Prevention of multidrug-resistant organism infection through chlorhexidine gluconate rubbing bathing in patients in intensive care unit / 中国感染控制杂志

Objective To study the effect of chlorhexidine gluconate rubbing bathing on preventing multidrug-resistant organism(MDRO)infection in patients in intensive care unit(ICU).Methods 108 critically ill patients in a tertiary first-class hospital between January and December 2016 were randomly divided into trial group and control group.Trial group adopted wet towel containing 2％ chlorhexidine gluconate for bathing, control group adopted water for bathing.Bacteriostasis rate, incidence of healthcare-associated infection(HAI), occurrence of MDRO infection, and adverse reaction between two groups of patients after rubbing bathing were compared.Results There was no significant difference in the bacteriostasis rate within 2 hours between two groups(P＞0.05), bacteriostasis rates of trial group after 4, 8, and 24 hours of bathing were significantly higher than control group(P＜0.001).Incidences of HAI in trial group and control group were 44.44％(24/54)and 66.67％(36/54)respectively(P＜0.05); incidences of MDRO infection in trial group and control group were 20.37％(11/54)and 40.74％(22/54)respectively(P＜0.05).The main infection sites in trial group and control group were both lower respiratory tract, accounting for 87.50％and72.22％respectively;8 cases(33.33％)in trial group and11(30.55％)in control group had ventilator-associated pneumonia(VAP).11 strains of MDROs in trial group and 22in control group were isolated, both were mainly carbapenem-resistant Acinetobacter baumannii (CRAB).There was no adverse reaction after the bathing in both groups.Conclusion Application of chlorhexidine gluconate bathing can effectively reduce the incidence of HAI and MDRO infection in ICU patients.

Increased 5-hydroxymethylcytosine and Ten-eleven Translocation Protein Expression in Ultraviolet B-irradiated HaCaT Cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>DNA hydroxymethylation refers to a chemical modification process in which 5-methylcytosine (5mC) is catalyzed to 5- hydroxymethylcytosine (5hmC) by ten-eleven translocation (TET) family proteins. Recent studies have revealed that aberrant TETs expression or 5hmC level may play important roles in the occurrence and development of various pathological and physiological processes including cancer and aging. This study aimed to explore the relation between aberrant DNA hydroxymethylation with skin photoaging and to investigate the levels of TETs, 5mC, and 5hmC expression 24 h after 40 mJ/cm2 and 80 mJ/cm2 doses of ultraviolet B (UVB) irradiation to HaCaT cells.</p><p><b>METHODS</b>To explore whether aberrant DNA hydroxymethylation is also related to skin photoaging, 40 mJ/cm2 and 80 mJ/cm2 doses of UVB were chosen to treat keratinocytes (HaCaT cells). After 24 h of UVB irradiation, 5mC and 5hmC levels were determined by immunohistochemistry (IHC) and immunofluorescence (IF), and at the same time, the expression levels of matrix metalloproteinase 1 (MMP-1) and TETs were assessed by reverse transcription-polymerase chain reaction or Western blot analysis.</p><p><b>RESULTS</b>After 40 mJ/cm2 and 80 mJ/cm2 doses of UVB exposure, both IHC and IF results showed that 5hmC levels increased significantly, while the 5mC levels did not exhibit significant changes in HaCaT cells, compared with HaCat cells without UVB exposure. Moreover, compared with HaCat cells without UVB exposure, the levels of TET1, TET2, and TET3 mRNA and protein expression were significantly upregulated (mRNA: P = 0.0022 and 0.0043 for TET1; all P < 0.0001 for TET2; all P = 0.0006 for TET3; protein: P = 0.0012 and 0.0006 for TET1; all P = 0.0022 for TET2; and all P = 0.0002 for TET3), and the levels of MMP-1 mRNA expression increased dose dependently in 40 mJ/cm2 and 80 mJ/cm2 UVB-irradiated groups.</p><p><b>CONCLUSION</b>UVB radiation could cause increased 5hmC and TET expression, which might become a novel biomarker in UVB-related skin aging.</p>

Association between maternal pre-pregnancy body mass index and adverse outcomes of late preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the association between maternal pre-pregnancy body mass index (BMI) and adverse outcomes of late preterm infants (LPI).</p><p><b>METHODS</b>A total of 367 LPI who were born from January 2011 to December 2015 and admitted to the neonatal ward were enrolled. The BMI criteria for Chinese population were used to analyze the factors for maternal pre-pregnancy BMI and its association with adverse outcomes of LPI (1 minute Apgar score ≤7, delivery room resuscitation, hospitalization days after birth >7 days, and ventilation duration ≥6 hours).</p><p><b>RESULTS</b>Of all LPIs, there were 64 LPI (17.4%) in the low maternal pre-pregnancy BMI group, 243 LPI (66.2%) in the normal maternal pre-pregnancy BMI group, and 60 LPI (16.4%) in the high maternal pre-pregnancy BMI group. Low pre-pregnancy BMI was the risk factor for 1 minute Apgar score ≤7 (OR=3.243, 95% CI: 1.102-9.546) and need for delivery room resuscitation (OR=3.492, 95%CI: 1.090-11.190), and high pre-pregnancy BMI was the risk factor for hospitalization days after birth >7 days (OR=1.992, 95%CI: 1.024-3.874).</p><p><b>CONCLUSIONS</b>Abnormal maternal pre-pregnancy BMI has adverse effects on the outcomes of LPI. In order to reduce these adverse outcomes BMI should be controlled within the normal range in pregnant women.</p>

Effect of caffeine citrate on early pulmonary function in preterm infants with apnea / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effect of caffeine citrate treatment on early pulmonary function in preterm infants with apnea.</p><p><b>METHODS</b>Forty preterm infants with apnea were randomly divided into aminophylline treatment group (20 infants) and caffeine citrate treatment group (20 infants). When the preterm infants experienced apnea after birth, they were given aminophylline or caffeine citrate in addition to assisted ventilation with continuous positive airway pressure (NCPAP). After drug discontinuation, pulmonary function was measured and compared between the two groups.</p><p><b>RESULTS</b>After treatment, compared with the aminophylline treatment group, the caffeine citrate treatment group had significantly higher tidal volume, minute ventilation volume, ratio of time to peak tidal expiratory flow to total expiratory time, ratio of volume to peak tidal expiratory flow to total expiratory volume, peak expiratory flow, and breathing flow at 75%, 50%, and 25% of tidal volume (P<0.05). The caffeine citrate treatment group had a significantly shorter time of oxygen use and NCPAP support than the aminophylline treatment group (P<0.01). Compared with the aminophylline treatment group, the caffeine citrate treatment group had a significantly lower frequency of apnea attacks (P<0.01).</p><p><b>CONCLUSIONS</b>In the treatment of apnea in preterm infants, caffeine citrate can improve early pulmonary function and reduce the incidence of apnea.</p>

Influencing factors for brain injury in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the incidence of different types of brain injury in preterm infants and their influencing factors.</p><p><b>METHODS</b>The clinical data and head magnetic resonance imaging (MRI) findings of 239 preterm infants were collected, and the influence of antepartum, intrapartum, and postpartum factors on brain injury in preterm infants was analyzed.</p><p><b>RESULTS</b>The incidence rate of brain injury in preterm infants was 25.5%; among these infants, 10.5% had hemorrhagic brain injury, 10.5% had ischemic brain injury, and 4.6% and hemorrhagic and ischemic brain injury. The infants with a lower gestational age had higher incidence rates of hemorrhagic brain injury and overall brain injury (P<0.01). The incidence rates of ischemic brain injury and hemorrhagic and ischemic brain injury were not correlated with gestational age (P>0.05). The incidence rates of hemorrhagic, ischemic, and overall brain injury were not correlated with birth weight (P>0.05). Multiparity (OR=0.292, 95%CI 0.088-0.972) and cesarean section (OR=0.075, 95%CI 0.015-0.368) were protective factors against brain injury in infants with a gestational age of <34 weeks; cesarean section (OR=0.296, 95%CI 0.131-0.672) was the protective factor against brain injury in infants with a gestational age of ≤34 weeks, and severe infection (OR=8.176, 95%CI 1.202-55.617) was the risk factor.</p><p><b>CONCLUSIONS</b>In order to prevent or reduce the occurrence of brain injury in preterm infants. the gestational age of preterm infants should be prolonged as much as possible and the indications for cesarean section should be grasped. Infections should be prevented and if occurring should be treated actively and effectively.</p>

Predictive value of qualitative assessment of general movements for adverse outcomes at 24 months of age in infants with asphyxia / 中国当代儿科杂志

<p><b>OJBECTIVE</b>To investigate the predictive value of the qualitative assessment of general movements (GMs) for adverse outcomes at 24 months of age in full-term infants with asphyxia.</p><p><b>METHODS</b>A total of 114 full-term asphyxiated infants, who were admitted to the neonatal intensive care unit between 2009 and 2012 and took part in follow-ups after discharge were included in the study. All of them received the qualitative assessment of GMs within 3 months after birth. The development quotient was determined with the Bayley Scales of Infant Development at 24 months of age.</p><p><b>RESULTS</b>The results of the qualitative assessment of GMs within 3 months after birth showed that among 114 infants, 20 (17.5%) had poor repertoire movements and 7 (6.1%) had cramped-synchronized movements during the writhing movements period; 8 infants (7.0%) had the absence of fidgety movements during the fidgety movements period. The results of development quotient at 24 months of age showed that 7 infants (6.1%) had adverse developmental outcomes: 6 cases of cerebral palsy and mental retardation and 1 case of mental retardation. There was a poor consistency between poor repertoire movements during the writhing movements period and the developmental outcomes at 24 months of age (Kappa=-0.019; P>0.05). There was a high consistency between cramped-synchronized movements during the writhing movements period and the developmental outcomes at 24 months of age (Kappa=0.848; P<0.05), and the results of predictive values of cramped-synchronized movements were shown as follows: predictive validity 98.2%, sensitivity 85.7%, specificity 99.1%, positive predictive value 85.7%, and negative predictive value 99.1%. There was a high consistency between the absence of fidgety movements during the fidgety movements period and the developmental outcomes at 24 months of age (Kappa=0.786; P<0.05), and its predictive values were expressed as follows: predictive validity 97.4%, sensitivity 85.7%, specificity 98.1%, positive predictive value 75.0%, and negative predictive value 99.1%.</p><p><b>CONCLUSIONS</b>Cramped-synchronized movements and absence of fidgety movements can predict adverse developmental outcomes at 24 months of age in full-term infants with asphyxia.</p>

Human umbilical cord blood mononuclear cell transplantation promotes long-term neurobehavioral functional development of newborn SD rats with hypoxic ischemic brain injury / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the effect of human umbilical cord blood mononuclear cells (UCBMC) promoting nerve behavior function and brain tissue recovery of neonatal SD rat with hypoxic ischemic brain injury (HIBI).</p><p><b>METHOD</b>A modified newborn rat model that had a combined hypoxic and ischemic brain injury as described by Rice-Vannucci was used, early nervous reflex, the Morris water maze and walking track analysis were used to evaluate nervous behavioral function, and brain MRI, HE staining to evaluate brain damage recovery.</p><p><b>RESULT</b>Newborn rat Rice-Vannucci model showed significant brain atrophy, obvious hemiplegia of contralateral limbs,e.g right step length [(7.67 ± 0.46) cm vs. (8.22 ± 0.50) cm, F = 1.494] and toe distance [(0.93 ± 0.06) cm vs. (1.12 ± 0.55) cm, F = 0.186] were significantly reduced compared with left side, learning and memory ability was significantly impaired compared with normal control group (P < 0.01); Cliff aversion [(8.44 ± 2.38) s vs.(14.22 ± 5.07) s, t = 4.618] and negative geotaxis reflex time [(7.26 ± 2.00) s vs. (11.76 ± 3.73) s, t = 4.755] on postnatal 14 days of HIBI+ transplantation group were significantly reduced compared with HIBI+NaCl group (P < 0.01) ; the Morris water maze experiment showed escape latency [ (23.11 ± 6.64) s vs. (34.04 ± 12.95) s, t = 3.356] and swimming distance [ (9.12 ± 1.21) cm vs.(12.70 ± 1.53) cm, t = 17.095] of HIBI+transplantation group were significantly reduced compared with those of HIBI+NaCl group (P < 0.01) ; the residual brain volume on postnatal 10 d [ (75.37 ± 4.53)% vs. (67.17 ± 4.08)%, t = -6.017] and 67 d [ (69.05 ± 3.58)% vs.(60.83 ± 3.69)%, t = -7.148]of HIBI+ transplantation group were significantly larger than those of HIBI+NaCl group (P < 0.01); After human UCBMC transplantation, left cortical edema significantly reduced and nerve cell necrosis of HIBI+ transplantation group is not obvious compared with HIBI+NaCl group.</p><p><b>CONCLUSION</b>Human UCBMC intraperitoneal transplantation significantly promoted recovery of injured brain cells and neurobehavioral function development.</p>

Comprehensive sequential interventional therapy for hepatocellular carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Since the 1980s, various approaches to interventional therapy have been developed, with the development and achievement of medical imaging technology. This study aimed to evaluate the effectiveness of comprehensive sequential interventional therapy especially personal therapeutic plan in 53 radical cure patients with hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>From January 2003 to January 2005, a total of 203 patients with HCC received sequential interventional treatment in our hospital. Fifty-three patients achieved radical cure outcomes. Those patients were treated with transcatheter arterial chemoembolization (TACE), radiofrequency ablation (RFA), percutaneous ethanol injection (PEI), or high intensity focused ultrasound (HIFU), sequentially and in combination depending on their clinical and pathological features. PET-CT was used to evaluate, assess, and guide treatment.</p><p><b>RESULTS</b>Based on the imaging and serological data, all the patients had a personal therapeutic plan. The longest follow-up time was 24 months, the shortest was 6 months, and mean survival time was 16.5 months.</p><p><b>CONCLUSION</b>Comprehensive sequential interventional therapy especially personal therapeutic plan for HCC play roles in interventional treatment of HCC in middle or advanced stage.</p>

Influence of neutrophils from severe burn patients on morphology and function of vascular endothelial cells and the protective effect of intervention with Shenmai concoction / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the influence of neutrophils from severe burn patient on the morphology and function of vascular endothelial cells (VEC), and the protective effect of Shenmai concoction on VEC.</p><p><b>METHODS</b>Neutrophils were isolated from the venous blood of healthy volunteers and burn patients [at 6, 24, 48 post burn hour (PBH)], and they were cocultured with VECs (ECV304) in vitro. The viability of VECs was assessed by MTT. The contents of endothelin (ET) land nitric oxide (NO) in supernatant were determined by radioimmunoassay, the ratio between ET-1 and NO (ET-1/NO) was also calculated. Blood samples from burn patients were collected at 24 PBH to repeat experiment as above, but 100 L microL isotonic saline or 100 microL Shenmai concoction in concentrations of 0.5, 2.0, 8.0 g/L was added to the cultures respectively. The effect of Shenmai concoction on above indices and morphology of ECV3O4 were also observed.</p><p><b>RESULTS</b>Compared with neutrophils from healthy volunteers, the activity of VECs cocultured with neutrophils from burn patients at 6 PBH was obviously decreased, the content of ET-1 obviously increased, especially with neutrophils obtained at 24 PBH (P < 0.01). The content of NO in supernatant of VEC co-cultured with neutrophils from burn patients at 6 PBH was increased obviously (48.9 +/- 2.6 micromol/L, P < 0.01). There were no obvious difference in the content of NO under the stimulation of neutrophils between that of healthy volunteers and burn patients blood obtained at 24, 48 PBH (P > 0.05). With different concentrations of Shenmai, the activity of VECs and the content of NO were obviously increased , while the content of ET-1 was significantly decreased. The morphology of VECs after treatment of neutrophils of 24 PBH and 2.0 g/L Shenmai was similar to normal VECs.</p><p><b>CONCLUSION</b>The morphology, activity of VEC, and ET/NO can be affected by neutrophils after severe burn, especially that of 24 PBH in vitro. Shenmai concoction can ameliorate above indices, thus might possibly exert protective effects on VECs after severe burn.</p>

mRNA and protein expression of haptoglobin in lesions of condyloma acuminatum / 中南大学学报(医学版)

OBJECTIVE@#To investigate the expression of haptoglobin in the lesions of condyloma acuminatum (CA) at the mRNA and protein level, and to explore its role in the pathogenesis of CA.@*METHODS@#The expressions of haptoglobin protein and mRNA in the skin tissues of 30 patients with CA and 20 normal controls were detected by immunohistochemistry(IHC), Western blot, and hybridization in situ.@*RESULTS@#The in situ hybridization study showed that haptoglobin mRNA was expressed in the epidermal cells in the lesions of CA. The distribution of haptoglobin mRNA expression in the lesions of CA was similar to that of the normal controls, and the expression of haptoglobin mRNA in CA was higher than that of the normal controls. There was a significant difference in the positive expression of haptoglobin mRNA between the CA group and the control group (P<0.05). The immunohistochemical study showed that haptoglobin protein was expressed in the whole layers of epidermal keratinocytes in the lesions of CA at a high level and stronger staining was seen in the stratum basale and stratum spinosum. Haptoglobin protein was expressed predominantly in the stratum basale in normal skin tissues, while weak staining was seen below the stratum spinosum.There was a significant difference in the mean gray value between the CA group and control group (P<0.05). Western blot showed that the haptoglobin expression in CA lesions significantly increased compared with the normal skins (P<0.05).@*CONCLUSION@#The expression of haptoglobin mRNA in the CA lesions obviously increases and the epidermal cells in the CA lesions are able to synthesize haptoglobin protein. Haptoglobin in the CA lesions may involve in the local immunity escape by preventing Langerhans cell functional maturation and inhibiting the immunocompetence of keratinocyte.

Female urogenital mycoplasma infection and drug sensitivity status in Changsha / 南方医科大学学报

<p><b>OBJECTIVE</b>To survey mycoplasma infection in female urogenital tract and analyze the drug sensitivity of mycoplasma in Changsha.</p><p><b>METHODS</b>Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) were detected in 6566 cases of female urogenital tract infection by means of mycoplasma culture and drug sensitivity reagent kit. Sensitivity tests for 10 antibiotics were also performed.</p><p><b>RESULTS</b>A total of 2938 cases were mycoplasma-positive (positivity rate of 44.75%), including 2469 Uu-positive cases (37.6%), 52 Mh-positive cases (0.08%) and 417 cases positive for both Uu and Mh (6.35%). Josamycin, doxycycline, clarithromycin and azithromycin were more effective against Uu infection. Josamycin, doxycycline and thiamphenicol were more effective against Mh infection. Mixed infection with Uu and Mh was more resistant to most antibiotics but Josamycin and doxycycline.</p><p><b>CONCLUSION</b>The female urogenital mycoplasma infection results mainly from Uu. Compared with simple Uu or Mh infection, mixed infection with Uu and Mh has significantly greater resistance to a wider variety of drugs. Josamycin and doxycycline are the primary choice for female urogenital mycoplasma infection in Changsha.</p>

Apoptosis of psoriatic keratinocytes and the severity of patients' condition / 中南大学学报(医学版)

OBJECTIVE@#To investigate the correlation between the apoptosis of psoriatic keratinocytes (KCs) in the psoriatic lesions and patient's condition.@*METHODS@#Thirty patients with psoriasis were included. Activated caspase-3 was examined by colorimetric method in skin biopsy specimens. The apoptotic KCs were detected with terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay in skin biopsy specimens. The severities of 26 patients with psoriasis vulgaris (PV) were assessed using the PASI scoring system and the severities of psoriatic lesions.@*RESULTS@#Apoptotic indexes (AI) were higher in the pustular psoriatic lesions than those in the vulgaris psoriatic lesions (P0.05). The severities of psoriatic lesions were positively correlated to AI or the expression of activated caspase-3 in PV lesions (P<0.05).@*CONCLUSION@#The amount of apoptotic KCs may be related to varied types, stages of psoriasis, and severities of psoriatic lesions.

Application of~(125)I seed permanent plantation in osseous metastases / 中华放射学杂志

Objective To evaluate the value of ~(125)I permanent plantation in treating osseous metastases.Methods Twenty-two patients with osseous metastases were accepted radioactive seeds ~(125)I permanent plantation.The curative effect was appraised according to the degree of ostalgia relieving and the changing of the radiology imaging in patients.Results Accepted radioactive seeds ~(125)I permanent plantation,relief of pain was obtained and the effective rate is 91%(20/22).However none of the patients showed severe side-effect.Among 32 lesions in 22 cases followed-up by CT in 2 months,4 obtained CR, 18 obtained PR,10 NC and 0 PD.The responsive rate was 68.7%.Conclusion ~(125)I permanent plantation procedure can be a safe and effective method in treating osseous metastases and obtaining good clinical effects with minimal damage and few comnlications.

Cisplation Microspheres Chemoembolization in Combination With Chemical Infusion Therapy for Relapsed and Advanced Nasopharngeal Carcinoma / 介入放射学杂志

From April.1993 to Jan.1994,transcatheter maxillary arterial chemoem- bolization using Cisplatin microspheres(DDP-ms)in combination with PBF(DDP,BLM,5- Fu)had been used in 14 cases with regional relapsed nasopharngeal carcinoma and 3 cases of untreated locally advanced nasopharngeal carcinoma got positive response.The result showed 2 patients with Cr,13 PR,1MR and 1 NC advanced cases with PR.The total suc- cessful rate(CR+PR)was 88 24%(15/17),In addition,the main toxicity and coplicaton had been discussed.