Objective To investigate the mechanism,clinical features of severe skin infection developed in the rehabilitation of the elderly diabetic patients and the commonly seen bacterium.Methods The causes of skin injury,the places of infection and bacterium were analyzed retrospectively.Meanwhile,chemical indicators on admission were analyzed.Results Skin injury was caused by the improper family care and the lake of self protection knowledge.The common places for infection were feet and then back and hip skin.Almost all the infections were caused by opportunists,among which staphylococcus was the most common one.The major separated risk factors were hypoalbuminemia,hyperglycemia,and high level fibrinogen and anemia.Conclusion The elderly diabetic patients are subject to skin infection.Diabetic education and careful nursing are the key to the prevention of severe skin infection.

Endophthalmitis ; etiology ; Humans ; Metals ; Occupational Exposure ; adverse effects

0.05).The ratio of TH~+ cells in the experimental group(7.38?0.84)% was higher than that in the control group(0.53?0.17)%,and there was significant statistical difference between the two group(P

Objective To study the correlation between the polymorphisms of NR3C1 gene and aggressive behavior in Yunnan Han population.Methods Five SNPs of the NR3C1 gene (rs6190,rs6191,rs6198,rs41423247 and rs56149945) were genotyped in 194 unrelated prisoners who committed violent-crimes and 301 healthy controls using improved Multiplex-ligase-detection reaction(iMLDR) method,and the data were statistically analyzed with the SPSS19.0soflware and PHASE2.1platform.Results Single locus analysis showed that the allelic distribution of rs6191and rs41423247did not show significant differencesbetween the control groupand the aggressive-behavior group as well as the robbery sub-group and intentional injury sub-group.However,significant difference was foundin the rs41423247 genotype distribution betweencontrol groupand robbery sub-group (p=0.048).In addition,there were no significant differences for the four haplotypes between the control group,the attack group,the robbery subgroup and the intentional injury subgroup.Conclusion These findings indicate that rs41423247 polymorphism of the NR3C1gene might play a role in susceptibility to aggressive behavior and rs6191 polymorphismmay not be correlated withaggressive behavior.

Objective To study and to optimize culture conditions of islet-like cells induced in vitro from fetus bone marrow(BM) mesenchymal stem cells(MSCs).Methods BM was obtained from miscarried human fetus.The MSCs between three to eight passages were used to differentiate into islet-like clusters-through three stages of culture supplemented with 2mercaptoethanol,epidermal growth factor(EGF),basic fibroblast growth factor(bFGF),B_(27) and nicotinamide.Results The 2nd stage cells expressed nestin and/or panceatic and duod-enal homeobox 1(PDX-1),and the 3rd stage cells formed islet-like clusters expressing insulin and glucagon together with positive dithizone staining.Specific insulin secretion could be detected(81.3?23.6?u /ml) from differentiated MSCs which have the capacity to respond to different glucose concentrations.Conclusion Fetal bone marrow MSCs can be differentiated into pancreatic islet-like clusters,and 20mmol/L nicotinamide could be the optimal concentration in culture.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Fluorouracil ; adverse effects ; Hepatitis B virus ; drug effects ; physiology ; Humans ; Leucovorin ; adverse effects ; Liver Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Organoplatinum Compounds ; adverse effects ; Virus Activation ; drug effects

Objective Using transcranial Doppler (TCD) to evaluate the effect of selective shunt (SS) during carotid endarterectomy (CEA). Methods TCD was used for intraoperative bilateral middle cerebral artery (MCA) cerebral blood flow continuous monitoring in 169 patients with carotid stenosis treated with CEA. The patients were divided into shunt (n =32)and non-shunt (n = 137) groups according to whether they performed shunt or not. The open approaches of anterior collateral circulation were recorded. The peak systolic velocity (PSV),mean velocity (MV), pulsatility index (PI), and ratio of MV in bilateral MCA were compared after anesthesia, before and after carotid artery occlusion, before and after shunt, and after carotid artery open. Results MV before carotid artery occlusion in the shunt and non-shunt groups were 34.73 ± 13.54 cm/sand 35.32 ± 13.18 cm/s, respectively, and there was no significant difference (P = 0. 825). MV in the shunt group after carotid artery occlusion was significantly decreased in the non-shunt group (P =0. 000). The mean decline rate of MCA MV was 69.34% ± 20. 93%, and it was decreased more significantly than that in the non-shunt group (P=0. 000). The decline rate of MCA MV was increased significantly after shunt operation, the average increase was 35.68 ± 16.69 cm/s (P=0. 000). Conclusions TCD can objectively evaluate the hemodynamic changes before and after shunt operation.

Objective To analyze the correlations of vascular structure, hemodynamic changes and surgical recanalization of carotid endarterectomy ( CEA) for the treatment of subtotal or complete occlusion of carotid artery. Methods A total of 107 patients with carotid artery occlusive disease diagnosed at Beijing Xuanwu Hospital,Capital Medical University received CEA therapy from January 2005 to January 2014 and were enrolled retrospectively. According to the findings of introperative ultrasound,they were divided into either a recanalization group (n=86) or a non-recanalization group (n=21). Preoperative and intraoperative carotid artery diameter and blood flow velocity were compared and analyzed with carotid ultrasonography. Intraoperative detected vascular abnormalities, residual vascular stenosis rate, blood flow velocity and pulsatility index of the ipsilateral middle cerebral artery ( MCA) were documented. Results (1) The peak systolic velocity (PSV) (82 ± 32 cm/s and 60 ± 17 cm/s),mean velocity (MV) (50 ± 19 cm/s and 42 ±13cm/s),and pulsatility index (PI) (0. 97 ± 0. 25 and 0. 67 ± 0. 14) on the ipsilateral MCA in patients of carotid artery recanalization before and after procedure were significantly higher than those during the procedure. There were significant differences (all P=0. 000). In patients failed to recanalize,the intraoperative and preoperative PSV,EDV,and MV of MCA were 46 ± 20 cm/s and. 63 ± 21 cm/s,24 ± 13 cm/s and 34 ± 12 cm/s, and 32 ± 16 cm/s and 44 ± 15 cm/s,respectively. They were reduced more significantly during the procedure than those after procedure. There were significant differences ( all P=0. 000 ) . But there was no significant difference in PI (0. 70 ± 0. 18 and 0. 67 ± 0. 15) compared with that before procedure (P=0. 317). (2) The diseased vascular diameter of the recanalization group was significantly widened (0. 6 ± 0. 4 mm vs. 3. 4 ± 0. 9 mm,P=0. 000) compared with before procedure. The overall recanalization rate was 80. 4% (86/107). Intraoperative ultrasound revealed that 13 patients had mild abnormal vascular structures among the recanalized patients. The non-recanalized patients had significantly abnormal vascular structure. Conclusion Intraoperative carotid ultrasound in combination with transcranial Doppler (TCD) for monitoring cerebral blood flow may effectively identify the carotid structure and the degree of cerebral hemodynamic improvement,and timely guide the secondary repair.

Objective To investigate the criteria of hemodynamic parameters for diagnosis of intracranial segment vertebral artery stenosis with transcranial color-coded sonography (TCCS ). Methods A total of 622 outpatients or inpatients with suspected posterior circulation ischemia were enrolled retrospectively,from which 216 patients were selected with TCCS,color Doppler flow imaging (CDFI)screen,and digital subtraction angiography (DSA)examination,including 33 patients (15. 3%) had normal intracranial vertebral arteries,the stenosis rates<50% were 45 cases (20. 8%),50%-69%were 44 cases (20. 4%),and 70%-99% were 94 cases (43. 5%). The mean velocity (MV)of intracranial segment,the ratios SPRP (PSV1/PSV2 ),SPRE (EDV1/EDV2 )of the systolic and end diastolic flow velocity between the intracranial segment and the intervertebral space segment were calculated respectively by detecting the intracranial segment of vertebral artery,the intervertebral space segment peak systolic velocity (PSV1 ,PSV2 )and end diastolic velocity (EDV2 ,EDV1 ). The DSA findings were used as the criteria,the area under the receiver operating characteristic (ROC ) curve was calculated and the optimal cut-off points were obtained. Results The optimal cut-off points of TCCS diagnosis of intracranial vertebral artery stenosis were as follows:the parameter standards of stenosis rate <50% were 110 cm/s≤PSV1≤145 cm/s and 65 cm/s≤MV≤85 cm/s,the parameter standards of stenosis rate 50%-69%were 145 cm/s≤PSV1≤190 cm/s and 85 cm/s≤MV≤115 cm/s,and the parameter standards of stenosis rate 70%-99% were PSV1≥190 cm/s and MV≥115 cm/s. Conclusion TCCS may effectively evaluate the hemodynamic changes of intracranial vertebral artery stenosis and provide reference for the ultrasound evaluation criteria of intracranial vertebral artery stenosis.

Objective To investigate color Doppler flow imaging (CDFI)and transcranial color-coded sonography (TCCS)for detection and evaluation of severe stenosis of intracranial vertebral artery (IVA) before and after stenting,as well as the hemodynamic changes of restenosis and their clinical value. Methods A total of 102 patients with severe stenosis of IVA confirmed by CDFI plus TCCS and DSA from November 2011 to November 2013 were analyzed retrospectively. Extra- and intracranial segments peak systolic velocity (PSV),end-diastolic velocity (EDV),IVA pulsatility index (PI),extracranial resistance index (RI),tube diameter,spectrum morphology,and hemodynamic parameters before stenting and 1 week, 3,6 and 12 months after stenting were compared. According to the results of TCCS,they were further divided into either a restnosis group (n=16 )or a non-restnosis group (n=86 ). Results (1 )The results of TCCS detection showed:PSV,EDV,and PI of the stenotic segments were improved significantly at 1 week after stenting,they were 109 ± 40 cm/s vs. 258 ± 63 cm/s,47 ± 18 cm/s vs. 132 ± 45 cm/s,0. 91 ± 0. 15 vs. 0.75 ± 0. 18,respectively. There were significant differences (all P<0. 01). PSV and EDV of the restenosis group were increased gradually from 3 to 12 months after procedure. There were significant differences between 12 months after procedure and one week after procedure (all P<0. 01). There were no significant differences in PSV,EDV,and PI of the non-restenosis group between the 12-month observation period after procedure and one week after procedure (P>0. 05). (2)The results of CDFI showed:PSV and EDV of the ipsilateral extracranial segment were improved significantly after procedure compare with those before procedure, they were 64 ± 15 cm/s vs. 51 ± 15 cm/s and 24 ± 6 cm/s vs. 19 ± 7 cm/s (all P<0. 05). The RI value and vertebral artery diameter of the extracranial segment were improved gradually,and they reached the peak at 12 months after procedure (0. 61 ± 0. 07 vs. 0. 63 ± 0. 12,P=0. 038;3. 6 ± 0. 4 mm vs. 3. 4 ± 0.5 mm,P=0. 009). Conclusion CDFI in combination with TCCS can objectively evaluate the extra-and intracranial hemodynamic changes before and after IVA stenting,and provide reference information for the effectiveness of stenting and the imaging evaluation of restenosis.