BACKGROUND:Periprosthetic joint infection is a complication that is difficult to deal with after joint arthroplasty. Early diagnosis is the key to treatment. To find a fast response, high-sensitivity and high-specificity molecular biomarker can significantly optimize the diagnosis process of periprosthetic joint infection. OBJECTIVE:To monitor blood procalcitonin, interleukin-6 and lipopolysaccharide binding protein levels, to compare with blood leukocyte count and C-reactive protein levels, to identify above indexes, and to distinguish sensitivity and specificity of periprosthetic joint infection. METHODS: A total of 81 patients with pain after arthroplasty who were treated in Affiliated Hospital of Jining Medical Colege from January 2008 to December 2013 were enroled in this study. The repair surgery of al patients was divided into two stages. In the first stage, complete debridement and the instalation of temporary occupancy device were conducted. After 3 months averagely, two-phase reconstruction was performed. At 1 day before surgery, venous blood was colected. Calcitonin, interleukin 6, lipopolysaccharide binding protein, leukocyte count and C- reactive protein levels were detected. During the operation, synovial membrane and sample of false envelope around the prosthesis were colected. Bacterial and histological examinations were performed. The sensitivity and specificity were calculated using receiver operating characteristic curve.
RESULTS AND CONCLUSION: One-way analysis of variance results showed that the receiver operating characteristic curve of lipopolysaccharide binding protein was bigger, 0.962; 95 confidence interval 0.924-1.000. Diagnostic value was optimal, and the critical value was 23.5 μg/L. These data suggested that when lipopolysaccharide binding protein exceeded 23.5 μg/L before surgery, periprosthetic joint infection would be identified. The receiver operating characteristic curve of C-reactive protein was 0.871. The receiver operating characteristic curve of leukocytes was close to 0.5. The diagnostic value of leukocyte count on periprosthetic joint infection was not great. These findings indicate that lipopolysaccharide binding protein has good application prospect in the diagnosis of periprosthetic joint infection after joint replacement, and shows high positive predictive rate and negative predictive rate of periprosthetic joint infection.

Objective To study the feasibility of microsurgical technique to denervate sympathetic of femoral artery in rabbit, providing a reliable animal experimental model for further study of the mechanism of neuralization in bone tissue engineering.Methods From July, 2014 to July, 2015, 21 New Zealand white rabbits were divided into 4 groups randomly: the control group (n =3), the 4 weeks group (n =6), the 8 weeks group (n =6) and the 12 weeks group (n =6).Bilateral femoral arteries of the 21 rabbits were exposed.Adventitia of femoral arteries in 3 test groups were removed for about 2cm by microsurgical technique, whereas adventitia of the control group remained intact without any treatment.The arteries samples were collected at 4 weeks, 8 weeks and 12 weeks after treatment.The structure of vascular were indicated by hematoxylin-eosin (HE) staining, and the distribution and volume of the sympathetic fibers were evidenced by glyoxylic acid staining and the expression of tyrosine hydroxylase (TH), the marked protein of sympathetic.Results The adventitia of 3 test groups were invisible or lost most of it while the control group remained intact shown by HE staining.For glyoxylic acid staining, the fluorescence intensity value of the control group, 4 weeks group, 8 weeks and 12 weeks were 0.08124 ± 0.00260, 0.02920 ± 0.00206, 0.02661 ± 0.00233, 0.03094 ± 0.00211, respectively (n =6).The distribution and fluorescence intensity of sympathetic nerve were both significantly reduced in test groups compared to the control group (P ＜ 0.05).And there was no statistical difference among the 3 test groups (P ＞ 0.05).Semi-quantitative analysis of the expression of TH was 0.8626 ± 0.03519, 0.3631 ± 0.03019, 0.3964 ± 0.02239, 0.3487 ± 0.02356 respectively, which showed the same tendency as glyoxylic acid staining test.Conclusion Microsurgical technique is promising as an ideal method for the local denervation of sympathetic nerve from artery system as it can significantly reduce sympathetic fibers on adventitia without regeneration during the experimental period.

ObjectiveTo explore the clinical features, treatment, and outcomes of tachycardia induced cardiomy-opathy (TIC) in children.MethodsThe clinical data of 20 children with TIC hospitalized from January 2007 to October 2014 were retrospectively analyzed.ResultsIn 20 patients with TIC, there were 11 infants, one toddler, 5 pre-school age children, and 3 adolescent patients were as follows: 15 cases of atrial tachycardia (distributed in each age group), 3 cases of paroxysmal supraventricular tachycardia (2 in infancy and one in adolescence), and 2 cases of ventricular tachycardia (2 in infancy). After the treatment of anti-arrhythmic drugs, sinus rhythm was restored in 11 patients and ventricular rate was controlled in 5 patients while poor effect of drug was found in one patient who received radiofrequency ablation eventually and got cured. Three patients received radiofrequency ablation after admission immediately. Compared with those before treatment, left ventricular ejection fraction (LVEF) and left ventricular diastolic diameter (LVDD) measured by cardiac ultrasonography were signiifcantly improved after treatment (P<0.01).ConclusionsTIC is common in infancy. Atrial tachycardia is the main type of arrhythmia. Generally drug therapy is the ifrst choice in the treatment of TIC but in older children and those refractory to drug therapy the radiofrequen-cy ablation is chosen.

Objective To establish a specific HPLC method and a standard fingerprint for quality control ofZiziphi Spinosae Folium.Methods The samples were separated on a Kinetex C18 column (100 mm × 2.1 mm,2.6 μm) by gradient elution at the flow rate of 300 μL/min using acetonitrile and 0.1％ aqueous formic acid as the mobile phase.The column temperature was 30℃.The detection wavelength was 225 nm and the sample size was 10 μL.The fingerprint evaluation software (2012 edition) for Chinese materia medica (CMM) was used to evaluate the similarity of the 12 batches of samples.Results There were 13 characteristic peaks identified in the characteristic spectra ofZiziphi Spinosae Folium samples.Peak 6 was Rutin.The similarities of 13 batches ofZiziphi Spinosae Folium samples were proved to behigher than 0.850.Conclusion The method is available with a good reproducibility and accuraty which can control the quality standards effectively.

Objective To study the conditions and methods of hydrodynamics-based transgene into rat regenerating liver in vivo. Methods The solution with concentration 30mg/L gene-containing plasmid was injected into rat tail veins at a speed of 2ml/s, then partial hepatectomy (PH) was performed at different times before/after injection, finally the rat (g) and regenerating liver (g) were weighed, and the liver coefficient (Lc) was calculated. Out of 15 groups which are Lc±Lc*0%, *5%, *10%, *15%, *20%, *25%, *30%, *35%, the most suitable group was chosen as correction coefficient to calculate the most appropriate volume of plasmid solution which was injected into the regenerating liver at different recovery times, and at the same time, right lobe of liver was gathered to make frozen section, then observe and quantify the positive green fluorescent protein (GFP) rate at 488 nm excitation wavelength. Results Injection of either physiological saline or empty plasmid has no significant difference compared with control (only PH performance). The appropriate time of hydrodynamics-based transgene is more than 12 hours before PH or anytime after PH. The solution volume of hydrodynamics-based transgene into liver regenerating rat after PH is rat weight (g) ×9%×1/3×corresponding correction coefficient (Trc). Both vector and target gene have effect on the time and abundance of gene expression. Conclusion Hydrodynamics-based transgene can effectively be applied to gene transfection in rat regenerating liver.

In this article, medical consumable materials supply catalog technology was introduced through the principle, method and application of topic studies, at the same time bar code tags to tag and identify medical consumable materials were introduced. These two techniques established the correspondence between the real supplies logistics and information flow system, provided foundation for medical supplies all process tracking and traceability management. Supply catalog and encoding identification technology provide a new solution for the effective management of medical consumable materials.
Automatic Data Processing ; Materials Management, Hospital ; methods

Objective To explore the prognostic impact of miR137 target gene Kruppel-like transcription factor 12 (KLF12) in multiple myeloma (MM). Methods The target genes of miR137 were predicted by software. The GFP analysis of KLF12 and the prognosis of MM were constructed. Overexpressing miR137 in MM NCI-H929 cell line was also constructed. Real-time qPCR and Western blot were used to detect the expression of KLF12 in this cell line. Results The target genes of miR137 were MITF, BUE2H, SH3BP5 and KLF12. High expression of KLF12 in 455 patients included 75 patients (16.5 %) died, 104 patients with low expression of KLF12, and 25 patients (24.0 %) died, but no significance was detected in the different subgroups. KLF12 expression was higher in MM NCI-H929 cell line with miR137 over expression. The expression of miR137 was positively correlated with the expression of KLF12. Conclusion miR137-KLF12 is an important index to judge the prognosis of MM.

Objective:To study the diagnostic value of non-enhanced lesions on enhanced CT in lung consolidation for necrotizing pneumonia in children.Methods:A total of 101 cases of necrotizing pneumonia with air sacs on CT scan who were hospitalized in the Department of Respiratory Intervention, Qilu Children′s Hospital of Shandong University from August 2016 to September 2018 were enrolled in this study(group with air lucency). Besides, another 75 cases of lobar pneumonia with non-enhanced lesions in lung consolidation but without air sacs on enhanced CT were also included from the same hospital over the same period(group without air lucency). Clinical data of these patients were retrospectively collected and statistically analyzed.Results:The white blood cell count was (12.5±5.5)×10 9/L in group with air sacs and (10.8±4.1)×10 9/L in group without air sacs, and the difference was statistically significant( t=-2.161, P=0.032). There was no statistical difference between the group with and without air sacs in age, gender distribution, the course prior to admission, duration of fever after admission, length of hospital stay, medical expense, the neutrophils percentage in peripheral blood, C-reactive protein, the erythrocyte sedimentation rate, serum procalcitonin, serum D-Dimer, serum lactate dehydrogenase, serum albumin, bronchoscopy times, the bronchial mucosal erosion ratio, the mucus plug score, the lavage purulent lavage ratio, and the ratio of luminal stricture or atresia in late bronchoscopy(all P>0.05). Conclusions:The clinical course of patients with non-enhanced lesions in lung consolidation but without air sacs is almost identical to that of patients with air sacs on CT scan.The presence of non-enhanced lesions in lung consolidation can be used as diagnostic basis of necrotizing pneumonia in children.

Objective:To study the early predictors of Mycoplasma pneumoniae necrotizing pneumonia in children.Methods:Clinical data of 291 children with lobar pneumonia caused by Mycoplasma pneumoniae who were hospitalized in Department of Respiratory Intervention, Qilu Children′s Hospital of Shandong University from August 2016 to September 2018, were retrospectively analyzed.The patients were divided into necrotizing pneumonia group (154 cases) and non-necrotizing pneumonia group (137 cases). After comparing clinical characteristics, laboratory tests, and bronchoscopy findings, multivariate logistic regression analysis was carried out on the indicators with statistical significance to obtain the independent predictive indicators of Mycoplasma pneumoniae necrotizing pneumonia, and then the cutoff value with the maximum diagnostic value of each indicator was found through receiver operating characteristic (ROC) curve analysis.Results:There were no significant differences in gender and age distribution, duration before admission, and platelet count between the 2 groups(all P>0.05). Necrotizing pneumonia group manifested with 11.0(8.3-14.4)×10 9/L of white blood cell count, 0.740±0.115 of neutrophil, 44.2(21.2-72.0) mg/L of C-reactive protein(CRP), 55(35-80) mm/1 h of erythrocyte sedimentation rate, 0.19(0.08-0.60) ng/L of procalcitonin, 2.63(1.62-3.79) mg/L of plasma D-dimer, 456(340-665) U/L of serum lactate dehydrogenase, (35.6±4.3) g/L of serum albumin, 121 cases(78.6%)of bronchoscopic mucosal erosion, 75 cases(48.7%)of purulent lavage, 119 cases(77.3%)of massive secretions embolism; non-necrotizing pneumonia group manifested with 8.7(6.9-11.6)×10 9/L of white blood cell count, 0.660±0.127 of neutrophil percentage, 15.9(7.5-34.3) mg/L of CRP, 45(30-60) mm/1 h of erythrocyte sedimentation rate, 0.10(0.06-0.20) ng/L of procalcitonin, 0.69(0.46-1.24) mg/L of plasma D-dimer, 314(250-419) U/L of serum lactate dehydrogenase, (38.9±3.7) g/L of serum albumin, 53 cases(38.7%)of bronchoscopic mucosal erosion, 20 cases(14.6%)of purulent lavage, and 76 cases(55.5%)of massive secretions embolism.All the above indicators had statistical differences between the 2 groups.Erythrocyte sedimentation rate, serum lactate dehydrogenase, D-dimer, and bronchoscopic mucosal erosion were independent predictors of Mycoplasma necrotizing pneumonia.The area under the ROC curve were 0.643, 0.749, 0.858 and 0.699, respectively, with the cut off point of 53 mm/1 h, 335 U/L, and 1.36 mg/L, respectively. Conclusions:Erythrocyte sedimentation rate≥53 mm/1 h, serum lactate dehydrogenase≥335 U/L, D-dimer≥1.36 mg/L, and bronchoscopic mucosal erosion are early independent predictors of Mycoplasma necrotizing pneumonia in children, among which D-dimer has the highest value.

Objective:To characterize the biological activity of fibroblasts on the surface of titanium alloy sheets with different ridge widths by investigating the effects of ridge widths on the adhesion, proliferation and differentiation of fibroblasts.Methods:Five groups of titanium sheets with ridge widths of 50 μm, 80 μm, 100 μm, 150 μm and 200 μm were prepared, with all the groove depths being 10 μm. The titanium sheets with no ridges were taken as a control group. After fibroblasts were incubated on the sheets, states of their adhesion were observed by scanning electron microscopy (SEM) at different time points. CCK-8 cell proliferation test and immunofluorescence staining were used to observe proliferation and shape of the cells. The effects of ridge widths on adhesion of fibroblasts were evaluated by Vinculin immunofluorescence staining, and the effects of ridge widths on expression of α-smooth muscle actin ( α-SMA) by immunofluorescence. Results:SEM showed that the cells adhered to the ridges on the titanium sheets 48 hours after inoculation. In the groups with smaller ridge widths (from 50 μm to 150 μm), the cells were slender in shape and grew along the ridge direction. CCK-8 indicated that different ridge widths had no significant effect on the proliferation of fibroblasts between the 6 groups ( P>0.05). Immunofluorescence staining showed that the cells arranged in an orderly direction along the ridges; the long axis of the cells in the 50 μm group showed the best consistency with the extending direction of the ridge, with significant differences among the 6 groups ( P<0.05). The Vinculin test found that the secretion of cell adhesion protein was concentrated in the ridge and semi-quantitative analysis showed that the 50 μm group had the most Vinculin secretion, with significant differences among the 6 groups ( P<0.05). The α-SMA test showed that the ridge width had a regulatory effect on the myogenic differentiation of fibroblasts, and the 50 μm group had the strongest expression of α-SMA, with significant differences among the 6 groups ( P<0.05). Conclusions:Modification of ridges on the surface of titanium sheets may affect arrangement, adhesion and myogenic differentiation of fibroblasts. The ridges of 50 μm in width may lead to stronger polarized arrangement of fibroblasts, more secretion of adhesion-related protein and more pronounced myogenic differentiation of fibroblasts.