Objective To realize the detection of pathogens and antimicrobial resistance of pathogens isolated from wound secretion in patients with open fractures,so as to guide clinical treatment.Methods 1 472 patients with open fractures from May 2012 to July 2013 were selected from a hospital,pathogens from wound secretions before and after debridement were identified and performed antimicrobial susceptibility testing.Results Before debride-ment,1 246 of 1 472 patients (84.65%)were isolated 2 246 bacterial strains,824 (55.98%)of patients were isola-ted at least 2 kinds of bacteria.Eight hours after debridement,201 pathogenic bacteria were isolated from 195 pa-tients (13.25%).The more serious of Gustilo type,the higher the positive rate of bacterial culture.Positive rate of wound culture were all >50% in patients of all Gustilo types before debridement;positive rate were all <5% in pa-tients of type I,Ⅱ and ⅢA,but type ⅢB and ⅢC were still high after debridement.Staphylococcus aureus and Staphylococcus epidermidis were sensitive to vancomycin,the resistant rates to furantoin were <5%,the resistant rates to penicillin G and erythromycin were all >75%.Acinetobacter baumannii had higher resistance to multiple antimicrobial agents,to cefoperazone/sulbactam was 20%;Pseudomonas aeruginosa to imipenem was 10.80%, sensitivity to cefoperazone/sulbactam,cefepime and ceftazidime were all higher.Conclusion For patients with open fractures,timely debridement can reduce wound pathogen,antimicrobial susceptibility testing result is helpful for guiding rational antimicrobial use.

Objective To investigate the neuroprotective effect of adiponectin on rats with cerebral ischemic-reperfusion injury and explore its possible mechanism.Methods Sixty-four SD rats were divided into normal group (C) and diabetic group (D) randomly.Type 2 diabetic rats model were made by high-fat diet before the middle cerebral artery occulation model (MCAO) surgery.Each group was divided into two subgroups.CAPNand DAPN groups were given exogenous recombinant globular adiponectin via jugular vein one hour after ischemic-reperfusion injury,C0 and D0 groups were given the same amount of normal saline at the same time.Body weight and blood glucose of the rats were measured before ischemia.We also evaluated the neurological function of rats 24 h after treatment according to Longa criteria and observed the morphological changes of cells in brain area via HE staining.The vascular density in ischemic-reperfusion injury area was detected through 3D confocal image system 2 weeks after the treatment.Results The body weight of diabetic rats was significantly lower than normal rats((284.06 ± 19.85)vs (220.31 ±21.87) g,t =8.634,P =0.000).Blood glucose of diabetic rats before ischemia was significantly higher than normal rats ((4.36±0.13)vs(22.92 ± 1.58) mmol/L,t =11.74,P =0.000).Compared with C0 group,the neurological function score of CAPN group was lower(2.29 ± 0.69 vs 17.0 ± 0.69,t =2.186,P =0.038).Compared with D0 group,the neurological function score of DAPN group was lower(2.89 ± 0.33 vs 2.40 ±0.51,t =2.567,P =0.018),too.HE staining showed that the neuronal injury were milder in CAPN,DAPN group,compared with C0,D0 group,respectively.Adiponectin increased the vascular density of ischemic cortex inC group ((2014.58±61.18)/0.002 mm2 vs(3211.95 ±71.64)/0.002 mm2,t =12.16,P=0.023) and D group ((502.86 ± 30.43)/0.002 mm2 vs (1426.69 ± 97.24)/0.002 mm2,t =25.64,P =0.001).Adiponectin increased the vascular density of ischemic striatum in C group (472.59 ± 4.78)/0.002mm2 vs (736.60 ±104.90) /0.002 mm2,t=7.11,P=0.007) and D group (432.04 ±4.65)/0.002 mm2 vs (1780.75 ± 74.54)/0.002 mm2,t =51.08,P =0.000).Conclusions Adiponectin exerts the neuroprotective effect on cerebral ischemic-reperfusion injury in normal and diabetic rats.And it may protect the brain through promoting angiogenesis.

Objective To observe the dynamic changes in matrix metalloproteinase-12(MMP-12) expression during the course of development of radiation pulmonary injuries in order to get an insight of the roles played by MMP-12 during early tissue remodeling after radiation pulmonary injuries.Methods Twenty-four Wistar rats were randomly assigned into four groups(6 each): normal control group and 1,2 and 4 weeks after irradiation groups.The rats in the last three groups received irradiation of the whole lung with 20Gy of 60Co ?-ray,and they were sacrificed 1,2 and 4 weeks post irradiation.The gene expression of MMP-12 was determined by RT-PCR;the protein expression was detected by Western blot;MMP-12 activity was examined by gelatin zymography;the tissue distribution of MMP-12 was observed by immunohistochemistry;the degradation and collapse of elastin were observed after tissue elastin specific staining.Results The gene expression of MMP-12 began to increase 1 week post irradiation,then decreased at 2 weeks,and it reached its peak value at 4 weeks,while its protein expression was elevated again 2 weeks post irradiation.MMP-12 was mainly expressed in macrophages and activated fibroblasts of the alveolar septum.With the elapse of time,the lung injury aggravated gradually,with thickening of alveolar wall and septum,breakdown of the structure of alveoli,collapss of a part of the alveolar space,extensive breakdown of elastin in the basement membrane of lung,appearing as irregular fibrils distributed in the lung.Conclusion 60Co ?-ray irradiation can up-regulate the expression of gene and protein of MMP-12 significantly,implying that it may play a very important role in early remodeling process in of radiation pulmonary injuries,and initiate the process of pulmonary remodeling by degrading elastin and destroying the normal structure of basement membrane.

Objective To test if the quality of produced water could come up to the standards of clinical biochemistry,and e-valuate the effect of the produced water after replacement of a new reverse osmosis film of the laboratory water purification system.Methods The ion concentration of the produced water was tested by ohmmeter in Beckman Coulter supporting TianChuang water purification system TCHS-RO/100A and HM COM-100 conductivity meter.The biochemical index ALT,AST,TBIL,ALP,GGT,TP,ALB,BUN,CR,UA,GLU,TC,TG,HDL,LDL,CK,LDH,P,Ca of mixed serum were tested 20 times by AU680 under the condition of normal purified water(control group),and the same operation were repeat-ed after changing to newly produced water(experimental group)to evaluate the effect of newly produced water to biochemi-cal analysis.The triglyceride (TG)reagent blank was tested 3times/d for 5 days to evaluate the glycerin level in the pro-duced water.Results The conductivity of purified water was reduced to (0.1±0.0)μS/cm 30 min after starting up by HM COM-100,and the electric resistance of purified water remained stable at 18.25MΩcm 50min after starting up.During the bi-ochemical analysis by AU680,the value of TG in control group=1.04 mmol/L,in experimental group=21.39 mmol/L,the differences showed statistical significance (P<0.01),but the bias of the others were limited in 5%,CV<1/4CLIA’88,and differences showed no statistical significance (P>0.05).The reagent blank was stable at A660nm=0.015 6±0.000 4 in the fifth day.Conclusion After produced approximately 2 800 L purified water in the system,glycerine could be cleaned up in produced water.It is needed to continuously test the quality of produced water to evaluate the effect of which to clinical bio-chemistry after replacement of a new reverse osmosis film.

Objective The purpose of this article is to analyze the domestic situation of co-authorship in the field of international classification of diseases using Social Network Analysis.Methods Using UCINET to do this research from the following five perspectives,namely density,degree centrality,betweenness centrality,closeness and subgroup analysis.Results The density of co-authoring network is 0.0021.The number of nodes which made up the main component accounts for 3.46％ of the total nodes.Lin Jie-zhong possesses the highest value of degree centrality,and Guo Yun-qing's value of betweenness centrality and closeness is the highest.Forty-four 2-plexes are found in all authors.Conclusions Currently,the co-authorship is not close,but to a certain extent,the authors liked Lin Jie-zhong,Liang Yao,Li Jian-wei,Fan Wei,Guo Yun-qing,Liu Ai-min and so on constitute the core members or leaders.From the overall point of view,the authors in this field have not yet formed a subgroup phenomenon obviously.The structure of this co-authoring network is loose and isolated.

Objective:To classify the interforaminal arch form of edentulous mandibles by measuring the anterior-posterior distance (A-P distance) of implants planned to be inserted in All-on-4 protocol using conebeam computed tomography (CBCT) data, and to investigate the influence of the arch form on the All-on-4 distally tilted implants.Methods: Seventy-four CBCT images of edentulous mandibles were collected, including 35 males and 39 females respectively.All-on-4implant supported fixed prostheses were designed for these patients based on the CBCT data.The A-P distance was measured in the plane which crossed bilateral mental foramens and was parallel to the occlusal plane.The interforaminal arch form of edentulous mandibles were classified according to the A-P distance.The radian of the jaw arch 7.5 mm mesially to the mental foramen was measured bilaterally, and its correlation with the A-P distance was studied.Results: The average A-P distance of implant supported fixed prostheses planned in the interforaminal region was (8.5±1.5) mm (minimum 4.5 mm, maximum 11.8 mm).In the study, 12.2% of the subjects'' mandibles were classified as square arch form with A-P distances ≤7 mm, 54.0% were classified as ovoid with A-P distances >7 mm and ≤9 mm, 33.8% were classified as tapered with A-P distances >9 mm.Bilaterally, 148 results of the radian of the jaw arch 7.5 mm mesially to the mental foramen were obtained, and the average radian was 15.9°±5.5° (minimum 5.6°, maximum 35.2°).The radian and the A-P distance showed a negative correlation with statistical significance.Conclusion: In this research, the ovoid arch form was the most common type in edentulous mandibles, followed by tapered arch form.The square arch form showed the lowest percentage.As the arch form went squarer, the A-P distance became shorter, the radian of the jaw arch mesially to the mental foramen went greater, and the bone width that distally tilted implants need became bigger.The interforaminal arch form of the edentulous mandible should be analyzed before an implant supported fixed restoration is designed in the interforaminal region.The angle of inclination of distal implants should be reasonable.The bone width of the distal implant site must be adequate.The square arch form contributes negatively to the structure of implant supported fixed prostheses with distal cantilever design.

Objective To investigate the correlations of serum adipocyte fatty acid-binding protein (AFABP),adiponectin (APN) and A-FABP/APN ratio with acute ischemic stroke (AIS) and its subtypes.Methods The consecutive patients with AIS (AIS group) of having complete data admitted within 24 hours of onset were enrolled,and at the same time,the healthy subjects of age,sex and body mass index matched with the AIS group were selected as a control group.The demographic characteristics and general clinical data of the AIS group and control group were collected.The serum A-FABP and APN levels were detected by enzymelinked immunosorbent assay.The patients in the AIS group were further divided into large artery atherosclerosis (LAA),small artery occlusion,(SAO),cardioembolism (CE),and stroke of other determined etiology (SOE) according to the TOAST classification criteria.Multivariable logistic regression analysis was used to investigate the relationship between all factors and AIS and its subtypes.Spearman correlation analysis was used to analyze the correlations of the A-FABP and APN levels and the NIHSS scores.Results The serum A-FABP level (P =0.017) and A-FABP/APN ratio (P =0.002) in the AIS group were significantly higher than those in the control group,and the serum APN level was significantly lower than that in the control group (P =0.011).Multivariate logistic regression analysis showed that the increased serum A-FABP level (odds ratio [OR] 1.48,95％ confidence interval [CI] 1.07-1.93; P =0.009) and the A-FABP/APN ratio (OR 1.59,95％ CI 1.10-2.34; P =0.002) as well as the decreased APN level (OR 0.36,95％ CI 0.14-0.65; P =0.011) were independently associated with AIS.And the A-FABP/APN ratio was better than the correlation of both separately.The serum A-FABP level and A-FABP/APN ratio in the LAA,SAO and CE groups were significantly higher than those in other subtype groups (all P ＜0.05),and the APN level was significantly lower than that in other subtype groups (P ＜0.05).Multivariate logistic regression analysis showed that the increased serum A-FABP level and A-FABP/APN ratio as well as the decreased APN level were independently associated with LAA,SAO and CE,and the A-FABP/APN ratio was better than the correlation of both separately.The baseline NIHSS score was positively correlated with the serum A-FABP level (r =0.236,P =0.019),it was negatively correlated with the serum APN level (r =0.307,P =0.002),and the correlation of the serum AFABP/APN ratio was higher than that of A-FABP or APN (r =0.326,P =0.001).Conclusions The increased serum A-FABP level and the decreased APN level may serve as the new risk factors for AIS,especially LAA,SAO and CE subtypes,and they can reflect the severity of AIS.

Objective To explore the effects of granulocyte colony stimulating factor (G-CSF)on chronic cerebral ischemia in rats,and its possible mechanism.Methods Chronic cerebral ischemia (2-VO) model was prepared and bilateral external jugular veins were isolated.A total of 30 rats were divided into 2 groups at random sham group (received no intervention,n=15) and operative group (received G-CSF or PBS through external jugular vein injection,n=15).At 6 weeks after operation,the rats in operative group were divided into G--CSF group (received G-CSF 10 mg/L,1 ml · kg-1 · d-1,1 times every 24 h for,3 times) and PBS control group (received PBS 10 mg/L,1 ml ·kg 1 · d-11,1 times every 24 h for 3 times).At 8 weeks after the operation,morris water maze was carried out to evaluate the learning and memory ability of the rats.The cell proliferation,threedimensional vascular distribution,ischemic neuronal apoptosis,cell morphological changes in ischemic area and the plasma VEGF levels were detected to explore the possible mechanisms.Results In morris water maze,escape latency at the 2rd to 5th day were significantly lower in G-CSF group than the PBS group (all P＜0.05).The swimming time spent in the first quadrant in G-CSF group was significantly longer than the PBS group (P＜0.05).There was a significant difference in the number of BrdU positive cells in the ischemical area between the G-CSF group and the control group [(27.7±4.76) vs.(10.4 ± 3.7),P =0.030).Three-dimensional quantitative measurements of vascular structure showed that the capillary diameters was smaller in the G-CSF group than in the PBS group [(2.90±0.20) μm vs.(3.45±0.26) μm,P=0.020] and the number of branch points in the boundary regions of ischemia had a significant difference in the G-CSF group compared with the control group [(207.82±10.73) /0.002 mm3 vs.(162.10±9.31) /0.002mm3,P=0.005].Threedimensional cerebral vessel surface area in the ipsilateral hemisphere was increased in the G-CSF group compared with the PBS group [(86498±2896) μm2/0.002 mm3vs.(73976±3826) μm2/0.002 mm3,P=0.003].The number of apoptotic cells in G-CSF group was decreased compared with the PBS group [(32.10±6.70) vs.(56.30±11.20),F=11.89,P=0.043].The electron microscope morphological observations showed inflammatory edema in intercellular gap was significantly reduced in the G-CSF group compared with the PBS group.The level of plasma VEGF was significantly increased in the G-CSF group compared with the PBS group [(58.81±6.61) ng/L vs.(20.81±4.35)ng/L,P=0.025].Conclusions G--CSF can improve the learning and memory ability in the chronic cerebral ischemic rats,and its possible mechanism might involve the nerve protection and the vascular regeneration associated with the VEGF.There is a great prospect for G-CSF in the therapy of chronic cerebral ischemic disease.

Objective To observe the effects of over-expression of matrix metalloproteinase-12 (MMP-12) on the transformation of pulmonary fibroblasts in radiation damaged rats. Methods Thirty-two male Wistar rats (weighed 250-280g) were randomly assigned into control group and 1, 2 and 4 weeks after irradiation groups (8 each). The whole lungs of rats in irradiation groups were irradiated by 60 Co ?-ray at a dose of 20Gy, and the lung specimens were harvested 1, 2 and 4 weeks after radiation. The change of MMP-12 activity was detected by gelatin zymography, the degradation and collapse of elastic fibers were observed by tissue specific staining, the "cross talking" phenomenon between alveolar type Ⅱ cells and mesenchymal cells was observed by transmission electron microscopy, the content of TGF-?1 was determined by ELISA, and the expression of ?-smooth muscle actin (?-SMA) was examined by immunohistochemistry. Results MMP-12 activity began increasing 1 week after irradiation, and seemed to decrease 4 weeks after irradiation. Elastin, a part of the basement membrane of alveolar wall, began to degrade and collapse 1 week after radiation, and became worse 4 weeks after irradiation. The expressions of both TGF-?1 and ?-SMA were elevated gradually within 4 weeks after radiation. The "cross talking" phenomenon was found by electron microscopy between alveolar type Ⅱ cells and mesenchymal cells. Conclusions Increased activity of pulmonary MMP-12 has been found after radiation, which may promote the transformation of pulmonary fibroblasts by degrading elastin and ultimately initiate the pulmonary fibrosis.

Objective To explore the clinical features of mitochondrial encephalomyopathy lactic acidosis and strokelike episodes (MELAS) syndrome in fratemal twins brothers.Methods The clinical data,the results of laboratory examinations,electroencephalogram (EEG),imaging,and gene detection,and the process of diagnosis and treatment were retrospectively analyzed the fraternal twin brothers with MELAS syndrome.Results The proband,a 7-year-old male,had intermittent headaches,vomit and twitching at onset.He suffered from exercise intolerance,fatigue,accompanied by short stature and hairy.The fasting blood lactic acid level was increased.Multiple video EEG showed the slowdown of background activity.Head MRI showed recurrent lesions with the characteristics of migration and variation.The point mutation rate of mtDNA A3243G was 34.7％.The diagnosis of MELAS was confirmed.At the same time,his fraternal twin brother was screened and found that his point mutation rate of A3243G was 30.0％.Although there was no clinical symptom at that time,he was onset with convulsion after 3 years.Conclusions Gene detection and family screening are helpful for the early diagnosis of MELAS.The mutation rate of A3243G is very high,which can cause an early onset and serious clinical symptoms.