OBJECTIVE:To investigate the perioperative prophylactic utilization of antibiotics in cataract patients in ophthalmology department of our hospital.METHODS:100 cases of cataract surgery in 2009 were randomly collected from our hospital.Category of antibiotics,administration time point,medication time,wound healing and drug costs in hospitalization period were analyzed statistically and the rationality of above indexes was evaluated.RESULTS:100 cases all received prophylactic antimicrobials by local and systematic administration in the perioperative period(100%).Drugs for systematic administration contained Levofloxacin(n=67,67%),Cefuroxime sodium for injection(n=25,25%),Clindamycin phosphate injection(n=2,2%) and Ceftazidime for injection(n=6,6%).63 cases were only given drugs 30 min before operation(63%);12 cases were given medicine 30 min before operation and within 24 h after operation(12%);above situation accounted for 75%.25 cases were given medicine before operation and within 24 h after operation(25%),in which the average medication duration was 2.5 days and the longest was 4 days.CONCLUSION:The irrational use of drugs in our hospital manifests inappropriate selection and too long use of antibiotics after operation.The interference of perioperative prophylactic utilization of antibiotics should be reinforced and it is urgent to intensify consciousness of physicians about rational use of antibiotics in perioperative period.

Objective To investigate the MR characteristics of ulnar nerve and muscles in cubital tunnel syndrome.Methods Twenty eight patients with cubital tunnel syndrome and 28 asymptomatic volunteers underwent MR imaging,MR neurography was performed by using an isotropic three dimensions T2 sampling perfection with application optimized contrasts using different flip angle evolutions (3D T2 SPACE)on 15 patients with cubital tunnel syndrome.To evaluate changes in T2 signal intensity of the ulnar nerve,regions of interest were placed in the center of the location of the highest apparent ulnar nerve signal intensity on the axial FS T2WI images and in normal muscle within the same image slice,and the ratio of signal intensity was calculated.The sensitivity of 3D T2 SPACE sequence in detecting cubital tunnel syndrome was determined.The standard t tests were used to assess whether ulnar nerve size and relative signal intensity in symptomatic patients were statistically different from normal volunteers.Results The cross-sectional area of ulnar nerve in 24 patients and 2 volunteers was enlarged,the signal intensity of ulnar nerve in 26 patients and 16 volunteers was increased.Increased signal and muscle atrophy adjacent to the ulnar nerve were detected in 4 patients.Cubital tunnel syndrome was detected in 14 patientson 3D T2 SPACE sequence.The mean ulnar nerve sizes in the symptomatic and normal group were (0.15±0.06)and (0.06±0.01)cm2 respectively,the mean relative signal intensities in the symptomatic and normal groups were (2.86± 1.45) and 1.57±0.39 respectively (t values were 2.220 and 4.546,P＜0.05).Conclusions Ulnar nerve size and T2 signal intensity were increased,in patients with cubital tunnel syndrome.In addition,muscles innervated by the ulnar nerve showed atrophy with increased T2 signal intensity.

Objective To evaluate multichannel functional electrical stimulation (FES) on motor and balance function of lower limbs in adolescent with cerebral palsy. Methods From January, 2014 to June, 2015, 20 adolescents with cerebral palsy were randomly divided into FES group (n=10) and control group (n=10). Both groups received routine exercise therapy. FES group received active and passive FES treadmill based on normal walking pattern. The Fugl-Meyer Assessment (FMA) was used to evaluate the motor function of lower limbs;the Berg Balance Scale (BBS) was used to assess the balance function, and the Gross Motor Function Measure (GMFM) was used to test the gross motor function. Results The scores of FMA, BBS and GMFM significantly improved 30 days after treatment (F>223.749, P<0.001), and the scores were higher in the FES group than in the control group (t>2.706, P<0.05). Conclusion FES treatment can improve the motor and the balance function of lower limbs in adolescents with cerebral palsy.

OBJECTIVETo observe the effective mechanism and side effects of thalidomide to multiple myeloma (MM).

METHODSTen cases of MM were studied, of which 3 were previously untreated and 7 refractory or relapsed. Bone marrow microvascular density (MVD) was detected by factor-VIII related antigen and CD(34) immunohistological staining and serum concentration of vascular endothelial growth factor (VEGF) before and after treatment was determined by ELISA. The initial dosage of thalidomide was 100 approximately 200 mg/d with a weekly escalation of 50 mg/d to 450 approximately 650 mg/d. The therapeutic effectiveness is classified into partial remission, improvement and uneffective according to the decrease of serum M protein and bone marrow myeloma cells. Anemia, renal function and blood electrolytes were also observed.

RESULTSBefore treatment, MVD was 73.32 +/- 28.80 and 32.30 +/- 12.50 in MM and control group, respectively, (P < 0.01). MVD in MM group decreased to 56.12 +/- 19.34 after treatment, and was of significant difference (P < 0.05) as compared to the pretreatment value. However, there was still a significant difference as compared to control (56.12 +/- 19.34 vs 32.30 +/- 12.50, P < 0.01). The concentration of VEGF significantly decreased after treatment [from (178.23 +/- 26.56) ng/L to (78.48 +/- 19.98) ng/L, P < 0.01)]. The total effective rate was 70%. There were no serious side effects.

CONCLUSIONMVD and VEGF concentration were decreased obviously by thalidomide treatment. The dosage of 450 approximately 650 mg/d might be effective in refractory or initial MM.

Aged ; Angiogenesis Inhibitors ; adverse effects ; therapeutic use ; Antigens, CD34 ; analysis ; Bone Marrow ; blood supply ; drug effects ; Constipation ; chemically induced ; Endothelial Growth Factors ; blood ; Fatigue ; chemically induced ; Female ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; blood ; Lymphokines ; blood ; drug effects ; Male ; Middle Aged ; Multiple Myeloma ; blood ; drug therapy ; pathology ; Nausea ; chemically induced ; Sleep Wake Disorders ; chemically induced ; Thalidomide ; adverse effects ; therapeutic use ; Treatment Outcome ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors ; von Willebrand Factor ; analysis

Objective:To evaluate the application values of small FOV surface coil and BLADE sequence in MR imaging on assessment of talar cartilage injury of ankle joint under traction.Methods:The clinical and imaging data of 53 patients with ankle cartilage injury in the Affiliated Suzhou Hospital of Nanjing Medical University from December 2018 to July 2020 were prospectively analyzed. All patients underwent the following MR sequences: sequence Ⅰ was fast spin echo proton density weighted (FSE-PD) BLADE sequence with surface coil small FOV, and sequence Ⅱ was FSE-PD-BLADE imaging of small FOV under horizontal load traction of ankle joint. Paired sample Wilcoxon rank sum test was used to compare the thickness of talus dome cartilage, cartilage space and subjective assessment score of image quality (including the outline of the upper surface of the cartilage at the injury, the thickness of the cartilage layer at the injury, the rupture of the cartilage at the injury, the relationship between cartilage and subchondral bone, subchondral bone collapse or trabecular fracture line) between sequence I and sequence Ⅱ.Results:There was significant difference in the thickness of central cartilage of talus between sequence Ⅰ and sequence Ⅱ [0.70 (0.60, 0.90) mm and 0.80 (0.70, 0.90) mm, Z=-2.900, P=0.004, respectively]. There was no significant difference in the thickness of medial and lateral talus cartilage between sequence Ⅰ and sequence Ⅱ (P>0.05). There were significant differences between sequence Ⅰ and sequence Ⅱ in the center [0.10 (0, 0.15), 0.89(0.63, 1.00) mm], medial [0.10(0, 0.31), 1.20(0.70, 1.25) mm] and lateral cartilage space [0.18(0.08, 0.23), 0.90(0.76, 0.94)mm] (all P<0.001). As for the subjective assessment score of talus cartilage injury, except for score in subchondral bone collapse or bone trabecular fracture line between sequence Ⅱ and sequence Ⅰ ( Z=-1.480, P=0.139), significant differences were found in all other scores ( P<0.05). Conclusion:MRI of the ankle under traction is safe and feasible. Under the condition of horizontal traction, small FOV surface coil combined with BLADE sequence can better display talus cartilage injury.

Objective:To investigate the value of serum microRNA-92a (miR-92a) and microRNA-146a (miR-146a) expression levels combined with lung ultrasound score (LUS) in predicting the severity and prognosis of acute respiratory distress syndrome (ARDS).Methods:116 patients with ARDS admitted to Danzhou People's Hospital from January 2017 to March 2020 were enrolled. On the day of admission, the expression levels of serum miR-92a and miR-146a were detected by real-time fluorescent quantitative reverse transcript-polymerase chain reaction (RT-PCR), and pulmonary ultrasound examination was performed in 12 lung regions, with the total score as LUS score. The difference of each index was analyzed among the ARDS patients with different 28-day prognosis (survival group and death group) and different severity [mild group: 200 mmHg < oxygenation index (OI) ≤ 300 mmHg (1 mmHg = 0.133 kPa), moderate group: 100 mmHg < OI≤200 mmHg, severe group: OI≤100 mmHg]. Multivariate Logistic regression was used to analyze the risk factors of death in patients with ARDS. Receiver operating characteristic (ROC) curve was drawn to analyze the value of miR-92a and miR-146a combined with LUS score in predicting the death of patients with ARDS.Results:116 ARDS patients were included, 39 cases in the death group, 77 cases in the survival group; 20 cases in the mild group, 38 cases in the moderate group and 58 cases in the severe group. The expression levels of serum miR-92a, miR-146a and LUS score in the death group were significantly higher than those in the survival group [miR-92a (2 -ΔΔCt): 3.75±1.64 vs. 2.10±0.78, miR-146a (2 -ΔΔCt): 1.93±0.72 vs. 0.76±0.20, LUS score: 25.80±4.75 vs. 13.40±3.60, all P < 0.01]. With the aggravation of ARDS patients, the expression levels of serum miR-92a and miR-146a and LUS score gradually increased ( F values were 8.115, 6.740 and 6.216 respectively, all P < 0.01). The expression levels of serum miR-92a, miR-146a and LUS score in severe group were significantly higher than those in the moderate group and mild group [miR-92a (2 -ΔΔCt): 3.65±1.62 vs. 2.87±1.16, 1.94±0.68; miR-146a (2 -ΔΔCt): 1.85±0.58 vs. 1.30±0.51, 0.68±0.17; LUS score: 24.15±4.65 vs. 18.60±4.20, 12.20±3.15, all P < 0.01]. Multivariate Logistic regression analysis showed that low OI [odds ratio ( OR) = 2.748, 95% confidence interval (95% CI) was 1.913-6.225, P = 0.024], high LUS score ( OR = 1.685, 95% CI was 1.183-2.758, P = 0.016), high expression levels of serum miR-92a ( OR = 2.560, 95% CI was 1.806-5.627, P < 0.001) and miR-146a ( OR = 1.984, 95% CI was 1.375-3.816, P = 0.008) were independent risk factors for the death of ARDS patients. ROC curve analysis showed that the area under ROC curve (AUC) of patients with ARDS predicted by miR-92a and miR-146a combined with LUS score was significantly higher than that predicted by the three alone (0.918 vs. 0.842, 0.825, 0.807, all P < 0.01), and the sensitivity (94.0%) and specificity (85.2%) were higher. Conclusion:The expression levels of serum miR-92a, miR-146a and LUS score are related to the severity and prognosis of the patients with ARDS, and the combination of the three indicators has better value in predicting the prognosis of the patients with ARDS.

Objective To explore the effect of recombinant human erythropoietin (rhEPO) on expression of brain-derived neurotrophic factor (BDNF) in different brain regions of aging rats. Methods Forty male SD rats were randomized equally into negative control group, D-galactose group, EPO treatment group, and positive control group. Rat models of subacute aging were established by continuous subcutaneous injection of 5%D-galactose. Immunohistochemical staining was used to analyze the variation of BDNF expressions in different brain regions of the aging rats with different treatments. Results Significant brain region-specific differences in BDNF expression were found among the rats in different groups. Compared with those in the negative control group, the numbers of BDNF-positive cells in the hippocampal CA1 region, CA3 region, dentate gyrus (DG) and frontal cortex were all decreased obviously in D-galactose group (P<0.05) but increased in both EPO group and the positive control group (P<0.05) without significant differences between the latter two groups. In the rats in the same group, the number of BDNF-positive cells varied markedly in different brain regions (P<0.05), and the expression level of BDNF was the highest in the frontal cortex followed by the hippocampal CA3 region and the dentate gyrus, and was the lowest in the hippocampal CA1 region. Conclusion Treatment with rhEPO enhances the expression of BDNF in rat neural cells, suggesting that rhEPO may protect the nervous system from aging by regulating the BDNF pathway.

Objective To explore the effect of recombinant human erythropoietin (rhEPO) on expression of brain-derived neurotrophic factor (BDNF) in different brain regions of aging rats. Methods Forty male SD rats were randomized equally into negative control group, D-galactose group, EPO treatment group, and positive control group. Rat models of subacute aging were established by continuous subcutaneous injection of 5%D-galactose. Immunohistochemical staining was used to analyze the variation of BDNF expressions in different brain regions of the aging rats with different treatments. Results Significant brain region-specific differences in BDNF expression were found among the rats in different groups. Compared with those in the negative control group, the numbers of BDNF-positive cells in the hippocampal CA1 region, CA3 region, dentate gyrus (DG) and frontal cortex were all decreased obviously in D-galactose group (P<0.05) but increased in both EPO group and the positive control group (P<0.05) without significant differences between the latter two groups. In the rats in the same group, the number of BDNF-positive cells varied markedly in different brain regions (P<0.05), and the expression level of BDNF was the highest in the frontal cortex followed by the hippocampal CA3 region and the dentate gyrus, and was the lowest in the hippocampal CA1 region. Conclusion Treatment with rhEPO enhances the expression of BDNF in rat neural cells, suggesting that rhEPO may protect the nervous system from aging by regulating the BDNF pathway.

ObjectiveTo evaluate the clinical efficacy and safety of Baoshen prescription in the treatment of stage Ⅳ diabetic nephropathy （DN） in the patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction， and to explore the mechanism of this prescription delaying the disease progression. MethodsA randomized， controlled， double-blind， multicenter clinical trial was conducted， in which 94 stage Ⅳ DN patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction were randomly assigned into Baoshen prescription and control groups （47 cases）. The treatment lasted for 12 weeks. The primary efficacy indicators were mainly renal function indexes， including urine albumin-to-creatinine ratio （UACR）， 24-hour urine total protein （24 h-UTP）， serum creatinine （SCr）， and estimated glomerular filtration rate （eGFR）. The secondary efficacy indicators were metabolic memory of hyperglycemia， podocyte epithelial-to-mesenchymal transdifferentiation-related indexes， and TCM syndrome score. ResultsAfter 12 weeks of treatment， the Baoshen prescription group showed lowered levels of advanced glycation end products （lgAGEs）， connective tissue growth factor （CTGF）， type Ⅳ collagen （Col-Ⅳ）， receptor of AGEs （RAGE）， urinary fibroblast-specific protein-1 （FSP-1）， UACR， 24 h-UTP， and glycated hemoglobin （HbAlc） （P<0.05）， and an upward trend of miR-21 mRNA. The control group showed elevated levels of SCr and UREA and lowered levels of urinary FSP-1， eGFR， and HbAlc （P<0.05）. After treatment， the Baoshen prescription group had lower levels of lgAGEs， CTGF， urinary FSP-1， SCr， UACR， and 24 h-UTP and higher levels of Col-Ⅳ and eGFR than the control group （P<0.05）. In addition， the Baoshen prescription group showed statistically significant differences in SCr， eGFR， UACR， and 24 h-UTP before and after treatment （P<0.05）. ConclusionBaoshen prescription can effectively improve the renal function， reduce the urinary protein level， and alleviate clinical symptoms in stage Ⅳ DN patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction. The mechanism may be related to the metabolic memory of hyperglycemia and epithelial-to-mesenchymal transdifferentiation of podocytes.

Objective: To investigate the distribution of peripheral blood lymphocyte subpopulations in 654 children aged 28 days to 7 years, and to provide a basis for establishing a normal reference range. Methods: A total of 654 healthy Han children aged 28 days to 7 years were enrolled.The children were divided into infant group(28 days-12 months)(180 cases, 27.52%), toddler group(1-3 years)(184 cases, 28.13%), and preschooler group(3-7 years)(290 cases, 44.34%). Peripheral blood samples were collected, and the percentages of lymphocyte subpopulation were detected by flow cytometry. Results: There were statistically significant differences between boys and girls in CD3⁺ CD4⁺ T cells, CD3⁺ CD8⁺ T cells percentages and the CD4⁺ /CD8⁺ ratio in infant group(Z=-2.595, 3.317, -3.492, all P<0.05); in CD3⁺ CD4⁺ T cells percentage in toddler group(Z=2.312, P<0.05); in CD3⁺ T cells, CD3⁺ CD4⁺ T cells, CD3^-CD19⁺ B cells, CD3^-CD16⁺ CD56⁺ NK cells percentages and the CD4⁺ /CD8⁺ ratio in preschool age group(Z=4.088, 4.991, 3.129, -6.949, 2.141, all P<0.05). The comparison in all age groups showed significant differences in CD3⁺ T cells, CD3⁺ CD4⁺ T cells, CD3^-CD19⁺ B cells, CD3^-CD16⁺ CD56⁺ NK cells percentages and the CD4⁺ /CD8⁺ ratio in boys(χ²=6.925, 51.543, 39.563, 87.751, 30.334, all P<0.05), in CD3⁺ CD4⁺ T cells, CD3⁺ CD8⁺ T cells, CD3^-CD16⁺ CD56⁺ NK cells percentages and the CD4⁺ /CD8⁺ ratio in girls(χ²=27.646, 44.046, 26.066, 54.238, all P<0.05). The CD3⁺ CD4⁺ T cells and CD3^-CD19⁺ B cells percentages declined with age(χ²=82.345, 40.214, all P<0.05); The CD3⁺ CD8⁺ T cells and CD3^-CD16⁺ CD56⁺ NK cells percentages increased with age(χ²=38.43, 108.302, all P<0.05). Conclusion The peripheral blood lymphocyte subpopulation values differ by gender and age.It is necessary to establish the reference range of lymphocyte subpopulations for children in Lanzhou according to gender and age.