Objective Broadcast storm caused by excessive datastream is dealt with by using VLAN (Virtual Local Area Network). Methods Through the VLAN, according to the location, roles and departments, network users or internet users, which application procedures and protocols are devided info groups. Results According to the hospital's network equipment and application situation, the local area network division of 16 VLAN is designed. Conclusion There are very good application prospects on improving the network manageability and providing better security.

Ventilator associated pneumonia (VAP) is a challenging complication of critical illness.Aerosolized antibiotic is an option for the management of VAP currently,as it is reported that it could increase levels of drug in alveolar without increasing systemic toxicity.The articles that focused on the aerosolized antibiotics in the treatment of VAP and its influence factors were reviewed,and it was found that to achieve maximum drug delivery efficiency and reduce the influence of nebulization method,some factors,such as ventilation modes,tidal volume,nebulizer type,should be adjusted and monitored during the treatment.

Objective To explore the effects of improved preparation before urodynamic examination in the elderly patients with voiding disfunction.Methods Totally 424 elderly patients underwent urodynamic examination after improvement of the preparation approach according to pathophysiological characteritics of the elderly patients,and 248 elderly patients before the approach improved in our center were collected as control.The compliance,discontinuation and repetition rate of urodynamic examination were compared between the two groups.Results The compliance of patients who used the improved preparation approach was significantly higher than control (92.5％ vs.59.3％,x2=106.428,P＜0.001).Whereas the discontinuation and repetition rates of urodynamic examination in the improved group were decreased as compared with control group ( 1.2％ vs.6.9％,x2 =14.176,P=0.0002; 8.5％ vs.21.4％,x2 =21.487,P＜0.001).Conclusions The improved preparation approach according to the pathophysiological characteritics of elderly patients is worthy to popularize in the urodynamic centers.

Objective To explore the expressions and significance of miRNA - 101,enhancer of ZESTE homo-log 2(EZH2)and transforming growth factor(TGF)- β1 in the kidneys with complete uniateral ureteral obstruction (CUUO). Methods Thirty male SD rats,(6 ± 1)weeks old,weighted(150 ± 10)g,were divided into sham group, 7 - day group with CUUO and 14 - day group with CUUO by using random number table method,10 rats in each group. The obstructed kidney samples were collected in 7 and 14 days,respectively,for detecting the expression of miRNA -101 by real time - polymerase chain reaction(RT - PCR)and TGF - β1 and EZH2 protein by Western blot,immuno-histochemistry and hematoxylin - eosin staining. Their correlated expressions were analyzed. Results RT - PCR results showed that the expressions of miRNA - 101 in sham group and 7 - day group with CUUO were(12. 69 ± 1. 60)times and(3. 74 ± 1. 24)times which were higher than those of 14 - day group with CUUO,respectively,there was a signifi-cant difference among these 3 groups(P ﹤ 0. 05). The expressions of TGF - β1 and EZH2 proteins were 1. 14 ± 0. 12, 1. 04 ± 0. 14,0. 76 ± 0. 18 and 1. 04 ± 0. 04,0. 89 ± 0. 03,0. 73 ± 0. 02 in 14 - day group with CUUO,7 - day group with CUUO and sham group,respectively. There was a negative correlation between miRNA - 101 with EZH2( r =- 0. 92,P ﹤ 0. 05),and negative correlation with TGF - β1(r = - 0. 63,P ﹤ 0. 05),and positive correlation between EZH2 and TGF - β1(r = 0. 67,P ﹤ 0. 05);the expressions of miRNA - 101,EZH2 and TGF - β1 were associated with each other in obstruction renal in different time periods. Conclusions With the extension of obstruction time, miRNA - 101 expression decreased,EZH2 and TGF - β1 expression increased,evidently,which indicates that the de-velopment of renal interstitial fibrosis may be affected through regulating EZH2 expression of renal obstruction through miRNA - 101 in the young rats.

Objective To evaluate the impact of age on the bladder-urethral function and the outcome of transurethral resection of the prostate (TURP) in the elderly men with benign prostatic hyperpiasia (BPH). Methods The elderly men with BPH undergoing TURP were divided into young elderly group [n=158, mean age of 68 + 4 years] and elderly group [n=47, mean age of 80± 3 years]. All patients were evaluated by International Prostate Symptom Score (IPSS). Quality of life (QOL). transrectal ultrasound and urodynamic examination one week before TURP, and they were followed by IPSS, QOL. free uroflowmetry and postvoid residual urine volume (PVR) measurement at 3 months after TURP. Results The incidence rates of detrusor overactivity, low compliance bladder, detrusor underactivity and benign prostatic obstruction in elderly group were 70%, 34%, 19% and 77% respectively, and they were significantly higher than in young elderly group (42%, 18%, 6.3% and 58%,x2 =10.623, 4.328, 5.637,4.771,P<0.05). However, the mean max detrusor voided pressure [62±29) cm H2O] was significantly lower in elderly group than in young elderly group [(76±22) cm H2O,t =3.265, P<0.05]. Moreover, the mean prostatic length, static functional length and bladder neck pressure were (52±8) mm, (63±11) mm and (36 15) cm H2O respectively, they were significantly higher in elderly group than in young elderly group [(47±7)mm, (59±6) mm and (25±13) cm H2O, t=4.157, 3.388 and 4.912,P<0.05]. The IPSS, QOL and PVR were significantly lower after TURP than beforeTURP, and the max flow rate (MFR) was significantly higher after TURP than before TURP in both groups (tyoung elderly group= 19.744, 64.671, 23.342 and 27.504;t elderly group= 27.308, 19.311,9.694 and 11.671, P<0.05). However, the MFR was significantly lower in elderly group than in young elderly group, and PVR and QOL were significantly higher in elderly group than in young elderly group after TURP (t=3.493, 15.245 and 10.750, P<0.05). Conclusions The risk of bladder-urethral dysfunction is increased and the therapeutic effects of TURP is decreased with ageing in the elderly men with BPH. It would be beneficial to have an urodynamic study for their treatment.

Seeding is the crucial step in bone tissue engineering. In current study, static and dynamic seeding methods for human bone marrow stem cells (hBMSCs) were compared. The methods for assay of DNA content in the constructs after seeding were adopted. The optic microscopy for histological apearance and the scanning electron microscopy (SEM) and fluorescent RT-PCR for osteogenic markers were performed. The maximal initial seeding concentration in static seeding is lower than that in dynamic seeding. Histology and SEM revealed the even distribution and spreading of cells in the dynamically seeded constructs, but showed cell aggregation in the statically seeded counterparts. Fluorescent RT-PCR again revealed stronger osteogenic potential of dynamically seeded constructs. Therefore, this initial study demonstrated that dynamic seeding of human bone marrow stem cells is a promising technique in bone tissue engineering.
Bone Marrow Cells ; cytology ; Cell Culture Techniques ; methods ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Humans ; Mesenchymal Stromal Cells ; cytology ; Osteogenesis ; Tissue Engineering ; methods

OBJECTIVE: Abnormalities of liver-related indices are common in ICU patients, but the effects of cholestasis and hypoxic hepatitis in critically ill patients remains unclarified. The purpose of this study was to investigate the effects of cholestasis and hypoxic liver dysfunction on the prognosis of ICU patients. METHODS: A retrospective study was conducted based on the data of patients admitted to the ICU for the first time between 2001 and 2011 archived in the MIMIC-Ⅲ database. The patients were divided into cholestasis, hypoxic hepatitis and control groups, and their 28-day case fatality rate as the primary outcome was compared among the groups. RESULTS: A total of 5852 ICU patients were included in the analysis. The incidence of cholestasis and hypoxic liver dysfunction was 31.9% (1869/5852) and 17.9% (1046/5852), respectively. There was no significant difference in 28-day case fatality rate between cholestasis group and the control group. Compared with the control group, the patients with hypoxic hepatitis had a significantly higher 28-day case fatality rate (46% 35%, < 0.01), a higher hospital case fatality rate (40% 31%, < 0.01), and a higher ICU case fatality rate (35.7% 22.2%, < 0.01). Logistic regression analysis showed that lactic acid (LAC), aspartate transaminase (AST), and international standard ratio (INR) were independent risk factors for 28-day case fatality rate. CONCLUSIONS The incidence of cholestatic liver dysfunction is higher than that of hypoxic hepatitis, but it does not increase the 28-day case fatality rate of the ICU patients, suggesting that cholestatic liver dysfunction may be the early adaptation of the liver to critical diseases.
Cholestasis ; Hepatitis ; Humans ; Intensive Care Units ; Prognosis ; Retrospective Studies

Objective:To report our experience in treatment of patients with orthopaedic trauma during COVID-19 epidemic.Methods:We retrospectively analyzed the 67 patients with orthopedic trauma who had been treated at Department of Orthopaedics, Peking Union Medical College Hospital from February 1 to March 31, 2020. After screening for COVID-19 infection was performed under strict protection, the patients were diagnosed and assigned to outpatient emergency treatment or hospitalization according to their specific condition. Twenty-six patients were treated at the outpatient emergency department. They were 8 males and 18 females with an average age of 69.5 years. Of them, 6 with vertebral compression fracture were placed on bed brakes, 14 with limb fracture immobilized after close reduction, 2 with skin laceration treated with debridement and suture, and 4 with hip fracture immobilized in bed. In the 41 hospitalized patients, there were 14 males and 27 females with an average age of 68.5 years. In them, hemiarthroplasty was performed for 7 femoral neck fractures, kyphoplasty for 5 vertebral compression fractures, total elbow arthroplasty for one humeral intercondylar fracture, exploration and suture for one case of Achilles tendon rupture, and internal fixation surgery for the remaining 27 cases.Results:Most of the patients had osteoporotic fractures which accounted for 61.5% (16/26) of the outpatients and 68.3% (28/41) of the inpatients, respectively. The duration from injury to surgery averaged 2.3 days and the length of hospitalization 4.5 days for the 41 hospitalized patients, decreased compared with the corresponding data (3.1 days and 11.5 days) for the similar inpatients in the same period last year. In the 41 inpatients, fever was observed upon hospitalization in 4 cases and after operation in 26 cases, and related to their primary injury or surgical trauma in all. Acute pulmonary embolism happened during operation in one patient with femoral shaft fracture.Conclusions:The prevention and control of COVID-19 should be continued. The awareness and behavior of health care providers are expected to be enhanced by strict screening protocol, protection and supervision. The proportion of elderly patients with osteoporotic fracture increased during the COVID-19 pandemic. Shortage of blood was the major problem affecting the treatment. Timely surgical treatment should be indicated for the patients with orthopedic trauma, especially those with lower extremity fracture.

Objective: To investigate the effects of fecal microbiota transplantation on septic gut flora and the cortex cholinergic anti-inflammatory pathway in rats. Methods: Sixty clean grade male Sprague-Dawley (SD) rats were divided into normal saline (NS) control group, sepsis model group and fecal microbiota transplantation group by random number table, with 20 rats in each group. The rat model of sepsis was reproduced by injection of 10 mg/kg lipopolysaccharide (LPS) via tail vein, the rats in the NS control group was given the same amount of NS. The rats in the fecal microbiota transplantation group received nasogastric infusion of feces from healthy donor on the 1st day, 2 mL each time, for 3 times a day, the other two groups were given equal dose of NS by gavage. Fecal samples were collected on the 7th day after modeling, the levels of intestinal microbiota composition was determined using the 16SrDNA gene sequencing technology. The brain function was evaluated by electroencephalogram (EEG), and the proportion of each waveform in EEG was calculated. After sacrifice of rats, the brain tissues were harvested, the levels of protein expression of α7 nicotinic acetylcholine receptor (α7nAChR) were determined by Western Blot, and positive cells of Iba-1 in brain tissue were detected by immunohistochemistry method. The levels of interleukins (IL-6 and IL-1β) and tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbent assay (ELISA). Results: Seven days after the reproduction of the model, all rats in the NS control group survived, while 10 rats and 8 rats died in the sepsis model group and fecal microbiota transplantation group, respectively, with mortality rates of 50% and 40% respectively. Finally, there were 20 rats in the NS control group, 10 in the sepsis model group and 12 in the fecal microbiota transplantation group. Compared with the NS control group, the diversity and composition of intestinal flora were changed, the incidence of abnormal EEG increased significantly, the expression of α7nAchR in the cortex decreased significantly, and the levels of Iba-1, TNF-α, IL-6 and IL-1β were significantly increased in the model group, suggested that the intestinal flora was dysbiosis, and severe inflammatory reaction occurred in the cerebral cortex, and brain function was impaired. Compared with the model group, the diversity of intestinal flora in the fecal microbiota transplantation group was significantly increased (species index: 510.24±58.76 vs. 282.50±47.42, Chao1 index: 852.75±25.24 vs. 705.50±46.50, both P < 0.05), the dysbiosis of intestinal flora at phylum, family, genus level induced by LPS were also significantly reversed, and with the improvement of intestinal flora, the incidence of abnormal EEG waveforms was lower in the fecal microbiota transplantation group compared with that in the model group [25.0% (3/12) vs. 80.0% (8/10), P < 0.05], and the expression of α7nAChR protein in the cerebral cortex was significantly increased (α7nAChR/β-actin: 1.56±0.05 vs. 0.82±0.07, P < 0.05), immunohistochemistry analysis showed that Iba-1 positive expression of microglia decreased significantly, and cerebral cortex TNF-α, IL-6, IL-1β levels were significantly decreased [TNF-α (ng/L): 6.28±0.61 vs. 12.02±0.54, IL-6 (ng/L): 28.26±3.15 vs. 60.58±4.62, IL-1β (ng/L): 33.63±3.48 vs. 72.56±2.25, all P < 0.05]. Conclusion The results reveal that fecal microbiota transplantation has remarkably modulated the dysbiosis of intestinal microbiota and activated cholinergic anti-inflammatory pathway, and ameliorate the brain dysfunction in septic rats.