BACKGROUND:Antibiotics are widely given for surgical patients to prevent infection. Because of the lack of study on the rational use of antibiotics in patients with human immunodeficiency virus (HIV) -infected during surgical procedures, we analyzed the risk factors affecting postoperative infectious complications in HIV-infected patients and explore the rational use of perioperative antibiotics. METHODS:This retrospective study consisted of 308 HIV-infected patients, 272 males and 36 females, who had undergone operation at the Shanghai Public Health Clinical Center from November 2008 to April 2012. The patients were divided into postoperative infection and non-infection groups. Their age and clinical variables were compared. The correlation between surgical incision, surgical site infection (SSI) and postoperative sepsis was analyzed. Prophylactic antibiotics were used for patients with type I and II incisions for less than 2 days. Patients with type III incisions were given antibiotics until the infection was controlled. Antiretroviral therapy (ART) was prescribed preoperatively for patients whose preoperative CD4 count was <350 cells/μL. For those patients whose preoperative CD4 count was <200 cells/μL, sulfamethoxazole and fluconazole were given preoperatively as prophylactic agents controllingPneumocystis carinii pneumonia and fungal infection. RESULTS:A total of 196 patients developed postoperative infectious complications, and 7 patients died. Preoperative CD4 counts, ratio of CD4/CD8 cels, hemoglobin level, and postoperative CD4 counts, hemoglobin and albumin levels were risk factors of perioperative infection in HIV-infected patients. Patients with a preoperative CD4 count <200 cel/μL, anemia, a postoperative CD4 count <200 cel/μL or albumin levels <35 g/L were correlated with a higher rate of perioperative infection. There was a significant correlation between SSI and the type of surgical incision. The rate of SSI in patients with type I surgical incision was 2％ and in those with type II surgical incision was 38％. Allthe patients who received type III surgical incision developed SSI, and they were more likely to develop postoperative sepsis. CONCLUSIONS:HIV-infected patients are more likely to develop postoperative infectious complications. The rational use of antibiotics in HIV-infected patients could help to reduce the rate of postoperative infectious complications in these patients.

Objective To investigate the present status of casualty epidemiology in Zhengzhou and the effects of different trauma care model.Method Statistic study of the classification of emergency disease and the number of ambulance responses to the call in Zhengzhou emergency rescue center from January,2004 through December 2006 was carried out and the efficiency between the trauma care model of an inclusive emergency rescue survices station and that of a simple emergency survices station was analyzed.Results The percentage of ambulance departure responses by Zbengzhou emergency rescue center for trauma care was 45.3 %,44.7 % and 45.8% of in 2004,2005 and 2006,respectively.There were 26 emergency rescue service stationa in Zhengzhou, including one independent station,eight internal medicine dominated semi-independent stations and seventeen simple model stations.The indicated surgical intervention can lye performed on the patients with severe multi- trauma in the independent emergency station in order to win the optimal operation time and reduce the mortality. Conclusions The trauma is the major reason for the emergency call.Emergency rescue service stations properly distrihtted,can offer quick and efficient pro-hospital first aid.The independent emergency rescue service station can increase successful resuscitation rate of serious casualties.

Objective:To do factor analysis related to post-stro ke anxiety.Method:206 inpatients(male 126,female 80,mean age 63?16 )with stroke were tested with SAS,DNF,MMSE,LES and ADL.Results:T h e rate of anxiety after 1 month of stroke in our sample was 18.4%(38 cases).Mu lt i-factorial analysis showed,many factors including female,younger at onset,sever ity of stroke,poor general physical condition,less compliance with treatment,and other psycho-social factors(heavier family burden,less income,more life events, less social support)were all associated with anxiety after stroke.Conchus ion:Anxiety is a common complication after stroke,its occurrence were asso ciated with a variety of factors including severity of illness and psychosocial factors.

ObjectiveTo explore the renal functions of vasopressin-deficient Brattleboro(BB) rats by using different concentrated Gadolinium-diethylenetetramine pentaacetic acid(Gd-DTPA) dynamic enhanced magnetic resonance imaging(MRI).MethodsThe study included 14 BB rats(male rats of 3 month-old) and 14 normal male Wistar rats used as control group.Dynamic MRI was performed by using either a low dosage(0.05 mmol/kg) or a high dosage of Gd-DTPA(0.5 mmol/kg).Data of 0-60 min renal cortex,medulla and pelvic were obtained after using contrast medium.MRI of kidneys at different time was analyzed and the mean relative signal intensity(RSI) was measured.Then the RSI curves of different groups were marked.Data of each group were caculated separately by SPSS 11.0 software.ResultsThe findings demonstrated that RSI curves of the vasopressin-deficient kidneys showed different patterns as compared with those of the control group(P

OBJECTIVETo study the immuno-tolerance mechanism of the third-party bone marrow-derived mesenchymal stem cells (BMSCs) in the allogeneic transplantation.

METHODSForty female C57BL/6 mice and forty male BALB/C mice were respectively used as donors and recipients in skin allogenic graft model. Forty male BALB/C mice were divided randomly into 4 groups: blank control group, CP group, BMSCs group , CP + BMSCs group, with 10 mice in each group. Before skin graft, high-dose abdominal injection of cyclophosphamide (200 mg/kg, 2 d, q. d.) was performed in recipient mice in CP and CP + BMSCs groups. On the transplantation day, a bonus of 2 x 10(6) BMSCs from the SD rat (SD-BMSCs) were injected through the tail vein in the BMSCs and CP + BMSCs groups. The observation and HE staining of skin grafts were used. The expressions of CD29, CD34, CD45 and CD90 of cells were analyzed by using flow cytometry in order to identify BMSCs. The CD4+, CD25+, Foxp3 and Treg cells of spleen were detected by flow cytometry. Cytokine in peripheral blood of recipient mice were measured by ELISA, including TGF-beta, IL-10 and IFN-gamma. T cells were co-cultured with 60Co-irradiated bone marrow MSCs from different individuals. The proliferative activity of T cells were evaluated with MTT assay.

RESULTSThe skin graft survival time was significantly prolonged in the CP + BMSCs group, as compared with that in the blank control group, the CP group, the BMSCs group, respectively. Cells cultured by whole bone marrow adherent cultivation showed CD29 (99.7%), CD44+ (96.7%), CD34- (1.6%), CD45- (1.3%). Compared with the control group and CP group, the ratio of the CD4+, CD25+, Foxp3+ and Treg cells significantly increased in the SD-BMSCs group and CP + BMSCs group (P < 0.05). Analysis of peripheral blood by ELISA showed significant high level of TGF-beta, IL-10 and low level of IFN-gamma in BMSCs group and CP group,compared with that in control group. When co-cultured with BMSCs from different individuals, T- lymphocytes proliferation decreased apparently in SD-BMSCs group and C57-BMSCs group (P < 0.05), but there was no significant difference between SD-BMSCs group and C57-BMSCs group (P > 0.05).

CONCLUSIONSThe immunotolerance mechanism of the third-party bone marrow-derived mesenchymal stem cells in the allogeneic transplantation might be associated with its effect on the proliferation of Treg cells and increasing expression of TGF-beta and IL-10, decreasing expression of IFN-gamma.

Animals ; Bone Marrow Cells ; immunology ; Female ; Immune Tolerance ; Interferon-gamma ; immunology ; Interleukin-10 ; immunology ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; immunology ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Rats ; Rats, Sprague-Dawley ; Skin Transplantation ; T-Lymphocytes, Regulatory ; immunology ; Transforming Growth Factor beta ; immunology ; Transplantation, Homologous

OBJECTIVETo study postoperative sepsis in HIV/AIDS patients who underwent abdominal operations.

METHODSA retrospective analysis was performed to study 34 HIV/AIDS patients treated between January 2009 and December 2010 at the Shanghai Public Health Clinical Center Affiliated to Fudan University.

RESULTSThere were 31 males and 3 females in this cohort with a mean age of 45±13 years. Nineteen patients developed postoperative sepsis. The levels of preoperative CD4, postoperative CD4, preoperative CD4/CD8, and postoperative platelet were significantly lower than those without sepsis (all P<0.05). Among 19 patients with a preoperative CD4 cell count less than or equal to 200×10(6)/L, the incidence of postoperative sepsis rate was 84.2%(16/19), and for those with a preoperative CD4 cell count greater than 200×10(6)/L, the incidence of postoperative sepsis rate was 20.0%(3/15), the difference was statistically significant(P<0.05). There were 3 postoperative deaths.

CONCLUSIONCD4 cell count can be used as a predictive marker for the development of postoperative sepsis in patients with HIV/AIDS.

Abdomen ; surgery ; Adult ; Aged ; CD4 Lymphocyte Count ; CD4-Positive T-Lymphocytes ; immunology ; Female ; HIV Infections ; complications ; immunology ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Sepsis ; etiology ; Young Adult

The research aimed to investigate the therapeutic effects and mechanisms of Opuntia dillenii Haw polysaccharide (OPS) on atherosclerosis of rats. First atherosclerotic rat models were established by high-fat and high-calcium diet. Thirty days later, the rats were treated with low dosage of OPS (0.2 g x kg(-1) x d(-1)) or high dosage of OPS (0.4 g x kg(-1) x d(-1)) by intraperitoneal injection for 60 days continuously. At the end of treatment, thoracic aorta rings were prepared and vasorelaxation of rat thoracic aorta in different experiment groups were determined by using 620M multi wire myograph system in vitro. Blood and livers of rats were collected. Then plasma levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein (LDL) of rats were separately determined using whole automatic biochemical analyzer; protein level of hepatic apolipoprotein B (ApoB) and that of hepatic diglyceride acyltransferase (Dgat1) were measured by Western Blot technique. Results showed that the ability of rat thoracic aorta to relax decreased markedly in the model group compared with that in the normal group, and significant differences existed in vasorelaxation ratios induced by different concentrations of carbamylcholine chloride (Carb) between these two groups (P < 0.01). After OPS treatment, the ability of rat thoracic aorta to relax improved markedly, the vasorelaxation ratios induced by Carb at 5 and 10 μmol x L(-1) were respectively 0.34 ± 0.08 and 0.62 ± 0.15 in the group treated with low dosage of OPS, while the ratios induced by Carb at 1 and 5 μmol x L(-1) were respectively 0.54 ± 0.08 and 0.98 ± 0.02 in the group treated with high dosage of OPS, which were all significantly different with those in the model group (P < 0.01). Plasma contents of TC, TG and LDL reduced significantly by the treatments both with low and high dosages of OPS compared with those in the model group (P < 0.01). Protein level of hepatic ApoB and that of hepatic Dgat1 decreased significantly after the treatment with high dosage of OPS compared with those in the model group (P < 0.01). These results indicate that OPS can markedly improve the vasorelaxation of thoracic aorta of atherosclerotic rats and has significant anti-atherosclerotic effect; inhibiting the expression of ApoB and Dgat1 and thus decreasing the amounts of TC, LDL and TG serving as one of the molecular mechanisms of its antiatherosclerosis effect.
Animals ; Aorta, Thoracic ; drug effects ; Atherosclerosis ; drug therapy ; Cholesterol ; blood ; Lipoproteins, LDL ; blood ; Opuntia ; chemistry ; Phytotherapy ; Rats ; Triglycerides ; blood

Objective To investigate the change of the basic fibroblast growth factor(bFGF) leve in human detrusor muscle(DM)in bladder outlet obstruction(BOO)due to benign prostatic hyperplasia(BPH)and its implication.Methods Fifty-four patients with BPH were divided into two groups:the obstructive DM stability and instability groups;and 15 men with bladder tumor who underwent operation in the same period were enrolled in the control group.The bFGF mRNA level in DM was measured by reverse transcription and polymerase chain reaction(RT-PCR)and the bFGF protein level was measured by immunohistochemical staining method.Results The bFGF-mRNA expression level of bladder smooth muscle cells was significantly lower in the control group than that in the obstructive DM stability and instability groups(all P＜0.05),but there was no significant difference between the obstructive DM stability and instability groups(P＞0.05). Conclusions The expression level of bFGF mRNA in bladder DM is elevated in BOO due to BPH,but there is little or no correlation between the increased expression of bFGF mRNA and detrusor muscle instability.

OBJECTIVETo study effects of soy extract on lipid metabolims in ovariectomized rats.

METHOD90 Wistar rats were randomly divided into 9 groups: control group, sham group, model group, estrogen group, soy isoflavone group of high dose, soy isoflavone group of low dose, soy extract of high dose, soy extract of low dose, and soy polysaccharde group, 10 rats in each group. Except fer of control and sham groups, the test rats were ovariectomized. One week after operation, the rats were treated with different drugs. Six weeks after operation, the rats were killed, with serum and liver taken, and serumglycerol(sGT), cholesterol(sGC), LDL, HDL and liver homogenate hGT, hGC, measured.

RESULTThe level of sGC, LDL in ovariectmized rats increased significantly, compared with that in control and sham groups. In liver both the level of hGT and hGC were higher than that in liver from control and sham groups. Administration of estrogen or soy extract or soy isoflavone could attenuate these in ovariectomized rats, but soy polysacchardes did not have any effects.

CONCLUSIONOvariectomized rats have an imbalance of lipid metabolism, the level of hGT and hGC were increased, and administration of estrogen, soy extracts or soy isoflavone could decrease these changes induced by ovariectomizing.

Animals ; Cholesterol ; blood ; metabolism ; Estriol ; analogs & derivatives ; pharmacology ; Female ; Isoflavones ; isolation & purification ; pharmacology ; Lipoproteins, LDL ; blood ; Liver ; metabolism ; pathology ; Ovariectomy ; Plant Extracts ; isolation & purification ; pharmacology ; Quinestrol ; analogs & derivatives ; Random Allocation ; Rats ; Rats, Wistar ; Soybeans ; chemistry ; Triglycerides ; blood ; metabolism

AIMTo investigate the role and mechanism of endothelium-derived hyperpolarizing factor (EDHF) in shear stress induced vasorelaxation of rat mesenteric artery.

METHODSThe changes in vessel diameter in response to variable flow (0-300 microL.min(-1)) were continuously examined. The contribution of prostacyclin (PGI2), NO and EDHF to shear stress induced relaxation were analyzed by inhibitory effects of indomethacin, N(G)-nitro-L-arginine (L-NA) and KCl. The nature and hyperpolarizing mechanism of EDHF were examined by the inhibitory effects of inhibitors of cytochrome P450 pathway and of various K+ channels.

RESULTSThe shear stress-induced relaxation were endothelium dependent and the contribution of NO was more prominent in large mesenteric arteries (400-500 microm) than that in resistance arteries (150-250 microm), whereas that of EDHF was noted in both-sized blood vessels. Tetrabutylammonium (a nonselective inhibitor of K channels) almost abolished, whereas the combination of charybdotoxin (an inhibitor of both large and intermediate-conductance Ca2+-activated K channels) and apamin (an inhibitor of small-conductance Ca2+-activated K channels) significantly inhibited the EDHF-mediated component of the shear stress-induced relaxations.

CONCLUSIONEDHF plays an important role in shear stress-induced endothelium-dependent relaxations, and K channels especially calcium-activated K channels appear to be involved.

Animals ; Apamin ; pharmacology ; Biological Factors ; physiology ; Charybdotoxin ; pharmacology ; Cytochrome P-450 Enzyme Inhibitors ; Endothelium, Vascular ; drug effects ; physiology ; In Vitro Techniques ; Large-Conductance Calcium-Activated Potassium Channels ; antagonists & inhibitors ; Male ; Mesenteric Arteries ; drug effects ; physiology ; Nitric Oxide ; physiology ; Potassium Channel Blockers ; pharmacology ; Proadifen ; pharmacology ; Quaternary Ammonium Compounds ; pharmacology ; Rats ; Rats, Wistar ; Small-Conductance Calcium-Activated Potassium Channels ; antagonists & inhibitors ; Vasodilation ; drug effects