BACKGROUND:Autologous peripheral blood hematopoietic stem cell transplantation,as the current latest therapy is widely used in the treatment of autoimmune diseases,however,the treatment on myasthenia gravis is still in the primary stage.OBJECTIVE:To create the model of myasthenia gravis with autologous peripheral blood hematopoietic stem cell transplantation in rats and to observe clinical manifestation,attenuation rate of repetitive nerve electric stimulation action potential and titer of serum acetylcholine receptor Ab in the models.DESIGN,TIME AND SETTING:The randomized control animal experiment was performed at the Human Anatomy Laboratory,Medical College of Zhengzhou University between July and December 2007.MATERIALS:Totally 50 female Wistar rats were randomly assigned into four groups,a normal group(n=10),an adjuvant control group(n=10),a stem cell transplantation group(n=15),and a model control group(n=15).METHODS:Rats in the normal group were intact.Rats in the adjuvant group were subjected to the same volume of saline and cyclophosphamide.Rats in the stem cell transplantation group were used to make experimental autoimmune myasthenia gravis by intraperitoneally infusing with serum of myasthenia gravis patients.Bone marrow stem cells were mobilized by granulocyte colony-stimulating factor.Autologous peripheral blood stem cells were collected and then were transplanted via tail vein injection after the pretreatment regimen of cyclophosphamide.Rats in the model control group were treated with an equal volume of peripheral blood,and with other procedures as the stem cell transplantation group.MAIN OUTCOME MEASURES:Swimming time and survival rate of rats from each group after stem cell transplantation;attenuation rate of repetitive nerve electric stimulation action potential and titer of serum acetylcholine receptor Ab were measured at 4 and 9 weeks after stem cell transplantation.RESULTS:The survival rate was higher in the stem cell transplantation group than in the model control group(P

Objective To summarize the value of early mechanical ventilation plus continuous vacuum suction in treatment of serious pulmonary contusion.Methods Forty-eight cases of severe pulmonary contusion were assigned to mechanical ventilation plus continuous vacuum suction (observation group,n =20) and mechanical ventilation plus discontinuous vacuum suction (control group,n =28)according to the random number table.Modes of mechanical ventilation were synchronized intermittent mandatory ventilation (SIMV),pressure support ventilation (PSV),and positive and expiratory pressure (PEEP).Changes in blood gas analysis,mechanical ventilation time,and associated complications were compared between groups.Results At ventilation time of 6 and 24 hours,PaO2 in observation group was (100.36 ± 5.90) mmHg and (105.34 ± 7.40) mmHg respectively,with significant differences from (75.36 ± 8.95) mmHg and (76.36 ± 8.35) mmHg in control group (P ＜ 0.01).At ventilation time of 24 hours,PaO2/FiO2 was (283.50 ± 15.20) mmHg in observation group and (201.50 ± 10.20) mmHg in control group (P ＜0.01).Mechanical ventilation time and PEEP at ventilation time of 48 hours in observation group was (3.2 ± 1.1) days and (4.5 ± 2.3) cmH2 O,with significant differences from (6.5 ± 2.8) days and (8.5 ± 2.5) cmH2O in control group (P ＜ 0.01).Associated complications of the two groups revealed no significant difference (P ＞ 0.05).Conclusion Early mechanical ventilation with sustained vacuum suction is effective to keep airway clear,improve oxygenation index,decrease PEEP level,and control the duration of mechanical ventilation,but may not lower the risks of ventilator-associated pneumonia and pulmonary atelectasis.

The peripheral blood T- lymphocyte percentage, lympocyte percentage in white blood cell (WBC) of mice in heat environment (45C, 15 min) were diminished, and serum corticosterone increased. Ginseng root saponins (GRS) 50, 100 mg/kg were administered ip at 15 min before the heat-stress, the suppression of peripheral blood T-lymphocyte percentage were prevented, but could not inhibit the increase ofserum corticosterone. GRS 50mg?kg-1ip could inhibit the redution of peripheral lymphocyte percentage. GRS 50mg?kg-1 ,reserpine 0.5mg? kg-1or physostigmine salicylate 0.3 mg?kg-1ip abolished the inhibiting effect of heat-stress on DTH reaction in mice.

Objective To study the expression of active efflux pump AdeABC in clinical Acineto-bacter baumannii islates and whether this efflux pump confers resistance to antibiotics. Methods The anti-biotic susceptibility and the function of efflux pump inhibitor were tested by micro-dilution broth method. The expression of adeB was examined by RT-PCR. The controlling gene adeRS was amplified by PCR and se-quenced. Results Thirty multidrug resistance Acinetobacter baumannii isolates and 5 sensitive isolates for PCR were both abtained the expected products of adeB and adeRS. The mRNA expression of adeB in 15 multidrug resistance(MDR) isolates were positive, but there was no expression of adeB in 5 sensitive iso-lates. The mutations of adeRS existed in 2 MDR isolates. Conclusion The expression of AdeABC may in-volved in the resistant mechanisms of the clinical MDR Acinetobacter baumannii isolates.

BACKGROUND:Intertrochanteric fracture showed shattered state of different degrees in the clinic. The medial cortex is often a lack of continuity. Indentation and lesser trochanter displacement often cause destruction of biomechanics of femoral calcar to different degrees. Under this condition, it is very important to perform detailed classification of fractures and to strictly master indication of dynamic hip screw. OBJECTIVE:To further analyze the reasons for failure of internal fixation with dynamic hip screw for intertrochanteric fracture. METHODS:Data of 82 patients with intertrochanteric fracture repaired by internal fixation with dynamic hip screw, who were treated at the Department of Orthopedics, Kangtai Branch of the Second Hospital of Lanzhou University from March 2004 to December 2013, were retrospectively analyzed. The reason for failure of internal fixation and prevention method were explored. RESULTS AND CONCLUSION:Al patients were fol owed up for 4-48 months. Time of fracture healing was 12-38 weeks. Fixation failure was found in 12 cases, with an incidence of 15%. Of 12 failure cases, 7 cases affected hip screw cutting out femoral head neck (including 1 case combined with avascular necrosis of the femoral head), 1 case suffered from compression screw slipping out of the tube, 3 cases experienced screw pul ing out and breaking, plate loosening, and 1 case affected steel plate breakage. There were 1 case of Evans II type (8%), 3 cases of type III (25%), 5 cases of type IV (42%), and 3 cases of type V (25%). Lesser trochanter was not completely reset in 5 cases (42%). There were tip-apex distance>25 mm in 7 cases (58%) and early weight loading (3 weeks after fixation) in 1 case (8%). These data confirmed that the selection of indications, the degree of stability after reduction, accuracy of implant position and postoperative unreasonable exercise wil cause fixation failure of dynamic hip screw. Preoperative careful and comprehensive analysis, intraoperative precise operation and postoperative reasonable functional exercise are the keys to ensure success of fixation.

Objective To compare the discrepancy and consistency in mechanical axis and component position measured by electromagnetic navigation and radiograph in total knee arthroplasty (TKA)to assess whether the navigation system can be used as a substitute for radiograph.Methods A perspective study was performed on 40 cases (61 knees) undergone primary TKA under electromagnetic navigation from July 2006 to December 2006.There were 4 males and 36 females,at a mean age of (66.9 ±8.1) years (range,58-79 years).Mechanical axis angle,distal femoral and proximal tibial cut slope in coronal view (angles cα,β) were recorded both pre-and post-operatively with an intraoperative navigation system and compared against the mechanical axis angle,coronal femoral and tibial slope (angles α,β)measured via full-length radiograph of the lower limb preoperatively and at postoperative 3 months.Consistency in measurement of the same parameters with the two methods was assessed using intraclass coefficiency correlation (ICC).Results Mechanical axis determined by navigation and radiograph showed a mean valgus angle of 9.60° and 9.99° preoperatively and of 1.23° and 1.64° postoperatively,but the two pair parameters revealed no significant differences in the non-parametric test.Mean angle α determined by navigation and radiograph was 89.98° and 88.96° respectively (P ＜ 0.05),and mean angleβ was 90.21 ° and 89.59°respectively (P ＜ 0.05).With deviation value ≤3°,ICC for pre-and post-operative mechanical axis angles,angle α and angleβ was 0.887,0.754,0.632,0.640 respectively.Conclusions Within the acceptable range of deviation,intraoperative navigation data can reflect the pre-and post-operative mechanical axis and prosthesis position evaluated by radiograph.However,the advantages over the consistency of the two measurement methods rest with the evaluation of pre-and post-operative mechanical

Objective To compare the lower limb alignment and prosthesis position after total knee arthroplasty (TKA) with or without using electromagnetic navigation.Methods Sixty-four patients (100 knees) underwent TKA under electromagnetic navigation,while 62 patients (100 knees) underwent conventional TKA.Three months after operation,the mechanical axial line angle and prosthesis position (angels α,β,γ) were measured via the full-length radiograph of both lower limbs and anteriorposterior and lateral Xrays of the knee.Results The average mechanical axial line angle and angle α were 1.20°±1.92°and 89.33°±1.64° in navigation group,respectively,and 2.31°±2.25° and 88.68°±2.57° in conventional group.And the differences were significant with regard to the above two indexes between two groups.The average angle β and angle γ were 89.64°±1.47° and 90.86°±2.37° in navigation group,respectively,and 89.26°±2.05° and 90.59°±3.44° in conventional group.However,the differences were not significant with regard to the above two indexes between two groups.After operation,mechanical axial line angle error was within ±3°in 86％ of patients in navigation group,while in 79％ of patients in conventional group; there was no significant difference between them.The angle α error was within 90°±3° in 92％ of patients in navigation group,while in 77％ of patients in conventional group; there was significant difference between them.However,there were no significant differences in percentage of patients whose errors of angle β and angle γ were within 90°±3° between two groups.Conclusion With using electromagnetic navigation in TKA,more precise prosthesis position and the mechanical axis can be achieved compared with the conventional technique.And its advantages mainly contribute to the coronal plane of the femoral side rather than the tibial side.

Objective To study the expression of active efflux pump AdeABC,AdeIJK,AdeFGH,AbeM,AbeS,CraA,MdtL in clinical Acinetobacter baumannii isolates and whether the efflux pumps confers resistance to antibiotics.Methods Thirty-two multi-drug resistant Acinetobacter baumannii islates and 10 sensitive isolates were collected.Genes of the exporter protein were amplified by PCR.The expression of adeB,adeJ,adeG,abeM,abeS,craA,mdtL were examined by real-time fluorescence quantitative RT-PCR.The controlling genes adeRS and adeL were amplified by PCR and sequenced.Results The positivity rates of adeB,adeJ,adeG,abeM,abeS,craA,mdtL were 100％,100％,100％,96.88％,100％,100％ and 93.75％ respectively in 32 multi-drug resistant Acinetobacter baumannii isolates,and all 100％ in 10 sensitive isolates.The difference of expression of adeB,abeM and mdtL were significant( P＜0.001,P =0.001,P=0.013) between 21 multi-drug resistant isolates of C clone and 10 sensitive isolates.The mutations of adeRS existed in 2 multi-drug resistant isolates,no point mutation of adeL.Conclusion The expression of AdeABC,AbeM and MdtL may involved in the resistant mechanisms of the clinical Acinetobacter baumannii islates.

Objective To understand genetic distribution, drug resistance, molecular typing and the epidemiological relativeness between strains of the Shigella boydii virulence. Methods Nine Shigella boydii strains were isolated form stool samples of patients with diarrhea from the Enteric Disease Clinic of the Second Hospital of Tianjin Medical University in June-October 2015. The strains were identified by biochemical test and serum agglutination test. Antibiotics susceptibility test was carried out using the Kirby-Bauer method. Polymerase chain reaction was used for detecting virulence genes. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) technique were used to determine the epidemiological relationship between nine Shigella boydii strains. Results There were three subtypes in nine isolated Shigella boydii samples, including one, three and five isolates inⅠ,Ⅱ,Ⅳsubtypes respectively. All of the 9 isolates were multi-drug resistant. The resistant rate of these strains for ampicillin was 100%(9/9), and then the resistant rates of these strains for ceftazidime, streptomycin, gentamicin, trimethoprim/sulfamethoxazole, cefotaxime, ceftriaxone, norfloxacin and levofloxacin were 1/9, 4/9, 4/9, 4/9, 5/9, 5/9, 6/9, 6/9 and 6/9, respectively. All of these strains were sensitive to amikacin, cefperazone-sulbactam and imipenem. The ipaH was carried by all the testing strains, and none of the strains carried the sen, set1A, set1B, ial, virA, icsA and SigA. The detective rates of pic, sepA and sat were 4/9, 5/9 and 7/9 strains, respectively. Nine shigella boydii strains were divided into 8 PFGE types. The similarity between the spectrums of PFGE was 63.21%-100%. Multilocus sequence typing showed that six isolates were belonged to ST648, two isolates were ST131 and one isolate was ST10. Conclusion Nine isolates of Shigella boydii (divided into three subtyping) isolated from our hospital are multi-drug resistant and they have distant relationships, belonging to the dissemination of case.

Electrical defibrillation is the most effective way to treat the ventricular tachycardia (VT) and ventricular fibrillation (VF). An automatic external defibrillator based on DSP is introduced in this paper. The whole design consists of the signal collection module, the microprocessor controlingl module, the display module, the defibrillation module and the automatic recognition algorithm for VF and non VF, etc. This automatic external defibrillator has achieved goals such as ECG signal real-time acquisition, ECG wave synchronous display, data delivering to U disk and automatic defibrillate when shockable rhythm appears, etc.
Algorithms ; Defibrillators ; Equipment Design ; Humans ; Tachycardia, Ventricular ; therapy ; Ventricular Fibrillation ; therapy