Clinical significance of plasma NT－proBNP in children with bacterial meningitis / 中国基层医药

Objective To investigate the clinical significance of plasma amino －terminal pro －brain natriuretic peptide(NT－proBNP) in children with bacterial meningitis.Methods From April 2013 to March 2017, 32 children with bacterial meningitis in PICU of the Second People′s Hospital of Liaocheng Affiliated to Taishan Medical College were selected.The patients were evaluated the severity of the disease by Glasgow coma scale (GCS).Thirty－five cases who admitted to the hospital in the same period were selected as the control group ,excluding congenital heart disease,chronic cardiac dysfunction ,cardiomyopathy,myocarditis,heart failure,chronic renal insufficiency.The blood samples were collected from the hospital in 24h, and the levels of the plasma NT －proBNP, procalcitonin (PCT),C－reactive protein(CRP) and Na ions were determined.Results Compared with the control group ,the levels of the plasma NT－proBNP was significantly increased [(7 123.97 ±6 901.60)ng／L vs.(39.29 ±19.41)ng／L,t＝5.839,P＜0.01],the level of PCT was significantly increased [(25.14 ±2.35) ng／dL vs.(0.63 ±0.15ng／dL,t ＝10.820,P＜0.01],the level of CRP was significantly increased [(97.89 ±4.63mg／dL vs.(5.23 ±1.22mg／dL,t＝21.130,P＜0.01],and the GCS was significantly decreased (t＝18.132,P＜0.01) in children with bacterial meningitis group.The plasma NT －proBNP level of children with GCS ＜8points [( 13 328.08 ±7 938.85 ) ng／L ] was significantly higher than that in children with GCS 8～14points[(3 401.50 ±1 526.75)ng／L](t＝5.816,P＜0.01) and GCS≥15points [(39.74 ±18.64) ng／L] ( t ＝5.816,P＜0.01).There was a significant positive correlation between the level of plasma NT －proBNP and PCT ( r ＝0.969, P ＜0.01), also a significant positive correlation between the level of plasma NT －proBNP and CRP (r＝0.961,P＜0.01),while a significant negative correlation between the level of plasma NT－proBNP and sodium ions(r＝0.886,P＜0.01) in children with bacterial meningitis by Pearson correlation test.Conclusion Detection of the plasma NT－proBNP has significant clinical significance for early diagnosis and assessment of the severity of the illness of children with bacterial meningitis .

Clinical significance of plasma NT-proBNP in children with bacterial meningitis / 中国基层医药

Objective@#To investigate the clinical significance of plasma amino-terminal pro-brain natriuretic peptide(NT-proBNP) in children with bacterial meningitis.@*Methods@#From April 2013 to March 2017, 32 children with bacterial meningitis in PICU of the Second People′s Hospital of Liaocheng Affiliated to Taishan Medical College were selected.The patients were evaluated the severity of the disease by Glasgow coma scale(GCS). Thirty-five cases who admitted to the hospital in the same period were selected as the control group, excluding congenital heart disease, chronic cardiac dysfunction, cardiomyopathy, myocarditis, heart failure, chronic renal insufficiency.The blood samples were collected from the hospital in 24h, and the levels of the plasma NT-proBNP, procalcitonin(PCT), C-reactive protein(CRP) and Na ions were determined.@*Results@#Compared with the control group, the levels of the plasma NT-proBNP was significantly increased[(7 123.97±6 901.60)ng/L vs.(39.29±19.41)ng/L, t=5.839, P<0.01], the level of PCT was significantly increased[(25.14±2.35)ng/dL vs.(0.63±0.15ng/dL, t=10.820, P<0.01], the level of CRP was significantly increased[(97.89±4.63mg/dL vs.(5.23±1.22mg/dL, t=21.130, P<0.01], and the GCS was significantly decreased(t=18.132, P<0.01) in children with bacterial meningitis group.The plasma NT-proBNP level of children with GCS<8points[(13 328.08±7 938.85)ng/L]was significantly higher than that in children with GCS 8~14points[(3 401.50±1 526.75)ng/L](t=5.816, P<0.01) and GCS≥15points[(39.74±18.64)ng/L](t=5.816, P<0.01). There was a significant positive correlation between the level of plasma NT-proBNP and PCT(r=0.969, P<0.01), also a significant positive correlation between the level of plasma NT-proBNP and CRP(r=0.961, P<0.01), while a significant negative correlation between the level of plasma NT-proBNP and sodium ions(r=0.886, P<0.01) in children with bacterial meningitis by Pearson correlation test.@*Conclusion@#Detection of the plasma NT-proBNP has significant clinical significance for early diagnosis and assessment of the severity of the illness of children with bacterial meningitis.

The middle and long term curative effects of percutaneous minimally invasive surgical treatment on lumbar spinal tuberculosis / 天津医药

Objective To explore the application value of minimally invasive surgery in the treatment of lumbar spinal tuberculosis, and to provide reference for clinical treatment of spinal tuberculosis. Methods Data of 252 cases of patients with lumbar spinal tuberculosis treated by conservative treatment in our hospital from January 2005 to December 2014 were retrospectively analyzed. Patients were divided into four groups on the basis of systemic application of antituberculosis chemotherapy. A total of 154 patients were given simple local chemotherapy of percutaneous placement of focus catheter (group A), 48 patients were received percutaneous perfusion drainage and local chemotherapy (group B), 32 patients underwent percutaneous puncture catheter debridement combined with local chemotherapy (group C), and 18 patients were given percutaneous debridement and internal fixation combined with local chemotherapy catheter (group D). Data of erythrocyte sedimentation rate (ESR), visual analogue scale (VAS), Oswestry disability index (ODI) score and the modified MacNab criteria were recorded before operation and at the end of the follow-up in four groups of patients. Results Of the 252 patients, 228 were followed up and 214 patients achieved clinical cure. The lost access were15 cases in group A, 5 cases in group B, 2 cases in group C and 2 cases in group D. The total rate of lost visit was 9.52%. The follow up duration ranged from 25-126 months. The mean duration of follow-up was 68(60, 76) months. A total 214 cases reached the standard of clinical cure. No complications (retrograde infection and cross infection) were found in all patients during treatment. ESR was statistically decreased to (7.26 ± 3.43) mm/1 h at the last follow-up (t=35.06, P=0.023) compared with that (44.96 ± 12.42) mm/1 h before operation. The VAS and ODI were 1.5(1, 3) and 30(25, 35)% at the last follow-up, which were significantly improved than those [7.5(7.0, 8.0) and 60(55, 65)%] before operation (Z=13.641 and 6.806, P<0.05). According to the improved MacNab criteria, the overall excellent and good rates for patients were 86.4%(197/228) at the last follow-up. Conclusion According to the stepped care and personalized treatment, patients of lumbar tuberculosis are preoperative comprehensive evaluated, and most patients can achieve long-term stability and a better clinical efficacy after interventional and minimally invasive treatment.

Effects of Different Doses of Sufentanil Citrate on Analgesic Effects of Crouzon Syndrome Children with Cra-niofacial Reconstruction / 中国药房

OBJECTIVE:To investigate the effects of different doses of sufentanil citrate on hemodynamic indexes and stress response indexes of Crouzon syndrome children with craniofacial reconstruction. METHODS:60 cases of Crouzon syndrome under-going craniofacial reconstruction were selected from our hospital during Jan. 2010-Jan. 2016,and then randomly divided into group A,group B and group C,with 20 cases in each group. 3 groups were given pump injection of Propofol injection 4-8 mg/(kg·h)for anesthesia induction+Sufentanil citrate injection [group A 0.3 μg/(kg·h),pump injection;group B 0.6 μg/(kg·h),pump injection;group C 1.0 μg/kg,iv,0.5 h/time] for anesthesia maintenance, Cisatracurium besilate for injection 0.1 mg/kg,iv,every 40 min, drug withdrawal 5 min before the end of surgery. The hemodynamic indexes(MAP,HR)and stress response indexes(ACTH,cor-tisol)were observed in 3 groups at different time points as well as the occurrence of ADR. RESULTS:MAP levels of group C at 5 min after skin incision,1 h after operation and immediately at the end of surgery were significantly higher than before anesthesia, while those of group B were significantly higher than group C at same time points. HR of group A at 1 h after surgery and that of group B at 5 min after skin incision and 1 h after surgery were significantly higher than before anesthesias;HR of group B at 1 h after surgery was significantly lower than that of group A,and its HR at 5 min after skin incision and 1 h after surgery were signifi-cantly lower than those of group C. ACTH levels of 3 groups at 5 min after skin incision,1 h after surgery and immediately after the end of surgery were significantly higher than before anesthesia. ACTH levels of group B at 5 min after skin incision,1 h after surgery and immediately after the end of surgery were significantly lower than those of group A and C,and the group A was signifi-cantly lower than the group C at same time points. Cortisol levels of group A at 1 h after surgery,and those of group C at 5 min af-ter skin incision,1 h after surgery and immediately after the end of surgery were significantly higher than before anesthesia. Corti-sol levels of group B at 1 h after surgery were significantly lower than those of group A;cortisol levels of group A at 5 min after skin incision and immediately after the end of surgery and those of group B at 5 min after skin incision,1 h after surgery and imme-diately after the end of surgery were all significantly lower than those of group C. There were statistical significance all above(P<0.05). No obvious ADR was found in 3 groups. CONCLU-SIONS:Pump injection of sufentanil citrate 0.6 μg/(kg·h) can maintain analgesic effect of Crouzon syndrome children with craniofacial reconstruction,can keep hemodynamics sta-ble and effectively inhibit stress response during surgery with good safety.

The Principles of minimally invasive spinal surgery / 天津医药

With the development of medical science, the level of minimally invasive spinal surgery is becoming higher and higher. Comparing to the traditional operation, the postoperative effect is equal to it or slightly better than it, with the higher patient satisfaction. The minimally invasive spine surgery is gradually accepted by the majority of patients. However, compared with the traditional operation, minimally invasive spinal surgery requires that spine surgeon must be familiar with principles and related concepts of minimally invasive surgery of the spine, due to its higher degree of fine operating, long learning curve. Only by following these principles and ideas, can the minimally invasive spine surgery be healthy sustainable and rapid developed.

Analysis of distribution and drug resistance of bacteria in 1 -6 months infants with lower respiratory infection / 中国基层医药

Objective To investigate the distribution and drug resistance of bacteria in 1 -6 months infants with lower respiratory infection(LRI).Methods Induced sputum was extracted from 326 infants with LRI who were 1 -6 months.Antibiotic susceptibility tests were performed after bacteria had been identified.Results 61 cases were detected pathogenic bacteria and the detection rate of bacteria was 18.71%.5 cases were detected two kinds of bacte-ria.66 bacterial strains were isolated among which gram -positive bacteria(33 strains)accounted for 50.00% and gram -negative bacteria(33 strains)accounted for 50.00%.Staphylococcus aureus was the most common gram -pos-itive bacteria and Streptococcus pneumoniae was the second.13 strains were methicillin -resistant Staphylococcus au-reus(MRSA).Hemophilus influenzae was the most common gram -negative bacteria,followed by Klebsiella pneumo-nia and Escherichia coli among which ESBL positive Klebsiella pneumonia were 5 cases and ESBL positive Escherich-ia coli were 4 cases.The common gram -positive bacteria had higher rate of penicillin resistance.MRSA had higher rate of penicillin,oxacillin,erythomycin and clindamycin resistance.Resistant strains to vancomycin and rina thiazole amine were not found.The common gram -negative bacteria had higher rate of ampicillin,ampicillin/shu tan,cefazo-lin and ceftriaxone resistance and had lower rate of cefepime,ceftazidime,piperacillin/he azole temple and imipenem resistance.Conclusion The common pathogenic bacteria in 1 -6 months infants with lower respiratory infection were Staphylococcus aureus,Hemophilus influenzae,Streptococcus pneumoniae,Klebsiella pneumonia and Escherichia coli. We should pay attention to the common antibiotic resistance.MRSA and ESBL positive bacteria were the common mul-tiple drug resistant bacterias.Reasonable selection of antibiotics should be based on susceptibility results earlier.

Syk and VEGF-C in breast cancer's expression with lymph node metastasis / 中国免疫学杂志

Objective:To explore the relationship of Syk and VEGF-C expression in breast cancer with lymph node metastasis . Methods:The expression of Syk and VEGF-C in 40 cases of breast cancer were determined using immunohistochemistry assay .Then, the positive rates of Syk and VEGF-C were compared with lymph node metastasis .Results:The expression rate of VEGF-C and Syk in breast cancer was respectively 77.5%(31/40), 37.5%(15/40).VEGF-C protein expression was not significant related with the tumor diameter (P>0.05) and histological grade (P>0.05), but was significantly associated with lymph node metastasis (P0.05) and the histological grade(P>0.05), and was associated with lymph node metastasis (P<0.05).The difference of Syk and VEGF-C had statistics significance(P<0.05).Con-clusion:Syk and VEGF-C involved in the lymphatic invasion and metastasis , may be an important indicator of prognosis .

A Meta-analysis on the relations between Helicobacter pylori infection and chronic urticaria / 中华流行病学杂志

Objective To investigate the relationship between Helicobacter pylori (HP) infection and the development of chronic urticaria.Methods Published case-control studies which concerned HP infection related chronic urticaria were searched in Wanfang,CNKI,CQVIP Chinese databanks and PubMed.Meta-analysis was applied to analyze the pooled odds ratio (OR) and 95％ confidence interval (CI).Results 37 studies which comprised 2 909 cases of chronic urticaria and 1 873 persons served as controls were enrolled.When compared with the controls,HP infection significantly increased the risk of chronic urticaria development with a pooled OR of 3.20 (95％CI:2.31-4.43).Results from Meta-regression analyses showed that the distribution of residential areas and detection method being used were potential influential factors.Conclusion HP infection seemed to be associated with an increased risk of developing the chronic urticaria.

Overexpression of Wnt3 inhibits apoptosis of hepatic progenitor cells in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of adenoviral vector-mediated over-expression of Wnt3 on the apoptosis of hepatic progenitor cells in vitro.</p><p><b>METHODS</b>Hepatic progenitor cells transfected with Ad-GFP-Wnt3 vector or the control vector Ad-GFP were examined for cell apoptosis under fluorescence microscopy with Hoechst 33342 staining, and the proportion of apoptotic cells were determined by flow cytometric analysis with Annexin-PE/7-ADD staining. The mRNA and protein expressions of Bax, Bcl-2 and Bcl-xl in the cells were detected by real-time PCR and Western blotting, respectively.</p><p><b>RESULTS</b>Real-time PCR and Western blotting showed a high expression of Wnt3 in Ad-GFP-Wnt3-transfected hepatic progenitor cells, which exhibited significantly decreased cell apoptosis as compared with the control group. The expressions of Bcl-2 and Bcl-xl mRNA and proteins increased significantly while Bax expression decreased obviously in Ad-GFP-Wnt3-transfected cells (P<0.05).</p><p><b>CONCLUSIONS</b>Adenoviral vector-mediated over-expression of Wnt3 can suppress apoptosis of hepatic progenitor cells possibly through the Bcl-2 pathway.</p>

Treatment of unstable upper and middle thoracic vertebrae fractures with vertebral pedicle screw / 中华创伤杂志

Objective To study the clinical effect of pedicle screw fixation in treatment of unstable upper and middle thoracic vertebrae fractures. Methods A retrospective study was performed on 17 cases of unstable upper and middle thoracic vertebrae fractures treated with vertebral pedicle screw system (GSS 全称in 11 cases and USS 全称in six) fixation, posterolateral bone grafting and fusion from March 2001 on. There were one case of T_3, two T_4, two T_5, four T_6, six T_7 and two T_8. Of all, nine cases were with compression fractures, five with fracture-dislocation and three with burst fractures. Results All cases were followed up for 10-38 months (average 21.1 months). During the follow up, the anterior vertebral body height was restored from preoperative 40% to postoperative 91%. Except for four screw malpositions, there was no postoperative neurologic deterioration, screw loose or breakage of the internal fixation, or loss of the normal spine curve and the spinal height of the injured vertebra. Conclusions Pedicle screw fixation is an effective way for treating unstable upper and middle thoracic vertebrae fractures. Correct placement depend on a comprehensive familiarity of pedicle anatomy, appropriate pedicle diameter and entry point and depth can avoid potential risks in placing pedicle screws into the upper and middle thorax.

CLINICAL RESEARCH OF MALIGNANT PERIPHERAL NERVE SHEATH TUMOR(36 CASES REPORT) / 解放军医学杂志

head and neck region. Postoperative recurrence rate was 42 10%, five year survival rate was 8 33%. Not a single case was found to be malignant degeneration of neurolemmoma or neurofibromatosis, nor as a result of radiotherapy. It is suggested that MNST is a primary soft tissue malignant tumor, and early complete excision is the key treatment. The biological characteristics of this tumor as revealed in this study suggest that it is different from what was reported in the foreign literature.

Fibrin gel therapy for sacral nerve root sheath cysts by lamina vertebra puncture under CT-guide / 中华骨科杂志

Objective To study the effect of fibrin gel delivered with CT g ui ded trans-laminar injection on sacral nerve root sheath cysts. Methods From Apri l 1998 to February 2001, thirty-eight cases of sacral nerve root sheath cysts we re treated by fibrin gel injection. The location of cysts consisted of 12 L5 S1, 15 S1,2, 11 S2,3. All the fibrin gel was delivered by CT guided trans-laminar i njection. Results Thirty-eight cases were followed up for 3 to 37 months (averag e 9 months). Most of the patients obtained lower back and sacral pain and sacral nerve symptom alleviation. No infection, nerve injury, recurrence and cerebrosp inal fluid(CSF) leaking occurred. According to the critia of the clinic symptom releasing and the radiographic signs, there were 17 cases (44.7%) rated as excel lent, 18 (47.4%) good and 3 (7.9%) fair, the excellent and good rate was 92.1%. Conclusion CT-guided trans-laminar fibrin gel injection is an effective economic al and mini-invasive way to treat sacral nerve root sheath cysts.

DIAGNOSIS AND TREATMENT OF EPIDURAL NEURILEMMOMA IN SPINAL CANAL / 解放军医学杂志

To evaluate the diagnosis and treatment of epidural neurilemmoma in the spinal canal, the diagnostic characteritics shown by X ray, MRI and CT were analyzed in 42 patients. Furthermore, peri operative conditions, operative time, blood loss and amount of blood transfusion during the operation, operative technique, changes in functions of the spinal cord before and after the operation were also analyzed. The results showed that there was marked recovery of nerve functions after the operation. MRI together with X ray and CT were in the diagnosis of the nature and site of the lesion. Excision of the tumor was done in all the patients. Among them, in 12 patients internal fixation was done at the same time. Follow up showed that the operation achieved good results. While radiologic examinations contributed greatly to the diagnosis, the final diagnosis depended on pathological examination. Internal fixation was optional depending on different situations.

TREATMENT OF DEGENERATIVE LUMBAR SPONDYLOLISTHESIS WITH ORIGINAL POSITION OR REDUCTION FUSION / 解放军医学杂志

To observe the clinical outcome of degenerative lumbar spondylolisthesis treated by TFC, transpedicle instrument and bone graft, transpedicle instrument and TFC, respectively, from May 1995 to Aug. 2000, 106 patients with degenerative lumbar spondylolisthesis were conservatively treated. According to Meyerding classification system of lumbar spondylolisthesis, 56 cases were classified as degree 1, 47 cases as degree 2, 3 cases as degree 3. The patients were followed up from 6 months to 10 years and 2 months, averaged 38 months. According to different operative methods, the patients were divided into 3 groups: TFC group, transpedicle instrument and bone graft group, transpedicle instrument and TFC group. Among the 31 cases in TFC group, 22 cases were followed up, the excellent rate was 95 5%. Among the 42 cases in transpedicle instrument and bone graft group, 35 cases were followed up, the anatomical reduction rate was 83%, the excellent rate was 94 8%. Among the 33 cases in transpedicle instrument and TFC group, 28 cases were followed up, the anatomical reduction rate was 81%, the excellent rate was 96 4%. According different indications, TFC and pedicle screw systems were all effective for spondylolisthesis. They had a lower complication rate. The use of spinal instrumentation is a valuable adjunct to achieve lumbosacral fusion in patients having undergone decompressive surgery for the spine.

HYDATIDOSIS IN BONES——A REPORT OF 3 CASES / 解放军医学杂志

Characteristics found in CT and MRI of osseous hydatidosis were analyzed. The incidence of osseous hydatidosis in China, and its diagnosis and treatment were discussed. The results showed that most of osseous hydatid disease was polycystic. On CT and MRI scanning, it was shown that there were many little cysts constituting a big lesion. Scolex and cyst wall were not clearly shown. Expansive growth was its main feature. The cystic wall was shown as a linear shadow. Recurrent signs of spinal cord compression called for reoperation. The patients led an acceptable life with the disease. Surgical eradication was the main treatment,but recurrence rate was high after the operation.