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.

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 study the preventive effect of Sanguisorba officinalis on renal fibrosis by observing the influence of San-guisorba officinalis tannins extract (STE) on the proliferation of human renal epithelia (HK-2) induced by transforming growth factor-β1 ( TGF-β1 ) . Methods:HK-2 cells were cultured in DMEM medium with high glucose containing 10% fetal bovine serum. The cul-tured cells were divided into 5 groups, including the blank control group, TGF-β1 group (5 ng· ml-1 TGF-β1), intervention group 1 (5 ng·ml-1 TGF-β1 +12. 5μg·ml-1 STE), intervention group 2 (5 ng·ml-1 TGF-β1 +25μg·ml-1 STE) and intervention group 3(5 ng·ml-1 TGF-β1 +50 μg·ml-1 STE). The changes of cell morphology were observed under an inverted microscope and the in-fluence of SET on the cell proliferation was detected by CCK8 assay. Results: TGF-β1 could significantly induce the proliferation of HK-2 and promote the cell fibrosis with significant difference when compared with the control group (P<0. 05). However, after trea-ted with STE, the cell proliferation was inhibited obviously (P<0. 05) and the cells morphology tended to be normal in a dose-depend-ent manner. Conclusion:STE can inhibit the proliferation of HK-2 and prevent renal fibrosis to some extent.

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 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 establish the electric controlled cortical impact (eCCI)-induced traumatic brain injury (TBI) model in rats with different severity in degree,which may serve as a suitable platform to provide experimental evidence for the pathophysiological following TBI.Methods A total of 40 male Wistar rats were randomly divided into 3 experimental groups and sham group.TBI rats (n=10/group) were positioned beneath the controlled cortical impactor device (eCCI) and subjected to impact injury at 2 mm depth of penetration,for a sustained depression of 200 ms,at 4 m/s,5 m/s,6 m/s velocity for mild,moderate,and severe TBI,respectively.Sham-operated rats (n=10) underwent identical surgical procedures,including craniotomy,without receiving the cortical impact.Neurological function and regional cerebral flow (24 h after CCI),contusion volume,histopathological,and ultrastructural changes (48 h after CCI) were measured,respectively.Results The severity of the pathological changes in rats was increased as the injury aggravated.The eCCI device impacted the brain at 4 m/s,5 m/s,6 m/s velocity for mild,moderate,and severe TBI,respectively.TBI groups showed impaired neurological function,and decreased rCBF lower than that of sham-operated group (all P＜0.01).Furthermore,neuronal pathological abnormalities in TBI groups,including neuron shrinking,perineuronal vacuole,and structural abnormalities of mitochondria.Increased severity of injury was apparent following the increased level of the impacted velocity,and significant differences were observed between TBI groups (P＜0.05).Conclusion The TBI animal model with mild,moderate,and severe brain injury can be established successfully by 4 m/s,5 m/s,and 6 m/s of impact velocity respectively with the eCCI-6.3 device.The novel eCCI-induced TBI model in rats possibly serves as a novel useful approach in the development of TBI models.

ObjectiveTo investigate the roles of 11 β-hydroxysteroid dehydrogenase type 1 ( 11 β-HSD1 )on hippocampus of rat with chronic unpredictable mild stress (CUMS).MethodsTwenty-four male SpragueDawley rats were randomly divided into control group and depressive model group. Chronic unpredictable mild stress (CUMS) was used to make up depressive animal model.Behavioral changes were recorded by body weight measuring,sucrose consumption test (SCT) and open field test (OFT),respectively.The mRNA transcription of 11β-HSD1 in hippocampus tissues of the rats were detected by real-time RT-PCR,and the protein expression of 11β-HSD1 were detected by western blot and immunofluorescence.ResultsBcforc starting CUMS protocol,the rats exhibited equivalent weight and sucrose consumption.Twenty-eight days after CUMS protocol,behavior parameters such as body weight,sucrose consumption,nunber of crossing,and number of rearing were significantly decreased in rats exposed to CUMS group compared with control group (P ＜ 0.05,P ＜ 0.01 ).Correspondingly,realtime RT-PCR assays showed the mRNA expression of 11 β-HSD1 in the hippocampus of CUMS group,which was (31 ±9) ％ lower than that of control group.Meanwhile,the protein expression of it in CUMS group was lower than that of control group (P ＜ 0.05 ).Inmunofluorescence revealed that the number of positive 11 3-HSD1 cells was high (223 ± 13) in the control group,while the number was decreased prominently (92 ± 11 ) in the CUMS group (P ＜ 0.01 ).ConclusionDepressive behavior of rats is induced and the expression of 11 β-HSD1 in the hippocampus is decreased prominently by CUMS,the mechanism of which is at least related to the low expression of 11β-HSD1 and disturbance of glucocorticoid metabolism caused by CUMS.

Objective To study the expression and clinical significance of EphB4 in breast infiltrating ductal carcinoma.MethodsSP immunohistochemical technique was used to examine the expression of EphB4 in 65 cases of breast infiltrating ductal cancer and 12 matched adjacent tissue samples.ResultsThe level of EphB4 in breast infiltrating ductal cancer was significantly higher than that of adjacent normal tissues(P0.05).ConclusionEphB4 plays a crucial role in the occurrence and development of breast cancer.