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ObjectiveTo observe the architectural parameter changes of the muscles around the knee in middle-aged and elderly women with early knee osteoarthritis (KOA) by musculoskeletal ultrasound, and to clarify the indicators of muscles that affect early KOA. MethodsFrom January to August, 2022, 20 healthy middle-aged and elderly healthy women (controls) and 20 middle-aged and elderly women with unilateral early KOA (KOA group) were recruited through Beijing Bo'ai Hospital, to measure muscle thickness of the popliteus muscle, the muscle thickness and the pennation angle of the quadriceps, as rectus femoris, vastus intermedius, vastus lateralis, vastus medialis longus and vastus medialis oblique. ResultsCompared with the healthy limb of KOA group, and the controls, the muscle thickness of vastus medialis longus, vastus medialis oblique and popliteus muscle of the affected limb of KOA group became thinner (t > 2.133, P < 0.05); the proportion of thickness of vastus medialis oblique to thickness of vastus lateralis became smaller (t > 3.660, P < 0.05). The pennation angle was smaller in the affected limb of KOA group than in the matched dominant side of the controls (t = 3.101, P < 0.05). Logistic regression analysis showed that the muscle thickness of vastus medialis oblique (OR = 0.235, 95%CI 0.068 to 0.805, P = 0.021) and popliteus muscle (OR = 0.387, 95%CI 0.152 to 0.980, P = 0.045) were related to the onset of early KOA. ConclusionThe thickness of vastus medialis longus, vastus medialis oblique and popliteus muscle decrease, and the balance of the strength of vastus medialis oblique and vastus lateralis weakens in the affected limbs of the middle-aged and elderly women with early KOA. The thickness of vastus medialis oblique and popliteus muscle are protective factors for onset of KOA.
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Objective To study the risk factors of intestinal bacteria colonization and antibiotic resistance among newborns in neonatal intensive care unit (NICU).Method From May 2014 to May 2015,newborns admitted to NICU in our hospital were enrolled and their feces were prospectively collected and cultured from day 5 to day 7 after birth.VITEK-2 system was used to identify the bacteria and determine their antibiotic susceptibility.Newborns were assigned into 8 groups according to their gestational age,mode of delivery and use of antibiotics,and the colonization rates of Escherichia coli (E.coli),Enterococcus and Klebsiella pneumoniae were compared.Result A total of 572 feces of newborns were collected,328 strains of E.coli,243 strains of Enterococcus and 70 strains of Klebsiella pneumoniae were isolated.The multi-drug resistance rates of E.coli and Enterococcus were 68.3％ (136/199) and 76.1％ (185/243),respectively.The colonization rates of E.coli,Enterococcus and Klebsiella pneumoniae of the full-term delivery without antibiotics group (77 cases),full-term Cesarean section (C-section) without antibiotics group (30 cases),premature C-section without antibiotics group (28 cases),premature delivery without antibiotics group (16 cases),premature delivery with antibiotics group (53 cases),full-term delivery with antibiotics group (155 cases),full-term C-section with antibiotics group (99 cases),premature C-section with antibiotics group (114 cases) were different.The antibiotics groups showed significantly less E.coli colonization rates and higher Enterococcus colonization rates than the non-antibiotics groups of the same gestational age and delivery mode (P ＜ 0.05).The result between the full-term C-section newborns and naturally delivered newborns without antibiotics indicated the similar trend (P ＜ 0.05).The colonization rates of Klebsiella pneumoniae showed no significant differences among the groups (P ＞ 0.05).Conclusion The multi-drug resistance of E.coli and Enterococcus in neonatal intestinal colonization is common and worrisome.Bacterial colonization is affected by antibiotics and the mode of delivery and prudent use of antibiotics is advised.
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BACKGROUND@#An increasing number of publications are drawing attention to the associations between six common polymorphisms in HOX transcript anti-sense RNA (HOTAIR) and the risk of cancers, while these results have been controversial and inconsistent. We conducted an up-to-date meta-analysis to pool eligible studies and to further explore the possible relationships between HOTAIR polymorphisms (rs920778, rs7958904, rs12826786, 4,759,314, rs874945, and rs1899663) and cancer risk.@*METHODS@#A systematic retrieval was conducted up to 1 July 2017 in the PubMed, Web of Science, and CNKI databases. Eighteen eligible publications including 45 case-control studies with 58,601subjects were enrolled for assessing the associations between the 6 polymorphisms in HOTAIR and cancer risk. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were analyzed to reveal the polymorphisms and susceptibility to cancer. All the statistical analyses were performed using STATA 11.0 software.@*RESULTS@#The pooled analyses detected significant associations between the rs920778 polymorphism and increased susceptibility to cancer in recessive, dominant, allelic, homozygous, and heterozygous models. For the rs7958904 polymorphism, we obtained the polymorphism significantly decreased susceptibility to overall cancer risk among five genetic models rather than recessive and homozygous models. For the rs12826786 polymorphism, we identified it significantly increased susceptibility to cancer risk in all genetic models rather than heterozygous models. However, no significant association was found between the rs1899663, rs874945, and rs4759314 polymorphisms and susceptibility of cancer.@*CONCLUSION@#These findings of the meta-analysis suggest that HOTAIR polymorphism may contribute to cancer susceptibility.
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Humans , Genetic Predisposition to Disease , Epidemiology , Genotype , Neoplasms , Epidemiology , Genetics , Odds Ratio , Polymorphism, Single Nucleotide , RNA, Long Noncoding , Genetics , Metabolism , Risk FactorsABSTRACT
Two-dimensional code technology is widely used in daily life,and its application is relatively rare in medical education.Students organized write the Chinese and English slices' information by the way of extracurricular teaching activities,and two-dimensional code transformed from slices' information as label was pasted onto slice to made slice specimen with two-dimensional code.The students can quickly and accurately read the slice information by scanning the two-dimensional code.This practice can stimulate students' interest in learning and creative ability.It not only creates convenient conditions for the opening of the histology experiment and the independent study of the students,but also provides a way of thinking for the information management of the experimental teaching.
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Objective To investigate the perioperative characteristics of hip fractures and the effects of early rehabilitation in elderly patients. Methods Clinical data of 123 elderly patients admitted to our department from January 2012 to January 2014 were retrospectively analyzed. Patients were divided into a rehabilitation group and a control group ,based on whether rehabilitation therapy was offered.Comparison was made between the two groups on postoperative mortality and postoperative complications. Results Of 123 patients ,there were 51 males and 72 females ,with a mean age of (83.5 ± 4.8)years(aged 67~96 years).Femoral fractures were seen in 32 patients and femoral intertrochanteric fractures in 91 patients.Before operation ,112 (91.1% ) patients had concomitant diseases. There were significant differences in postoperative complications and one-year mortality after operation between patients receiving early rehabilitation and controls (5/60 or 8.3% vs.14/63 or 22.2% ,4/60 or 6.7% vs.13/63 or 20.6% ,χ2=4.539 and 5.034 ,P=0.033 and 0.025 , respectively ). Conclusions Elderly hip fracture patients have many concomitant diseases before operation.With appropriate perioperative management ,well-chosen methods of anesthesia and surgery ,and early postoperative rehabilitation measures ,the incidence of perioperative complications and one-year mortality can be decreased ,and desirable surgical outcomes can be attained.
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Objective To understand the antibiotic resistance of bacteria colonized in intestine of the neonates from neonatal intensive care unit (NICU) and provide evidence to guide clinical antibiotic treatment.Methods From May,2014 to May,2015,a total of 572 stool samples were collected from the neonates of NICU in our hospital.Escherichia coli and Enterococcus were detected with VITEK-2 system.Results A total of 328 strains of E.coli and 243 strains of Enterococcus were isolated respectively in this study.The 199 strains of E.coli selected for drug susceptibility test showed lower resistant rate to imipenem,ertapenem,amikacin,nitrofurantoin,ranging from 0.50％ to 3.52％ and showed higher resistant rate to ampicillin,tetracycline,trimethoprim/sulfamethoxazole and cefazolin,ranging from 54.27％ to 84.92％.No meropenem resistant strainsere were found.The percentage of ESBLs production strains was 45％.The multi drug resistance test showed that 34.6％ of the strains were resistant to four antibiotics.Three strains were resistant to seven antibiotics.The 243 strains of Enterococcus showed lower resistant rate to quinupristin/dalfopristin,nitrofurantoin,streptomycin,ranging from 0.41％ to 4.53％ and showed higher resistant rate to ampicillin,benzylpenicillin,ciprofloxacin,tetracycline,gentamicin and erythromycin,ranging from 70.78％ to 91.77％.No strains which were resistant to tigecycline,vancomycin,rina thiazole amine/ketone were found.The multi drug-resistance test showed that 86.5％ of the strains were resistant to five antibiotics.Conclusions According to the analysis of the 199 strains ofE.coli and 243 strains of Enterococcus isolated from the neonates,we found that the resistance of intestinal bacteria in the neonates was very serious,showing multi drug resistance.It is necessary to use antibiotics according to the drug susceptibility test results in clinical treatment.
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Objective To research an ultrasound imaging workstation based on DICOM so as to construct a patient-centered effective digital hospital.Methods Several interfaces of ultrasound imaging workstation based on DICOM were showed and their advantages and disadvantages were analyzed.Ultrasound imaging workstation based on DICOM was also compared with that based on video capture card.Results DICOM-based ultrasound imaging workstation gained advantages over the one based on video capture card in availability,resolution and management.Conclusion The workstation may contribute to enhancing clinical efficiency,promoting digital hospital and regional medical image sharing,and thus is worthy popularizing practically.
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Objective To explore the efficacy of arthroscopic treatment for acute avulsion fracture of posterior cruciate ligament (PCL) using double titanium plate TightRope. Methods From December 2014 to January 2015, two cases with acute avulsion fracture of PCL were treated with double titanium plate TightRope under arthroscopy, after assessment of three dimensional reconstructive CT and MRI. Rehabili-tation was carried out after operation. Results One case succeeded with double titanium plate TightRope, and rehabilitation could be per-formed early postoperatively. Another case failed in TightRope fixation, and accepted two internal hollow screws fixation instead. Rehabili-tation was delayed until two weeks postoperatively. The function of the knee was satisfactory in the former patient after three months, who could extend the knee in a normal range, without pain or locking. The same effect was gained in the latter patient after four months. Conclu-sion For acute tibial avulsion fracture of PCL with larger and intact fragment without osteoporosis, arthroscopic restoration and fixation with double titanium plate TightRope offers the opportunity to achieve anatomic reconstruction and rigid fixation for early rehabilitation in adult patients.
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Objective To explore an effective evaluation method for students' self-and peer-assess-ment. Methods The students of 6 groups participating in extracurricular teaching activities were selected as research subject. Traditional method (final score = mean score of group/2 + teacher's score/2) and mean difference method [final score=teacher's score-(mean difference of group-mean difference of all groups)] were used to calculate final score of each group, and effect of two methods were compared. Results Scores of most groups were higher than the teacher's scores, and high scores were given by group 3 in self- and peer-assessment. The final score of all groups were higher than teacher's scores in traditional method. Compared with teacher's scores, final scores increased significantly in group 1, 4, 5 below mean difference, final score decreased significantly in group 2, 3 above mean difference, and final score did not differ in group 6 equal to mean difference in mean difference method. Conclusion The mean difference method can reflect the effect of student's self- and peer-assessment, and guide student to make objective and accurate evaluation. It is a more reasonable and scientific evaluation method for self-and peer-assessment.
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Objective To understand the antibiotic resistance of bacteria colonized in intestine of the neonates from neonatal intensive care unit (NICU) and provide evidence to guide clinical antibiotic treatment.Methods From May,2014 to May,2015,a total of 572 stool samples were collected from the neonates of NICU in our hospital.Escherichia coli and Enterococcus were detected with VITEK-2 system.Results A total of 328 strains of E.coli and 243 strains of Enterococcus were isolated respectively in this study.The 199 strains of E.coli selected for drug susceptibility test showed lower resistant rate to imipenem,ertapenem,amikacin,nitrofurantoin,ranging from 0.50％ to 3.52％ and showed higher resistant rate to ampicillin,tetracycline,trimethoprim/sulfamethoxazole and cefazolin,ranging from 54.27％ to 84.92％.No meropenem resistant strainsere were found.The percentage of ESBLs production strains was 45％.The multi drug resistance test showed that 34.6％ of the strains were resistant to four antibiotics.Three strains were resistant to seven antibiotics.The 243 strains of Enterococcus showed lower resistant rate to quinupristin/dalfopristin,nitrofurantoin,streptomycin,ranging from 0.41％ to 4.53％ and showed higher resistant rate to ampicillin,benzylpenicillin,ciprofloxacin,tetracycline,gentamicin and erythromycin,ranging from 70.78％ to 91.77％.No strains which were resistant to tigecycline,vancomycin,rina thiazole amine/ketone were found.The multi drug-resistance test showed that 86.5％ of the strains were resistant to five antibiotics.Conclusions According to the analysis of the 199 strains ofE.coli and 243 strains of Enterococcus isolated from the neonates,we found that the resistance of intestinal bacteria in the neonates was very serious,showing multi drug resistance.It is necessary to use antibiotics according to the drug susceptibility test results in clinical treatment.
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Objective To compare different methods on the identification of Cronobacter (C.) spp.species and to choose an optimum one.Methods Biochemical test,16S rRNA and fusA sequencing methods were carried out.Results When using the biochemical test,105 strains showed six different conditions but C.turicensis and C.universalis could not be effectively identified.Under the 16S rRNA sequencing analysis,all the strains were divided into 5 groups but C.sakazakii and C.malonaticus were tangled.Finally,all the strains were identified into 58 C.sakazakii,30 C.malonaticus,11 C.dublinensis,5 C.turicensis,1 C.muytjensii,under the fusA sequencing analysis.Conclusion Currently,fusA sequencing analysis seemed an effective method for identifying the species of Cronobacter.Since fusA sequencing analysis method was less intuitive,another method for rapid testing should be developed.
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Orthopaedic rehabilitation is an important part of rehabilitation resident standardization training, that is complex and unique. Introduction of the discipline, as well as optimizing teaching methods, clinical practice and test are very important for a satisfactory out-come, such as combination of theory and practice, and systematical rehabilitation procedures, principles and operation.
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Objective To compare different methods on the identification of Cronobacter (C.) spp.species and to choose an optimum one.Methods Biochemical test,16S rRNA and fusA sequencing methods were carried out.Results When using the biochemical test,105 strains showed six different conditions but C.turicensis and C.universalis could not be effectively identified.Under the 16S rRNA sequencing analysis,all the strains were divided into 5 groups but C.sakazakii and C.malonaticus were tangled.Finally,all the strains were identified into 58 C.sakazakii,30 C.malonaticus,11 C.dublinensis,5 C.turicensis,1 C.muytjensii,under the fusA sequencing analysis.Conclusion Currently,fusA sequencing analysis seemed an effective method for identifying the species of Cronobacter.Since fusA sequencing analysis method was less intuitive,another method for rapid testing should be developed.
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Information literacy is the essential literacy in medical education and training of information analysis ability is the difficulty in information literacy education .Described in this paper is the trial to help postgraduates and long-term schooling undergraduates select their study orientation and topics in ChinaMedical University , including their course targets, contents and teaching outcomes.
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<p><b>OBJECTIVE</b>To investigate the molecular epidemiological characteristics and antibiotic resistance profiles of Vibrio cholerae O139 in Shandong province.</p><p><b>METHODS</b>A total of 13 strains of V. cholerae O139 (9 clinical strains and 4 environmental strains) isolated from cholera epidemics in Shandong province since 1997 were recovered and confirmed with serum agglutination and biochemical reaction. Pulsed-field gel electrophoresis (PFGE) was carried out for molecular subtyping. Virulence genes and drug resistance related genes were detected by PCR. Antibiotic susceptibility tests were performed using micro-broth dilution method.</p><p><b>RESULTS</b>Thirteen strains of V. cholerae O139 were differentiated into seven pulsetypes. One clinical strain and two environmental strains isolated from Jining in 2013 were clustered into the pulsetype namely KZGN11O139. CN0077, and an identical PFGE pattern of KZGN11O139. CN0002 was found among three clinical strains from Jinan in 2005, Jining in 2005 and Heze in 2009. Other pulsotypes were unique in China and found only in Shandong province. Because of deletion of ctxAB and tcpI, the PFGE patterns of two strains isolated from Yantai in 2000 and 2004 were different from other 11 strains which harbored ctxAB, tcpA, tcpI, rtxA, hlyA and toxR. All strains contained one or more drug resistance related genes such as intI 1, intI 4 and sxt, and were resistant to two kinds of antibiotics at least. Among the 12 kinds of antibiotics, the resistant ratioes to kamamycin, trimethoprim-sulfamethoxazole, ampicillin and gentamicin were 11/13, 9/13, 7/13 and 7/13, respectively.</p><p><b>CONCLUSION</b>Molecular subtyping indicates possible epidemiological links among V.cholerae O139 in Shandong province, and almost all strains were toxigenic and drug resistant.</p>
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Humans , China , Cholera , Cholera Toxin , Drug Resistance, Bacterial , Electrophoresis, Gel, Pulsed-Field , Epidemics , Molecular Epidemiology , Polymerase Chain Reaction , Vibrio cholerae O139 , VirulenceABSTRACT
<p><b>OBJECTIVE</b>To understand the ctxB and rstR variations of toxigenic Vibrio cholerae (V.cholerae) O1 El Tor strains isolated from different provinces in China from 1961 to 2010.</p><p><b>METHODS</b>All 385 toxigenic V.cholerae O1 El Tor strains were selected, which were isolated in China between year 1961 and 2010. ctxB gene was amplified by PCR method and sequenced for further analysis. rstR was detected with PCR by using the genotype specific primers.</p><p><b>RESULTS</b>ctxB sequence analysis revealed that 52.5% (202/385) isolates carried ctxB(ET) and 47.5% (183/385) carried ctxB(class), namely Y(39) to H and I(68) to T substitutions which were specific to the classical biotype CT-B sequence. From 1961 to 1992, strains carrying ctxB(ET) were predominant and the proportion was as high as 98.4% (182/185). After 1993, strains carrying ctxB(class) were sharply increased. Especially during year 1993 to year 2005, 97.2% (174/179) of the isolated strains carried ctxB(class). Since 2006, resurgence of dominant strains carrying ctxB(ET) or co-existing of strains with ctxB(ET) or ctxB(class) was noticed. rstR genotype detection showed that 62.9% (242/385)of the tested strains carried the rstR(ET), while 6.8% (26/385) with rstR(class), and the remainings contained at least two types of rstR in different combination forms, among which rstR(ET)+rstR(class) combination were the most, accounting for 75.7% (75/99) . Similar to the ctxB, the distribution of rstR genotypes showed time specificity. From 1961 to 1992, strains carrying rstR(ET) predominated (87.0%, 161/185). After 1993, the diversity of rstR genotypes was observed accompanying by a sharp increase of strains containing other rstR genotype, such as rstR(class), rstR(env) and different combinations. There were separately 96% (25/26), 84% (63/75) and 18/18 strains containing rstR(class), rstR(ET)+rstR(class) and rstR(ET)+rstR(class)+rstR(env) isolated after 1993.</p><p><b>CONCLUSION</b>The distribution of different genotypes of ctxB and rstR showed obvious time-specificity, and there were various combining forms of rstR, reflecting the diversity of the genetic and evolutionary characteristics of Chinese V.cholerae isolates.</p>
Subject(s)
China , Cholera , Genotype , Molecular Epidemiology , Polymerase Chain Reaction , Vibrio cholerae , Vibrio cholerae O1ABSTRACT
<p><b>OBJECTIVE</b>To create the fingerprint library of Yunnan Yersinia pestis by pulse field gel electrophoresis(PFGE)with Fse I enzyme digestion method and to study its epidemiological significance.</p><p><b>METHODS</b>We used rare cutting restriction enzyme Fse? to digest Yunnan Yersinia pestis strains that were isolated from foci including Rattus flavipectus Plague Focus,Apodemus chevrieri-Eothenomys miletus Plague Focus and Yulong Plague Focus. Fingerprints to Bionumerics software were used for cluster analysis.</p><p><b>RESULTS</b>30 tested strains were divided into 16 genotypes with the similarity value as 79.8%-100.0% . 16 genotypes wee formed into 4 clusters, with one consisted of only EV76 while the other three belonged to Rattus flavipectus,Apodemus chevrieri- Eothenomys miletus and Yulong clusters, respectively.</p><p><b>CONCLUSIONS</b>PFGE genotypes of Yunnan Yersinia pestis accorded with its ecotypes and biovars, with clustered regional features. The strains isolated from Yulong showed an unique PFGE type, indicating a new clone group was identified.</p>
Subject(s)
Animals , Humans , Rats , China , Epidemiology , Cluster Analysis , Electrophoresis, Gel, Pulsed-Field , Genotype , Phylogeny , Plague , Epidemiology , Yersinia pestis , GeneticsABSTRACT
Objective To compare the efficacy and complications among three surgical treatments of femoral intertrochanteric fractures in elderly patients.Methods Totally 209 elderly patients with femoral intertrochanteric fracture were divided into 3 groups:DHS group[n =115,patients treated with dynamic hip screws (DHS)],PFNA group [n=57,patients treated with proximal femoral nails anti-rotation (PFNA)] and SEFT group [n=37,patients treated with singlearm external fixator technique (SEFT)].The length of hospitalization,operative time,bleeding volume,hip function scores and complications were compared among the three groups.Results All patients were followed up for 5-12 months (10.6 months in average).The length of hospitalization,operative time,bleeding volume,weight-bearing time and Harris hip score in postoperative 3 months were (14.3±2.7) d,(102.4±22.7) min,(240.8±38.4) ml,(50.2±7.7) d,(88.7±12.8) min in DHS group,(11.2±3.4) d,(50.3±15.6) min,(80.5±18.7) ml,(22.6±4.8) d,(92.6±15.4)min in PFNA group,(15.1±3.3) d,(35.8±10.9) min,(52.6±12.9) ml,(55.4±10.1) d,(87.3 ± 12.6) min in SEFT group,respectively.There were significant differences in the length of hospitalization,operative time,bleeding volume,weight-bearing time and Harris hip score in postoperative 3 months among the three groups (all P ＜ 0.05),while there was no significant difference in healing time among the three groups (all P＞0.05).The incidence of complications was highest in DHS group,higher in SEFT group,and lowest in PFNA group (all P＜0.05).Conclusions DHS is more suitable for patients with good physical condition and stable fractures.SEFT is suitable for patients with poor condition,who can not tolerate trauma,anesthesia and bleeding.PFNA has more advantages including stable fixation,less invasive,less complications and wide indications,which is more suitable for femoral intertrochanteric fractures than the other two treatments.
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The purpose of this research was to understand fecal micro-flora of Enterococcus-related diarrhea feces and the clone characteristics of isolated Enterococcus strains.Primer was designed according to 16S rRNA gene and integrated DNA extracted from patients' fecal samples was used as the template to amplify the conserved sequence of 16S rRNA by PCR.After the PCR product was purified and cloned into T vector to sequence,PFGE was used to analyze 20 out of 50 Enterococcus isolates from each specimen.The 16S rRNA gene sequencing analysis indicated that these 4 portions of diarrhea feces were dominated by Enterococcus faecium (>68%) and the isolates were clonal except only one portion.Although the basic flora characteristics of diarrhea feces could be revealed by 16S rRNA gene sequencing analysis and PFGE analysis,the pathogenicity and mechanism of Enterococcus were still waiting for further experimental exploration.
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@#ObjectiveTo investigate the characteristics of knee stiffness and the results of rehabilitation after the fractures of distal femur （DF）, tibial plateau （TP） or patella （PF）. Methods70 cases with knee stiffness after DF, TP or PF were analyzed retrospectively. ResultsNo significant difference was observed in passive range of motion (PROM) among three groups (F=1.671，P=0.196) before rehabilitation. The differences were significantly different (F=19.264, P=0.000) 8 weeks after rehabilitation. Further LSD analysis revealed that there was significant difference between DF and TP (P=0.000) as well as DF and PF (P=0.000), but no significant difference was observed between TP and PF (P=0.114). ConclusionThe outcome of rehabilitation is associated with the locations of fracture, and the distal femoral fractures is the worst.