BACKGROUND: Acinetobacter baumannii (AB) bacteremia is an increasingly common and often fatal nosocomial infection. Identification of morbidity and mortality risk factors for AB bacteremia in emergency department (ED) patients may provide ways to improve the clinical outcomes of these patients. METHODS: The records for 51 patients with AB bacteremia and 51 patients without AB infection were collected and matched in a retrospective case-control study between 2013 and 2015 in a singlecenter ED. Risk factors were analyzed by Chi-square and multivariate logistic regression statistical models. RESULTS: A signifi cant risk factor for morbidity was the presence of a central venous catheter (CVC) (P<0.001). The mortality rate for the 51 patients with AB bacteremia was 68.6%. Risk factors for mortality were the presence of a CVC (P=0.021) and an ED stay longer than two weeks (P=0.015). CONCLUSION: AB infections lead to high morbidity and mortality. The presence of a CVC was associated with higher morbidity and mortality in patients with AB bacteremia. Avoiding CVC insertions may improve outcomes in ED patients with AB bacteremia.

Abundant evidences indicate a role of GABAergic system in the pathogenesis of neuropsychiatric dis-orders. GABAA receptors modulators have been long used in clinical. But the unwanted side-effect and risk of drug dependence have limited their use. With the increase understanding of the role of individual GABAA recep-tor subtypes in the pathology of these diseases, the subtype-selective GABAA receptors modulators and the multi-compound therapy may serve as potential therapeutic strategies. Here we review the researches which revealed the involvement of GABAA receptors in anxiety, depression and schizophrenia, and the research for new development in subtype-selective GABAA receptor modulators.

Glaucoma is a group of irreversible blind eye diseases with specific optic nerve damage and visual field defect. Early diagnosis and treatment of glaucoma is vital for prognosis, but difficult in clinical practice. Macular ganglion cell complex thickness(mGCC) consists of the inner three layers of retina:retinal nerve fiber, ganglion cell and inner plexiform layers, which is glaucoma target tissue so to be measured the thickness of the mGCC as better indicator for early diagnosis in glaucoma. Optical coherence tomography ( OCT ) is a non-contact, good repeatability technique to obtain fast high- resolution images from the anterior and posterior segments of the eye, and it has been widely used in ophthalmology. Spectral- domain ( SD ) OCT allows a higher image resolution and can measure the thickness of mGCC thickness, providing new parameters for the early diagnosis of glaucoma.

Anti-Bacterial Agents ; therapeutic use ; Antibiotic Prophylaxis ; Dry Socket ; drug therapy ; etiology ; Humans ; Inflammation ; drug therapy ; Mandible ; Molar, Third ; microbiology ; surgery ; Surgical Wound Infection ; drug therapy ; etiology ; Tooth Extraction ; adverse effects ; Tooth, Impacted ; microbiology ; surgery

Objective To determine the prevalence of dental anxiety in children patients before tooth extraction.Methods　A modified Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and Venham's clinical ratings of anxiety and cooperative behavior were used in 150 children patients ranging in age from 5 to 12 years olds before tooth extraction. The former scale was answered by parents on behalf of their children, and the latter ratings was assessed by the author. Results　CFSS-DS scores and clinical ratings of behavior of the children were significantly higher in the children whose oral hygiene condition, dental experience, tooth extraction experience, spirit status on that day and whose mother's educational background were bad or low. A step regression analysis showed that oral hygiene condition had most significant interrelationship with both of the two scales（P＜0.01）. The correlation of the two scales was high (r=0.67).Conclusion　Children’s oral hygiene condition, dental experience, tooth extraction experience, spirit status on that day and their mother’s educational background are closely related to the dental anxiety level. Oral hygiene condition is the most important predictor of anxiety level before extraction and clinical ratings of behavior during extraction.

Existing antidepressants exhibit delayed onset of action,which can decrease the compliance of the patients and enhance the risk of suicide.How to produce early-onset antidepressants with higher efficacy and lower adverse reactions has become a crucial point in the research of antidepressants.It has been demonstrated that selective 5-HT1Aantagonist,?2 antagonist and 5-HT2Aantagonist can accelerate the response of classic antidepressants.Furthermore,5-HT/NE dual reuptake inhibitor and 5-HT/NE/DA triple reuptake inhibitor can also produce early onset of action.Here,several reasons for the delayed onset of action and the progress in the development of early-onset antidepressants are reviewed.

AIM: To observe the efficacy of intravitreal injection with ranibizumab combined with laser photocoagulation for macular edema ( ME ) secondary to macular branch retinal vein occlusion( MBRVO) .
METHODS:A retrospective analysis included 33 patients (33 eyes) with ME secondary to MBRVO were taken. All patients received intravitreal injection of 0. 5mg ranibizumab ( 0. 05ml ) at first visit. The continue PRN treatment and laser photocoagulation were based on the visual acuity changes and optical coherence tomography findings. The changes of best corrected visual acuity ( BCVA) , central macular thickness( CMT) , and amplitude density and latency of P1 wave in mfERG were observed before treatment and 6mo after treatment.
RESULTS: Before the treatment, logMAR was 0. 68±0.35, 6mo after treatment was 0. 34±0. 23, BCVA was improved obviously ( P < 0. 01 ), BCVA in 21 patients ( 63.64%) were improved in two rows among all the patients. CMT before treatment was(487. 30±63. 58) μm, after treatment was(238. 84±52. 66) μm(P<0. 01). The amplitude densities of P1 wave in ring 1, ring 2 and ring 3 after treatment were significantly increased(all P<0. 01), and the latencies were decrease ( all P < 0. 05 ). The conjunctival hemorrhage was observed in 2 eyes after treatment.
CONCLUSION: Intravitreal injection with ranibizumab combined with laser photocoagulation for ME secondary to MBRVO can reduce the CMT and improve visual function.

Objective To observe the clinical efficacy of ginger-partitioned moxibustion in improving blood flow velocity in lower limbs of post-stroke patients.Methods Ninety post-stroke patients were randomized into a treatment group and a control group, 45 in each group. The treatment group was intervened by ginger-partitioned moxibustion, while the control group was by conventional acupuncture. Before and after intervention, the blood flow velocity in lower limbs, National Institute of Health Stroke Scale (NIHSS) and modified Barthel Index (MBI) were evaluated.Results After 4-week treatment, the maximum blood flow velocity (Vmax) was significantly changed in the treatment group (P<0.05), and there was a significant difference in comparing the Vmax between the two groups after intervention (P<0.05); the NIHSS and MBI scores were significantly changed after intervention in the treatment group (P<0.05), and there was a significant difference in comparing MBI score between the two groups after intervention (P<0.05).Conclusions Ginger-partitioned moxibustion can accelerate the blood flow velocity in lower limbs of the post-stroke patients, improve blood circulation and the activities of life.

OBJECTIVETo investigate the therapeutic effect of V-Y advanced flap pedicled with posterior perforator from medial malleolus for small skin defect at achilles tendon region.

METHODSFrom Mar. 2011 to Sep. 2012, 7 cases with small skin defect at achilles tendon region were treated by V-Y advanced flap pedicled with posterior perforator from medial malleolus. The flaps was 6.0 cm x 3.0 cm-9.0 cm x 4.5 cm in size. The defects at the donor sites were closed directly.

RESULTSAll flaps survived completely. 7 cases were followed up for 6-8 months after operation. The flaps had good texture and color match. The function of ankle was normal. All patients were satisfied with postoperative function and shape.

CONCLUSIONIt is an ideal reconstruction method for skin defect at achilles tendon region with V-Y advanced flap pedicled with posterior perforator from medial malleolus. It is easily performed with low risk and short recovery time.

Achilles Tendon ; injuries ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Surgical Flaps ; Treatment Outcome ; Young Adult

Objective To compare the roles of Toll-like receptor 4 (TLR4)/NF-κB signal pathway in acute lung injury (ALl) induced by blunt chest trauma and by blunt chest trauma-hemorrhagic shock and resuscitation (double hits) in rats.Methods Forty male Sprague-Dawley rats,aged 8 weeks,weighing 240-280 g,were randomly assigned into 3 equal groups (n =10 each) using a random number table:sham operation group (S group),blunt chest trauma group (T group),and blunt chest trauma and hemorrhagic shock and resuscitation group (group THSR).Lung contusion was induced in anesthetized rats by dropping a 300 g weight onto a precordial protective shield to direct the impact force away from the heart and toward the lungs.Blood was withdrawn via the femoral artery 5 min later until MAP was decreased to 35-45 mmHg within 15 min and maintained at this level for 60 min,followed by resuscitation.At 6 h after the model was established,the arterial blood samples were collected for blood gas analysis and detection of tumor necrosis factor-alpha (TNF-α) concentrations in serum.Oxygenation index (PaO2/FiO2) was calculated.The rats were then sacrificed and pulmonary specimens were obtained for determination of TLR4 expression and NF-κB ac tivity (by immunohistochemistry and Western blot) in lung tissues and for microscopic examination.Results Compared with group S,PaO2 and PaO2/FiO2 were significantly decreased,PaCO2 and TNF-α concentrations in serum were increased,TLR4 expression was up-regulated,and NF-κB activity was enhanced in T and THSR groups (P ＜ 0.05).Compared with group T,PaO2 and PaO2/FiO2 were significantly decreased,PaCO2 and TNF-α concentrations in serum were increased,TLR4 expression was up-regulated,and NF-κcB activity was enhanced in THSR group (P ＜ 0.05).The histopathological damage to lung tissues was aggravated in THSR group as compared with T group.Conclusion The role of TLR-4/NF-κB signal pathway in ALI induced by blunt chest traumahemorrhagic shock and resuscitation (double hits) is significantly stronger than that in ALI induced by blunt chest trauma alone in rats.