STITCH by database mining, and its topological parameters and important nodes were analyzed. All will provide a systematic understanding for molecular mechanisms of pacltaxel and docetaxel in a quick and visual way

Efficacy of heated humidified high-flow nasal cannula in preterm infants aged less than 32 weeks after ventilator weaning / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of heated humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (nCPAP) in preterm infants aged 26-31(+6) weeks with respiratory distress syndrome after ventilator weaning.</p><p><b>METHODS</b>A total of 161 preterm infants were randomly divided into two groups after ventilator weaning: HHHFNC treatment (n=79) and nCPAP treatment (n=82). The two groups were subdivided into 26-28(+6) weeks and 29-31+6 weeks groups according to the gestational age. The treatment failure rate, reintubation rate within 7 days after extubation, incidence of complications, and mortality during hospitalization were compared between the two groups.</p><p><b>RESULTS</b>The treatment failure rate and reintubation rate showed no significant differences between the HHHFNC and nCPAP groups. The preterm infants aged 26-28(+6) weeks in the HHHFNC group had a significantly higher treatment failure rate than those in the nCPAP group (P<0.05), while the reintubation rate showed no significant difference. As for the preterm infants aged 29-31(+6) weeks, the treatment failure rate and reintubation rate showed no significant differences between the two groups. The incidence of complications and mortality showed no significant differences between the HHHFNC and nCPAP groups.</p><p><b>CONCLUSIONS</b>In preterm infants aged 29-31(+6) weeks, HHHFNC has a similar efficacy as nCPAP after ventilator weaning, while in those aged less than 29 weeks, HHHFNC should be used with great caution if selected as the first-line noninvasive respiratory support.</p>

The effects of heroin on intracellular free Ca2+ of rat myocardium / 法医学杂志

OBJECTIVE@#To observe the effects of heroin on intracellular free Ca2+ in rat myocardium.@*METHODS@#The effects of heroin on intracellular free Ca2+ were observed in cultured neonatal rat myocardium by measuring intracellular free Ca2+ concentration using calcium fluorescent probe Flou-3/AM and laser scanning confocal microscope.@*RESULTS@#Different doses and concentrations of heroin appeared to have different effects on intracellular free Ca2+ concentrations, with a dosage dependent short linear increase in the fluorescence intensity (i.e., Ca2+ concentration) leading to [Ca2+]i peak.@*CONCLUSION@#Heroin could affect concentrations of [Ca2+]i in myocardium and its dosage related effect needs further investigation.

Effects of serum from crush injury rats on vascular endothelial cell apoptosis and their potential mechanism / 法医学杂志

OBJECTIVE@#To investigate the effects of serum from crush injury rats on vascular endothelial cell apoptosis and their potential mechanism.@*METHODS@#Bovine aorta endothelial cells were cultured in vitro and the effects of serum from crush injury rats on cell apoptosis and intracellular calcium concentration ([Ca2+]i) were observed. Meanwhile, the levels of rat blood plasma endothelin-1 (ET-1) and atrial natriuretic peptide(ANP) were measured.@*RESULTS@#Compared with normal rat serum treatment, the cell apoptosis rate decreased from (8.26+/-1.75)% to (2.75+/-0.90)%, while the concentration of [Ca2+]i increased from (96.98+/-3.95) to (118.79+/-3.22) nmol/L in serum from crush injury rats, respectively. The concentration of ET-1 and ANP increased significantly in crush injury rat serum.@*CONCLUSION@#Serum from crush injury rats could inhibit apoptosis of the vascular endothelial cells. These effects may be related to increased level of [Ca2+]i mediated by ET-1 and ANP.

A study on miRNA alternation after H2O2-induced PC12 cell apoptosis using microarray technique / 法医学杂志

OBJECTIVE@#To screen the differentially expressed microRNAs(miRNA) between H2O2-induced PC12 cell apoptosis and normal PC12 cells with microarray chips.@*METHODS@#PC12 cells were treated with different concentrations of H2O2 for 12 hours, and then the cell viabilities were evaluated by MTT assay and cell apoptosis rates were assessed by flow cytometry (FCM). miRNAs were isolated from control (0 nmol/L H2O2) and H2O2 treated (at concentrations of 50, 100, 200, and 400 nmol/L H2O2, respectively) groups of the PC12 cells, respectively, and were then detected and analyzed by microarray chips.@*RESULTS@#The P12 cell viabilities in control and H2O2 treated group were (92 +/- 9.8)%, (90 +/- 14.70)%, (80 +/- 13.85)%, (54 +/- 12.23)%, and (22 +/- 7.35)%, respectively. The apoptosis rates for them were 2.6%, 5.2%, 7.2%, 10.4%, 16.6%, and 72.2% accordingly. Expression of 68 miRNAs and 46 miRNAs were detected in both control group and the H2O2 treated groups. Of the 46 miRNAs in the H2O2 treated groups, 39 were similar to that of the control group and 6 were significantly down-regulated.@*CONCLUSION@#Our preliminary data may provide a new potential foundation for further study of pathogenesis and its treatment of nerve cell apoptosis caused by cerebral ischemia reperfusion.

Apoptosis of cultured cortical neurons of rat's brain induced by heroin / 法医学杂志

OBJECTIVE@#To investigate whether heroin can directly induce apoptosis in primary cultured cortical neurons of rat's brain.@*METHODS@#Cultured primary neurons cultures were obtained from cerebral cortex of embryo rats. After 7 days, the cells were incubated with different concentrations of heroin (purity-80%) for 24 hours. The neuronal survival was assessed by cell viability counting with fluorescent diacetate (FDA) staining. The morphological and biochemical changes were observed with Hoechst 33258 fluorescent staining and then analyzed by agarose gel electrophoresis, respectively.@*RESULTS@#After treatment with different concentrations of heroin, the neurons showed a decreased survival rate in a dose dependent manner, and there was a significant difference in the survival rate between the heroin group and the control group (P < 0.05). When exposed to different concentrations of heroin, neurons exhibited the morphological and biochemical features of apoptosis, including cell shrinkage, neurite degeneration, network disappearance, condensation and aggregation of nuclear chromatin, and the formation of DNA ladders. With the increase of heroin concentration of rat's brain more apoptotic bodies were seen.@*CONCLUSION@#Heroin can directly induce apoptosis in primary cultured cortical neurons in rat's brain.

Hydroxyapatite modified titanium promotes superior adhension and proliferation of corneal fibroblast in comparison with pure titanium / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To determine whether hydroxyapatite modified titanium promotes superior adhension and proliferation of rabbit corneal fibroblast in comparison with pure titanium.METHODS: We used bioactive hydroxyapatite to modify titanium surfaces. Fourth passage fibroblasts of rabbit cornea were seeded on hydroxyapatite modified titanium surfaces, pure titanium and glass surfaces. Cell adhension, proliferation and morphology were detected at 24 hours, 48 hours, and 72hours using a acridine orange stain. Further studies of cell morphology were performed using scanning electron microscopy.RESULT: Ceil counts were significantly greater on hydroxyapatite modified titanium surfaces at each time point(P＜0.05).At 24 hours, cell spreading was greater on hydroxyapatite-coated titanium and glass than on the pure titanium. At 72 hours, compared with pure titanium and glass surfaces, the cells on hydroxyapatite modified titanium surfaces had greater spreading area and longer stress fibers.CONCLUSIONS: Hydroxyapatite modified titanium promotes superior adhension and proliferation of rabbit corneal fibroblast in comparison with pure titanium.

Vitrectomy for the treatment of posttraumatic endophthalmitis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the efficacy of vitrectomy in combination with intravitreal dexamethasone and vancomycin Derfusion in the management of severe post-traumatic endophthalmitis.METHODS:30 eyes diagnosed as posttraumatic infectiouis endophthalmitis were analyzed retrospectivly from April 2004 to April 2006.All the patients underwent vitrecLomy in combination with intravitreal drugs perfusion and were followed up for 12 to 24 weeks.The visual acuity,traumatic causes and microorganisms culture were analyzed.RESULTS:There are significant reduction in inflammation at 3 months after surgery.Infectious symptoms were completely controlled in 97% of the Cases(29/30).Final visual acuity were improved in 93% of cases (28/30).Among traumatic causes,foreign body is the most common cause (57%).StaphylococCUS aureus is the commonest microorganism.CONCLUSION:Vitrectomy in combination with intravitreal dexamethasone and vancomydn peffusion iS the most effective method in the treatment of Severe posttraumatic endophthamitis.

The role of diaphgram fatigue in the death from hanging with bound upper limbs of rabbits / 法医学杂志

OBJECTIVE@#To explore the role of diaphgram fatigue in the death from hanging with bound upper limbs of rabbits.@*METHODS@#Rabbits were hanged with upper limbs bound, then the data of EMGdi were gathered@*RESULTS@#By analyzing power spectral of EMGdi in experiment, we compare the ratio change of H/L between pre-experiment and post-experiment. There is a significance decrease of the ratio of H/L, so it indicates that diaphgram fatigue does exist.@*CONCLUSION@#Diaphgram fatigue plays an important role in the death from hanging with limbs of rabbits bound.

Cellular mechanism of heart injury in the early stage of crush injury in rats / 法医学杂志

OBJECTIVE@#To study cellular mechanism of cardiomyocytes injury in the early stage of crush injury by observing some effects of crush injury rat sera on cultured neonatal rat cardiomyocytes.@*METHODS@#One to three days old neonatal rat cardiomyocytes were cultured in vitro and some effects of crush injury rat sera on beating rate, cell surface area, total protein content, 3H-Leu incorporation, intracellular calcium concentration ([Ca2+]i) and Fos protein expression were observed in cultured rat cardiomyocytes.@*RESULTS@#Compared with normal rat serum group, crush injury rat sera decreased beating rate(beats/min) of cardiomyocytes from 88.3 to 26.4, cell surface area, total protein content, 3H-Leu incorporation, [Ca2+]i (nmol/L) and PI of Fos protein expression were increased.@*CONCLUSION@#Crush injury rat sera suppress cell beating, increase intracellular calcium, induce Fos protein synthesis and cause cell hypertrophy, which may cause cardiac injury in the early stage of rush injury.

The coordinated effect of the excessive protein and cholesterin intake on inducing rat myocardial fibrosis and its mechanism / 中国应用生理学杂志

<p><b>AIM</b>To investigate the coordinated role and its mechanism of the high protein and hypercholesterol intake on inducing rat myocardial fibrosis.</p><p><b>METHODS</b>The tissue level of the collagen in left ventricule, the concentrations of the plasma and the cardiac tissue angiotensin II (Ang II) and Aldosterone (Ald), the serum concentration of nitrite (NO2-), in the Wistar rats on diet which adding 20% protein or/and 100 mg/d cholesterin in the rat standard foods for 8 weeks, were measured by the colorimetric analysis of the hydroxyproline, by the radioimmunoassay, and by the assay of Griess, respectively.</p><p><b>RESULTS</b>1.69 times left ventricular collagen contents, 0.7 times plasma concentrations of total cholesterin, 1.5 times levels of the plasma Ang II and 1 time myocardial ald contents were higher, and the serum NO2- concentration was significant lower, in the rats of the high protein and hypercholesterol intake than in the rats of the high protein intake. That 0.48 times left ventricular collagen contents, 0.23 times plasma Ang II in the high protein and hypercholesterol intake rats were higher than in the high cholesterin intake rats.</p><p><b>CONCLUSION</b>The excessive protein and cholesterin intake can induce the coordinated effect on developing the myocardial fibrosis of rats. And the mechanism of the fibrosis in rat left ventricule maybe result with the activation of RAAS and the endothelial injury.</p>

The damage of cardiovascular system in heroin abuses / 法医学杂志

The heroin abuses can seriously damage human body system, among them the damage of cardiovascular system is various. In this paper those damages involved heart rate, blood pressure, electrocardiogram, heart function, blood circulation, the changes of some material inside, and complications of cardiovascular system are reviewed.

Study on the changes of electrocardiogram and ultrastructural in heroin dependence in rats / 法医学杂志

OBJECTIVE@#To study the changes of electrocardiograms (ECG) and myocardial ultrastructure in heroin dependence in rats, in order to reveal the mechanisms of the myocardial injury by heroin.@*METHODS@#Establish heroin addict model in SD mice, investigate the changes in electrocardiograms, HE staining and myocardial ultrastructure.@*RESULTS@#The electrocardiograms of the addict group had prominently changes, main expressions: heart rate decreased, P wave and T wave amplitude reduced and duration increased, S-T reduced and duration increased, QT interval prolongation, these changes indicated that myocardium had been injured, myocardial ischemia, ventricle function declined. These difference was significant (P<0.05) between before inject heroin and after inject heroin. Transformations in the ultrastructure: nuclear concentrate, reduce, nuclear membrane shrink, chromatin agglutinate, mitochondria cristal had disorder formation, disappeared or hollowed, these indicated that heroin could cause pathological changes in myocardial ultrastructure.@*CONCLUSION@#Above-mentioned changes indicated that heroin can injure myocardium, and the changes of myocardial ultrastructure suggested that myocardial apoptosis may be one of the mechanisms of the myocardial injury by heroin.

Expression of the glycoprotein in atrioventricular cell membrane of acute myocardial infarction in human / 法医学杂志

OBJECTIVE@#To study the expression of the glycoprotein in atrioventricular cell membrane of the acute myocardial infarction.@*METHODS@#The glycoprotein changes occurred at the atrioventricular cell membrane of the acute myocardial infarction of 8 cases were observed by using immunohistochemical methods.@*RESULTS@#Positive staining of PNA could be observed in atrioventricular cell membrane.@*CONCLUSION@#This experiment proved that atrioventricular cell membrane expressed D-galactose as same as myocardial cell membrane in the acute myocardial infarction.