Hospital acquired infection (HAI) is one of the common complications of hospitalized patients and poses a serious threat to public health worldwide, which causes an exacerbation, prolonged hospitalization and increased medical costs. Because of higher illness severity and more invasive operations, patients in neurosurgical intensive critical unit (NICU) are more susceptible to HAI such as hospital acquired pneumonia (HAP) and surgical site infection (SSI), leading to theincrease of mortality. Therefore, the prevention and treatment of HAI is an important challenge during the treatment of diseases in NICU. In this paper, we summarized the common types, pathogenic characteristics, prevention measures and antimicrobial treatment of HAI in NICU, aiming to provide ideas and reference on HAI treatment for medical personnel in NICU.

The aim of this study is to improve liposome encapsulation efficiency of water soluble drug ATP-2Na with hydrophobic ion pairing method, and evaluate its effect on tissues energy state in myocardial ischemia mice. Ion pair complex of ATP-2Na with HTAB was prepared first; then the liposomes were prepared by ethanol injection method. The size and zeta potential of ATP-2Na liposome were investigated. Its effect on tissues energy state in myocardium ischemia mice was evaluated by detecting ATP-2Na concentration in tissues and blood after injection in comparison to ATP-2Na solution. The diameters and zeta potential of ATP-2Na liposomes were (144.0 +/- 2.7) nm and (+16.2 +/- 1.6) mV, respectively. The encapsulation efficiency was (85.02 +/- 2.31) %. The in vitro drug release pattern from liposomes matches with Weibull equation. Compared with ATP-2Na solution, ATP-2Na liposome increased the ATP concentration of blood in myocardial ischemic mice very significantly; compared with blank, ATP-2Na liposome increased ATP content of myocardium and liver in myocaridal ischemic mice significantly, but ATP-2Na solution didn't show this effect. ATP-2Na liposome might have an advantage in improving tissue energy state on myocaridal ischemic animals.

Objective To explore the characteristics of diagnosis and treatment for the pyogenic spinal osteomyelitis. Methods From July 1999 to August 2003, 12 patients with pyogenic spinal osteomyelitis were involved, 7 males and 5 females, aging from 13 to 61 years, with an average of 36.6 years. The pain in the thoracolumbar area was early in the beginning, the temperature was above 39 ℃, and there was no redness and swelling, but the pain on deep pressure and percussion. The spinal movement was limited, but without any symptoms from compression of the spinal cord or cauda equina, and the sphincter function remained normal. The white cell count, ESR, X-ray and MR imaging were analyzed. Among 12 patients, the ESR above 60 mm/1 h in 10,28 mm/1 h and 50 mm/1 h in each 1 respectively. The white cell count of 2 patients increased (1.0?109/L). Transpedicular core biopsy was taken in 4 cases with doubtful diagnosis,the positive rates were 75%. The antibiotics was administrated intravenously for at least 6 weeks in hospital, then succeeded orally for about another 6 weeks. The ESR of 11 of patients decreased more than 50% after 1 month treatment. The conservative treatment was effective in 91.7% cases. Results 9 of 12 patients were available at final follow-up, the mean duration was 2 years and 2 months (ranged from 6 months to 4 years). Among these 9 patients, 7 patients were free of symptoms, 1 patient had slight back pain, 1 patient had chronic severe back pain who was operated because of the relapse after the conservative treatment. Among 7 patients who underwent MR imaging,2 still had destruction in their vertebra and disc. The extent of T1-weighted low signal decreased, while T2-weighted high signal was obvious, but they had no back pain. Conclusion ESR is a more sensitive index than the white cell count for the diagnosis of pyogenic spinal osteomyelitis. MR and pathologic examination are of important significance for the diagnosis of the disease. After the sequential intravenous and oral antibiotic treatment for 1 month, the decrease of ESR is hallmark of the success of conservative treatment, while the failed cases should be treated with surgery.

OBJECTIVEDesign and make triple cannula dual-lumen vacuum extractor to improve effect of decompression in operation of intestinal obstruction.

METHODSTriple cannula dual-lumen vacuum extractor was applied in 32 patients who underwent operation of intestinal obstruction from 2012 to 2015 in our hospital. The effect of intestinal decompression and patient prognosis were observed.

RESULTS32 patients that used triple cannula dual-lumen vacuum extractor had good recovery except for one patient abdominal incision with fatty liquefaction. The other patients had one-stage healed without any complication such as intestinal fistula, abdominal infection etc.

CONCLUSIONApplication of triple cannula dual-lumen vacuum extractor in operation for intestinal decompression could avoid contamination of abdomen and injury of intestinal mucosa, which had satisfied effect of intestinal decompression and promoted the effect of operation for intestinal obstruction.

Catheters ; Decompression, Surgical ; Digestive System Surgical Procedures ; instrumentation ; Humans ; Intestinal Obstruction ; surgery ; Vacuum

OBJECTIVETo investigate the protective effect and mechanism of Xingnaojing(Traditional Chinese Medicine) injection on brain injury in rats.

METHODSSixty-three healthy adult male SD rats were randomly divided into 3 groups (n = 21): sham operation group, model group, xingnaojing group. The model of traumatic brain injury model group and Xingnaojing group used the free fall impact injury method, the sham operation group underwent craniotomy, did not cause brain damage. Xingnaojing group in rats after 10 min by tail vein injection Xingnaojing injection 10 ml/(kg x d), model group and sham operation group were intravenously injected with 0.9% sodium chloride solution, three groups were administered continuously for 7 days. At administration of the seventh days compared the S-100B protein in the serum and neuro specific enolase (NSE) level, the water content of brain tissue, serum superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) content, and neurological function of rats among groups.

RESULTSCompared with the sham operation group, the nerve defect, brain water content, MDA, S100B protein and NSE levels were obvigusly increased in Xingnaojing group and model group; SOD, GSH-Px content decreased significantly; In Xingnaojing group nerve impairment and brain moisture were significantly lower than those of model group, the serum MDA, S-100B protein and NSE levels were significantly lower than those in the model group, the SOD, GSH-Px activity was significantly higher than that in the model group.

CONCLUSIONXingnaojing injection has protective effects on rat brain injury, and its mechanism may be related to reduce brain edema after traumatic brain injury and inhibit the reaction of oxygen free radical, protect nerve cells.

Animals ; Brain Injuries ; metabolism ; prevention & control ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Glutathione Peroxidase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Phosphopyruvate Hydratase ; metabolism ; Rats ; Rats, Sprague-Dawley ; S100 Calcium Binding Protein beta Subunit ; blood ; S100 Proteins ; metabolism ; Superoxide Dismutase ; metabolism

Objective To assess the outcomes of the surgical treatment of supination external rotation trimalleolar fractures,comparing the techniques of lateral plating and antiglide plating as described previously.Methods This is a retrospective review.A total of 31 patients meeting our inclusion criteria,with supination external rotation trimalleolar fractures surgically treated between 2009 and 2011,were studied.17 patients were treated with antiglide plating,whereas the remaining 14 patients underwent traditional lateral plating.They were followed up by a period ranging from 14 to 38 months(average,26 months).The functional results were evaluated with olerud and molander scoring system described previously.All the data including time to surgery,operating room time,tourniquet time,hospital stay and ankle joint function scores,were respectively analyzed in accordance with the complete randomized design t-test.Results There was no statistically significant in time to surgery,operating room,tourniquet time,hospital stay and ankle joint functional scores.Conclusions The outcome of the surgical management of supination external rotation trimalleolar fracture is comparable with both techniques.Our data do not support one technique over the other.

Objective To study the clinical features and therapeutic method of severe cerebral injured patients with hyponatremia.Methods The electrolyte and central venous pressure were examined on 45 cases of severe cerebral injured patients with hyponatremia every day.According to plasma sodium value and central venous pressure,we regulated treatment perscription daily.Results 45 patients occured hyponatremia in total 288 of severe cerebral injured patients.Hyponatremia was detected 5～13 days after operation or after injure.The morbility is usually the highest in the seventh day.Plasma sodium recovered to normal value in 14 days after operation.Conclusion Severe cerebral injured patients with hyponatremia should be diagnosed and treated as early as possible,then it will receive better prognosis.

BACKGROUND:Neural stem cel s with self-proliferation and differentiation potential are the ideal seed cel s for central nervous tissue engineering. Although col agen and silk fibroin as biological scaffold materials have been widely used, both of them used alone have certain shortcomings. Is it possible to combine the two materials to build a novel neural tissue-engineered scaffold? What is the effect of this novel scaffold on the growth and differentiation of neural stem cel s? OBJECTIVE:To observe the growth and differentiation of neural stem cel s seeded onto the novel composite scaffold. METHODS:The rat embryonic neural stem cells were inoculated onto new composite scaffolds, and then, their growth and differentiation were observed by light microscopy and scanning electron microscopy. Neural stem cells were cultured in conventional suspension culture as control group. Cell counting kit-8 assay was used to detect viability of neural stem cells in the two groups. Three-dimensional composite scaffolds carrying neural stem cells were slic ed into paraffin sections to observe the growth and differentiation of neural stem cells by hematoxylin-eosin staining and immunofluorescence staining. RESULTS AND CONCLUSION:Neural stem cel s cultured on the new composite scaffold grew and differentiated wel , and interconnected synapses were observed. Cel counting kit-8 assay showed that neural stem cel s on the scaffold grew wel , and the cel viability was significantly higher in the composite scaffold group than that in the control group (P<0.05). Hematoxylin-eosin staining and immunofluorescence staining of paraffin sections further provided evidence for good growth and differentiation of neural stem cel s on the scaffold. These results indicate that the novel composite scaffold with good biocompatibility benefits the growth and differentiation of neural stem cel s, promising a favorable application prospect.

BACKGROUND:Col agen and silk fibroin materials for construction of spinal cord scaffolds have been proven to repair or partial y repair damaged spinal cord nerve function. OBJECTIVE:To introduce partial characteristics of the col agen and silk fibroin and to review the recent progress and application as scaffolds in spinal cord tissue engineering. METHODS:A computer-based search of CNKI and PubMed databases (2003-01/2012-10) was performed for articles addressing the application of col agen and silk fibroin scaffolds in spinal cord injury with the keywords of“col agen, silk fibroin, scaffold, spinal cord injury”in Chinese and English, respectively. RESULTS AND CONCLUSION:Col agen has low antigenicity, good biocompatibility and biodegradability. Col agen and its degradation products can cause no inflammatory reactions in the body, but have the disadvantages of rapid degradation and poor mechanical properties. Silk fibroin has good biocompatibility and excellent mechanical properties, but its degradation is slow. The col agen and silk fibroin are compounded using an electrostatic spinning technology to improve the physical properties of the material on the basis of maintaining good biocompatibility. At present, fibroin or col agen materials in terms of nervous system repair have been studied, laying some foundation for spinal cord tissue engineering. Considering the similar characteristics and mechanics performance to the spinal cord tissue, col agen/silk fibroin composite materials are expected to become the ideal scaffold materials for spinal cord tissue engineering.

Objective To evaluate the indications and surgical procedure of bronchial-pulmonary arterial sleeve resection for patients with centrally located non-small cell lung cancer (NSCLC),and to prevent complications. Methods From October 1987 to December 2004, 96 cases of central NSCLC were treated with bronchial-pulmonary arterial sleeve resection and reconstruction. The results were retrospectively analyzed. Results The complication rate was 19.8%(19/96), the mortality rate in 30-day postoperation was 3.1%(3/96), the overall 1, 3, 5 year survival rates were 82.6%(76/91), 57.8%(37/64) and 39.1%(18/46) respectively. Conclusion Bronchial-pulmonary arterial sleeve resection and reconstruction in the treatment of patients with central NSCLC can not only maximize preservation of functional pulmonary parenchyma and improve the quality of life, but also provide an opportunity for those patients with poor pulmonary function to receive surgical resection of the tumor.