RESUMEN
Objective:To explore the clinical efficacy of a retrograde pubic ramus intramedullary nail (RPRIN) in the treatment of anterior pelvic ring fractures.Methods:A retrospective study was conducted to analyze the 14 patients with anterior pelvic ring fracture who had been treated and followed up at Department of Traumatic Surgery, Tongji Hospital From June 2020 to February 2021. There were 10 males and 4 females with an age of (44.8±12.5) years. By the AO/OTA classification for pelvic fractures, 5 cases were type 61-A, 4 cases 61-B, and 5 cases type 61-C; by the Nakatani classification, 1 case belonged to unilateral zone Ⅰ fracture, 5 cases to unilateral zone Ⅱ fracture, 2 cases to unilateral zone Ⅲ fracture, 3 cases to right zone Ⅱ and left zone Ⅲ fracture, 2 cases to zone Ⅲ fracture on both left and right sides, and 1 case to zone Ⅱ fracture on both sides. The time from injury to operation was (7.8±1.8) days. All the anterior pelvic ring fractures were fixated with a RPRIN. The time and fluoroscopic frequency for placement of every single RPRIN, quality of fracture reduction, and pelvic function and incidence of postoperative complications at the last follow-up were recorded.Results:A total of 18 RPRINs were placed in the 14 patients. For placement of each RPRIN, the time was (35.9±8.6) min, and the fluoroscopic frequency (22.8±1.9) times. No complications such as infection occurred at any surgical incision after RPRIN placement. According to the Matta scoring, the quality of postoperative fracture reduction was assessed as excellent in 7 cases, as good in 5 cases and as fair in 2 cases. The 14 patients were followed up for (18.1+1.5) months. Their X-ray and CT images of the pelvis at the last follow-up showed that the fractures healed well and the intramedullary nails were placed in the cortical bone of the anterior ring of the pelvis. According to the Majeed scoring at the last follow-up, the pelvic function was assessed as excellent in 10 cases, as good in 3 cases and as fair in 1 case. One patient reported discomfort during squatting 2 months after operation but the symptom improved 3 months later without any special treatment. No patient experienced such complications as displacement or slippage of RPRIN, or pain at the insertion site.Conclusion:RPRIN is effective in the treatment of anterior pelvic ring fractures, showing advantages of small surgical incision, limited intraoperative fluoroscopy and short operation time.
RESUMEN
Objective This research aims to improve the ability and level of the management of scientific research reagent in better support of hospital scientific research.Methods Establish a sound management system and build an information system for scientific research reagents,meanwhile summarize and optimize system functions in practice constantly.Results Scientific research reagent management work has been organized orderly and the procurement and use of scientific research reagents has been standardized in the hospital,which effectively reduced the purchase cost of scientific research reagents and ensured the smooth development of scientific research.At the same time,this manner provides researchers with a convenient and quality service as well as accelerates the scientific research process.Conclusions The perfect scientific research reagent management system can provide effective support and guarantee for the scientific research work of the hospital,which is conducive to the sustained and stable development of hospital scientific research.
RESUMEN
Background Human LECs can express telomerase activity,which participates in the formation of cataract.It is reported that estrogen can increase the expression of telomerase activity in human endometrial cancer and breast cancer cells and play an important role in promoting proliferation and anti-apoptosis,but whether estrogen exerts its role on human LECs is still unclear.Objective This study aimed to investigate whether β-estradiol (β-E2) can increase the telomerase activity of human LECs and the influence of β-E2 on proliferation and apoptosis of human LECs.Method Human LECs line was cultured and passaged in vitro,and 1×10-6 mol/L β-E2 was added in the medium for 0,6,12,24 and 48 hours,and reverse transcription PCR was used to determine the optimal time of the expression of human telomerase reverse transcriptase (hTERT) mRNA in the cells.Cultured cells were divided into five groups.The cells in the blank contol group were cultured in the routin medium.Ethanol of 0.1％ was added in the solvent control group,and 1 × 10-8,1 × 10-7 or 1 × 10-6 mol/L β-E2 was added in the medium in different contents of β-E2 groups,respectively.The relative expression level of hTERT mRNA in different groups was detected by reverse transcription PCR.Telomere repeat amplification protocol (TRAP)-ELISA was employed to determine the telomerase activity.The proliferative value of the cells was assayed by cell counting kit-8,and the apoptosis rate of the cells was examined by Hoechst33258 staining.Results The optimal time of β-E2 to rise the expression of hTERT mRNA (absorbance) was at 24 hours under the 1×10-6 mol/L.The relative expression levels of hTERT mRNA in the cells were 0.477±0.015,0.712±0.013 and 0.914±0.031 in the 1 ×10-8,1 ×10-7 and 1 ×10-6 mol/L β-E2 group,which were signifincatly higher than 0.428±0.010 in the blank control group and 0.426±0.010 in the solvent control group (all at P＜0.05).The telomerase activity values (absorbance) were 0.711 ±0.015,0.941±0.010 and 1.249±0.047 in the 1×10-8,1×10-7and 1×10-6 mol/L β-E2 group,which were higher than 0.535±0.013 in the blank control group and 0.543 ±0.013 in the solvent control group (all at P =0.000).The proliferantive values of the cells (absorbance) were significantly raised in the 1 × 10-8 mol/L β-E2 group compared with l × 10-7 and 1 × 10-6 mol/L β-E2 group (both at P =0.000),and no significnant difference was found in the proliferetive values between the blank control group and the solvent control group (P =0.718,0.856).The apoptosis rates of the cells in the 1 × 10-8,1 × 10-7 and 1 × 10-6 mol/L β-E2 group were lower than those in the the blank control group and the solvent control group (all at P=0.000),and there was no significant difference between the blank control group and the solvent control group (P =0.777).No obvious correlation was found between the HLECs preliferative values and hTERT mRNA expression levels or telomerase activity values (r=-0.299,P=0.278;r=-0.157,P=0.576).However,significantly negative correlations were seen between apoptosis rates and hTERT mRNA expression levels or telomerase activity values (r =-0.975,P=0.000;r=-0.981,P=0.000).Conclusions β-E2can increase the activity of telomerase in human LECs,and high dose of β-E2can inhibit apoptosis,but it dose not promote proliferation.
RESUMEN
The paper described the professional approach of Shanghai Hospital Development Center(SHDC)in developing a professional team of public hospital directors by such means as operation and management-autonomy,fixed tenures system,performance appraisal,part-time job control and income distribution. Recommendations raised include an organic unity of management functions of investors and power of management of the directors to motivate them in their management;building a comprehensive investor management system and strict cadre management mechanism to enhance supervision of the directors.
RESUMEN
Objective To understand antimicrobial resistance and homology of carbapenem-resistant Klebsiella pneumoniae (CRKP)from an intensive care unit (ICU).Methods 11 CRKP isolates from patients and environment of an ICU in a hospital were performed antimicrobial susceptibility testing,the homology of CRKP was analyzed by randomly amplified polymorphic DNA (RAPD)method.Results Of 11 CRKP isolates,8 were from patients,and 3 from environment,the main specimen was sputum(n =6,54.55%).Antimicrobial susceptibility testing results re-vealed that 10 (90.91%)CRKP isolates were resistant to ciprofloxacin;11 isolates were susceptible to compound sulfame-thoxazole,intermediate to imipenem,and resistant to other antimicrobial agents(100%).All 11 CRKP isolates had 3 bands,and were divided into two types:(typeⅠ,n=10;type Ⅱ,n=1).Conclusion Antimicrobial resistance of Kleb-siella pneumoniae in ICU is serious,CRKP isolated from ICU patients and environment are of the same clone. Cleaning,disinfection,and monitoring of ICU environment should be strengthened,which is helpful for reducing, timely warning of multidrug-resistant organisms,and reducing healthcare-associated infection.
RESUMEN
Objective To analyze antimicrobial use in the different grades of hospitals within 3 years after the car-rying out of rectification activities of antimicrobial use,and provide basis for making continuous improvement pro-gram of antimicrobial management.Methods Retrospective analysis was performed,outpatient and emergency pre-scriptions and medical records of discharged patients (100 were type Ⅰ incision surgery)were selected from 5 tertia-ry hospitals and 5 secondary hospitals within 3 months,antimicrobial use and management were investigated. Results 200 outpatient prescriptions,100 emergency prescriptions,and 200 medical records of discharged patients were selected from each hospital.In tertiary and secondary hospitals,antimicrobial usage rate in outpatient prescrip-tions was 17.40% and 18.00% respectively,emergency prescriptions was 31 .60% and 40.10% respectively;a-mong inpatients,antimicrobial usage density(AUD)was (28.13±8.04)and (49.67±11 .63)respectively,and anti-microbial usage rate was 41 .30% and 56.20% respectively;pathogenic detection rate of antimicrobial therapeutic cases was 45.70% and 22.70% respectively,therapeutic cases with limit level of antimicrobials was 61 .50% and 27.40% respectively;antimicrobial usage rate in type I incision surgery was 20.00% and 40.40% respectively;The rational rate of antimicrobial types was 94.60% and 59.20% respectively,rational rate of opportunity of antimicro-bial use was 95.20% and 48.20% respectively;combination rate was 8.80% and 36.60% respectively,and rational rate of treatment course was 84.00% and 52.80% respectively.Conclusion In tertiary hospitals,antimicrobial use after 3 years rectification of antimicrobial use conform to the antimicrobial management requirement of Ministry of Health,the overall quality index is better than secondary hospitals,management of antimicrobial in secondary hos-pitals use should be improved.