Hemodynamic Analysis on Anomalous Origin of the Right Coronary Artery from the Left Coronary Artery Sinus / 医用生物力学

Objective To analyze the hemodynamic parameters of anomalous origin of the right coronary artery from the left coronary artery sinus (AORL) based on computational fluid dynamics (CFD), so as to make an evaluation of the disease. Methods A normal right coronary artery (RCA) case and an AORL case were selected. Two models were reconstructed in Mimics software and imported into ANSYS CFX software for hemodynamics simulation. The hemodynamics of normal RCA model and AORL model were compared. Results AORL model had a smaller volume flow (9.35 cm3/s), which might lead to insufficient blood supply downstream of the RCA; the pressure at the acute corner of AORL model (13.78 kPa) was lower than normal RCA model (14.9 kPa); the wall shear stress (WSS) of AORL model (12.83 Pa) was larger than that of normal RCA model (9.74 Pa); the total deformation of AORL model was relatively large. Conclusions The entrance velocity and pressure of AORL were lower than those of normal RCA, which might lead to ischemic symptoms. The research findings are of theoretical significance for the effective evaluation of ischemia and other diseases in clinic.

Pathogenic bacteria and drug resistance in 132 cases of peritoneal dialysis related peritonitis / 中国感染与化疗杂志

Objective To investigate the pathogens and their antibiotic resistance in patients with peritoneal dialysis‐related peritonitis .Methods The clinical data including pathogens ,antibiotic resistance profile of 213 patients with peritoneal dialysis‐related peritonitis who were treated in our peritoneal dialysis center from January 2011 to December 2013 were analyzed retrospectively .Results Dialysate culture was positive for 132 (62 .0% ) of the 213 cases ,resulting in a total of 140 strains of microorganisms ,including 84 strains of gram positive cocci ,37 strains of gram‐negative bacilli ,10 strains of fungus and 9 strains of gram positive bacilli . Coagulase‐negative Staphylococcus was the most common gram positive bacteria while Escherichia coli was the most common gram negative bacteria isolated from the effluent .The prevalence of methicillin‐resistant S .aureus and methicillin‐resistant coagulase negative Staphylococcus was 14 .3% (1/7) and 43 .2% (19/44) ,respectively . About 44 .4% (8/18) of the E .coli and K . pneumoniae isolates produced extended spectrum beta‐lactamases .All the gram‐positive cocci were sensitive to vancomycin and linezolid and slightly resistant to chloramphenicol (6 .3% ) , moxifloxacin (8 .5% ) , and rifampicin (9 .5% ) , but highly resistant to cefazolin (90 .0% ) ,followed by ampicillin (76 .7% ) ,oxacillin (71 .2% ) and penicillin (69 .7% ) . Coagulase negative Staphylococcus isolates were sensitive to vancomycin , linezolid , tigecycline , quinupristin‐dalfopristin and daptomycin ,but all resistant to cefazolin and ampicillin ,and highly resistant to penicillin (91 .9% ) and oxacillin (82 .5% ) .All the gram‐negative bacilli were sensitive to meropenem ,ertapenem ,cefoperazone‐sulbactam and tigecycline .About 80 .6% and 65 .5% of the gram‐negative bacilli were resistant to ampicillin and peperacillin ,respectively .E .coli isolates were sensitive to meropenem ,ertapenem and piperacillin‐tazobactam but highly resistant to ampicillin (81 .3% ) and piperacillin (71 .4% ) . Conclusions Gram‐positive cocci especially Staphylococcus and gram negative bacteria E .coli are major pathogens in peritoneal dialysis‐related peritonitis .Adequate microbiological culture and suitable antimicrobial therapy are key to successful treatment of the peritonitis associated with peritoneal dialysis .

Expression and significance of HMGB1 and RAGE in patients with lupus nephritis / 安徽医科大学学报

Objective To explore the role of high mobility group box protein 1 ( HMGB1 ) and receptor for ad-vanced glycation endproducts( RAGE) in lupus nephritis( LN) . Methods The serum and urine levels of HMGB1 were detected by ELISA in SLE patients and normal controls, and intrarenal expressions of HMGB1 and RAGE were detected by immunohistochemistry in renal tissues of SLE patients and normal-appearing renal tissues. Results The serum and urine levels of HMGB1 were significantly higher in SLE patients compared to healthy controls( P<0. 01 ) , in patients with active disease compared to those with inactive disease ( P <0. 05 ) , serum levels of HMGB1 were found to be significantly higher in patients with renal involvement compared to those without renal in-volvement(P<0. 05). In addition, the levels of serum HMGB1 showed positive correlation with SLEDAI,urine pro-tein(24 h) and lencocyte count (P <0. 05). The expression of urine HMGB1 showed positive correlation with SLEDAI ( P<0. 05 ) . Intermediate-intensity staining of HMGB1 and RAGE was detected in renal tubules in normal-appearing renal tissues, however, both renal tubules and glomerular cells had the strong expression of HMGB1 and RAGE in SLE patients. The intrarenal production of HMGB1 and RAGE in SLE patients was obviously higher than that in normal-appearing renal tissues(P<0. 05), and the expression levels of HMGB1 in SLE IV and IV+V were higher than those in SLE II ( P<0. 05 ) . The expression levels of RAGE in SLE IV were higher than those in SLE II(P<0. 05). Conclusion HMGB1 and RAGE may play key roles in the pathogenesis of LN and may associate with the pathology category of LN.

Longtime soaking of high concentration tranexamic acid in total hip arthroplasty: a prospective randomized controlled trial in 224 patients

Objectives: To evaluate the efficacy and safety of intra-articular Soaking of high concentration Tranexamic Acid [TXA] in total hip arthroplasty

Methods: From March 2013 to March 2014, 224 patients who underwent unilateral primary THA in our hospital was enrolled in this randomized, prospective double-blinded study. The patients were allocated into two groups according to intra-articular solution received: Intra-articular soaking of TXA group, Control group [physiologic saline]. The solution was injected from intermuscular space following fixation of the implants and closure of articular capsule, short external rotators. Total blood loss, total volume of drainage and transfusion were recorded. Postoperative deep vein thrombosis and other complications was also measured

Results: The mean total blood loss was 730 +/- 296 ml in intra-articular soaking of TXA group compared with 1048 +/- 295ml in control group [P<0.05].The postoperative mean total volume of drainage was 93 +/- 50 mL in intra-articular soaking of TXA group versus 312 +/- 136 mL in control group.22 patients [19.8%, control] and 6 patients [5.3%, Intra-articular soaking of TXA] required transfusion [P=0.001].Postoperative deep vein thrombosis and other complications were no statistical significance between the two groups

Conclusions: Intra-articular soaking of high concentration TXA with 2-hour clamping drain can reduce the total blood loss and transfusion rates in primary THA without significant increase in postoperative thrombotic complications

Effect of methionine-enkephalin on proliferation and mechanism involved by opiate receptor of peripheral blood lymphocyte from patients with systemic lupus erythematosus / 中国药理学通报

AIM\ To observe the effect of methionine enkephalin(Met Enk) on proliferation and mechanism involved by opiate receptor of peripheral blood lymphocyte(PBL) from patients with systemic lupus erythematosus(SLE). METHODS\ Lymphocyte proliferation assay. RESULTS\ Naloxone (Nal,1?10 -6 mol?L -1 )could block the increasing effect of Met Enk(1?10 -8 ～1?10 -6 mol?L -1 )on the PBL proliferation of normal humans,but there was no direct effect on that. However,Nal could not only block the promotive action of Met Enk on PBL proliferation of SLE patients,but there was a direct decreasing effect on it. CONCLUSION\ Endogenous Met Enk may participate in the abnormal regulation with SLE PBL via opiate receptor.