Metals,due to their unique and excellent antibacterial properties,have been widely used in biomedical fields. However,their antibacterial mechanisms are not yet completely clear,so that studies on metal toxicity to bacteria have been a frontier in recent years. There are two main antibacterial mechanisms that have been reported so far. One is based on oxidative damage to bacte?ria induced by the reactive oxygen species,and the other is based on structural changes induced by the Coulomb attraction. The results of bacterial damage could be due to the combination of the two mechanisms. In this paper,current research progress in antibacterial mechanisms of metal has been discussed,which will technically facilitate further development and applications of antimicrobial metal?lic materials.

ObjectiveTo investigate the feasibility and clinical effect of bispectral index (BIS) monitoring target controlled infusion of midazolam and propofol for sedation of mechanically ventilated patients.MethodsEighty cases with severe respiratory failure,sane,the need for endotracheal intubation mechanical ventilation for at least 24 h were divided into 4 groups by random digits table with 20 cases each.Group A and group C patients routinely received propofol and midazolam,group B and group D patients used BIS monitoring target controlled infusion of propofol and midazolam.The correlation of BIS and Ramsay score was analyzed,and the changes of mean arterial pressure (MAP) and heart rate (HR) were compared among 4 groups.ResultsBIS was negatively correlated with Ramsay score in group B and group D (P ＜ 0.05).MAP after 24 h intubation was lower than that at intubation immediately among 4 groups [group A:(63.89 ±4.68) mm Hg (1 mm Hg =0.133 kPa) vs.(92.33 ±3.57) mm Hg,group B:(62.66 ±3.97) mm Hg vs.(93.76 ± 4.02) mm Hg,group C:(64.59 ± 3.29) mm Hg vs. (93.78 ± 4.61 ) mm Hg,group D:(63.18 ±2.51 )mm Hg vs. (93.61 ± 5.36) mm Hg],and there were significant differences (P＜ 0.05).Group A and group B reached the standard after 1 h intubation.HR after 24 h intubation decreased in 4 groups,but there was no significant difference (P ＞ 0.05).ConclusionsBIS monitoring target conmolled infusion of midazolam and propofol for sedation of mechanically ventilated patients can achieve similar sedative effects,in addition,the need for rapid sedation of mechanically ventilated patients with suitable choice of propofol.At the same time,BIS is negatively correlated with Ramsay score.

Objective To investigate the accuracy of myeline base protein (MBP) in evaluation of brain injury in patients undergoing cardiac surgery performed under CPB. Methods Thirty-two ASA Ⅱ- Ⅳ patients of both sexes (20 males, 12 females) aged 59-76 yr weighing 52-72 kg undergoing coronary artery bypass grafting (CABG) under CPB were studied. Patients with history of neurological disease were excluded. Preoperative National Institute of Health stroke scale (NIHSS) score ≤ 9. According to postoperative NIHSS score on 2nd postoperative day, the patients were divided into 3 groups: group A no neurological deficit ( NIHSS score 0-9 );group B mild neurological deficit (NIHSS score 10-19) and group C moderate or severe neurological deficit (NIHSS score 20-45). Blood samples were taken from internal jugular vein before CPB (T0), at 30 min of CPB (T1), at the discontinuation of CPB (T2), and at 1, 6, 24 h after discontinuation of CPB (T3-5) for determination of the plasma MBP concentration. The duration of operation, CPB time, aortic cross-clamping time were recorded.Results In group B the plasma MBP level peaked at 6 h after CPB (T4) and then decreased rapidly while in group C the plasma MBP level exceeded the normal upper limit at T2 and kept increasing till 24 h after CPB (T5 ).The plasma MBP level decreased at T1-3.5 in group A as compared with the normal upper limit. The plasma MBPlevel was significantly higher at T3-5 in group B and at T1-5 in group C than in group A and at T1-5 in group C than in group B. Linear regression analysis indicated that there was positive correlation between plasma MBP level and CPB time at T5. NIHSS scores were positively correlated with plasma MBP level at T1 , T2, and T5. Conclusion MBP can early reflect the severity of brain injury in patients undergoing cardiac surgery under CPB.

Objective To evaluate the changes in plasma S-100β protein concentration in patients undergoing cardiac surgery performed with cardiopulmonary bypass (CPB).Methods ASA Ⅱ or Ⅲ patients aged 60-77 yr weighing 55-75 kg with national institutes of health stroke scale(NIHSS) ＜ 10 undergoing coronary artery bypass grafting with CPB were enrolled in this study.Cerebral function was evaluated and scored using NIHSS at 2 d after operation.The patients were divided into 3 groups according to NIHSS scores:group A uncomplicated (NIHSS score 0-9),group B mild brain injury (NIHSS score 10-19) and group C moderate and severe brain injury (NIHSS 20-45).Plasma S-100β protein concentration was measured before CPB,at 30 min of CPB,the end of CPB and 1 h,6 h,24 h after CPB.The duration of operation,CPB time,aortic cross-clamping time and length of ICU stay and hospital stay were recorded.Results Ten patients in groups A and B and 12 in group C completed the trial.Plasma S-100β protein concentration was significantly increased during and after CPB as compared with the baseline at T0 and peaked at T3 (groups A,B) and T4 (group C).The plasma S-100β protein concentration was highest in group C and lowest in group A.The duration of operation,CPB time,aortic cross-clamping time and length of ICU stay and hospital stay were longest in group C and shortest in group A.Conclusion Plasma S-100β protein concentration can be used as a marker of cerebral injury after cardiac surgery performed with CPB and the concentration measured at 6 h after CPB is more significant in evaluating the degree of cerebral injury and prognosis.

Objective To investigate the effectiveness of Varenicline combined with MEDCHART application software for health education and follow-up in patients at smoking cessation clinic.Methods A total of 104 cases who had smoking cessation counseling and intervention at smoking cessation clinic from February 2014 to January 2015 were divided randomly into MEDCHART APP group (n=51) and conventional group (n=53).Both groups were intervened by brief admonishment and given Varenicline.The 9-12 weeks and 26th week protracted continuous abstinence rates were observed.Results There were no significant difference in 9-12 week protracted withdrawal rate between 26th week APP and conventional groups (56.9％ vs.45.3％),the 26th week abstinence rates in group MEDCHART APP (41.2％) were significantly higher than the conventional group (20.8％)(x2=5.088,P＜0.05).There was significant difference in full course completion rates between the two groups;15 cases (29.4％) completed the course in group MEDCHART APP,whereas 5 cases (9.4％) did so in conventional group (x2=4.405,P＜0.05).Conclusion MEDCHART APP can strengthen health education and follow-up,which helps extend the time for Varenicline,increase 26th week smoking cessation withdrawal rate.It is a useful tool for smoking cessation education and follow-up.

Objective:To explore the clinical characteristics, plasma levels of hydrogen sulfide(H 2S) and the relationship between the genotype and phenotype of cardiovascular involvement in children with methylmalonic acidemia and homocystinemia. Methods:The clinical and laboratory data of 66 outpatients diagnosed with methylmalonic acidemia combined with homocystinemia in Department of Pediatrics, Peking University First Hospital from January 2014 to July 2014 were collected and analyzed respectively, and the patients were divided into 2 groups: cardiovascular involvement group (10 cases) and non-cardiovascular involvement group(56 cases). The differences in the clinical characteristics, plasma levels of H 2S and genotypes were compared between 2 groups. Results:(1) There were 45 cases of early-onset children under 1 year old, including 4 cases of cardiovascular system involvement and 41 cases of non-cardiovascular system involvement.Twenty-one cases had onset above 1 year old, including 6 cases of cardiovascular system involvement and 15 cases of non-cardiovascular system involvement. There were 44 male children, including 8 cases with cardiovascular system involvement and 36 cases without cardiovascular system involvement; 22 cases female children, including 2 cases with cardiovascular system involvement and 20 cases without cardiovascular system involvement. There was no significant difference in onset age and gender distribution between the 2 groups ( χ2=2.910, 0.368, all P>0.05). (2)In the 10 cases with cardiovascular involvement, there were 3 cases with hypertension, 2 cases with hypertension combined with pulmonary hypertension, 2 cases with mild myocardial hypertrophy, 1 case with atrial septal defect combined with pulmonary hypertension, 1 case with pulmonary hypertension, 1 case with myocardial noncompaction.Compared with the non-cardiovascular involvement group, the proportion of kidney involvement was increased and that of nervous system was decreased in cardiovascular system involvement group( χ2=20.34, 5.79, all P<0.05), the proportion of hematological system involvement between the 2 groups had no significant differences ( χ2=1.28, P>0.05). The plasma levels of hydrogen sulfide of children with cardiovascular involvement was significantly lower than that of non-cardiovascular involvement[(33.8±3.6) μmol/L vs.(39.3±5.2) μmol/L, t=-3.22, P<0.01]. (3) MMACHC gene mutation (cblC type) was identified in all 46 patients.It was found that the most common type of gene mutation was c. 80A>G in cardiovascular involvement group, while c. 609G>A was the most common type of gene mutation in non-cardiovascular involvement group. Conclusions:The clinical manifestations of children with methylmalonic acidemia and homocystinemia involving cardiovascular system are multiple and prone to multiple system involvement, especially renal involvement.A decrease in plasma hydrogen sulfide levels may be involved in the involvement of its cardiovascular system.The MMACHC gene c. 80A>G mutation is the most common genetic mutation site in children with cardiovascular involvement with methylmalonic acidemia and homocystinemia.

Objective: To analyz the current situation of the diagnosis, treatment and prevention of methylmalonic acidemia, the phenotypes, biochemical features and genotypes of the patients in the mainland of China, were investigated. Methods: Tottally 1 003 patients of methylmalonic acidemia from 26 provinces and municipalities of the mainland of China were enrolled. The clinical data, biochemical features and gene mutations were studied. Blood aminoacids and acylcarnitines, urine organic acids, and plasma total homocysteine were determined for the biochemical diagnosis. Gene analyses were performed for the genetic study of 661 patients. The patients were treated with individual intervention and long-term follow up. Prenatal diagnoses were carried out for 165 fetuses of the families. Results: Among 1 003 patients (580 boys and 423 girls), 296 cases (29.5%) had isolated methylmalonic acidemia; 707 cases (70.5%) had combined homocysteinemia; 59 patients (5.9%) were detected by newborn screening; 944 patients (94.1%) had the onset at the ages from several minutes after birth to 25 years and diagnosed at 3 days to 25 years of age. The main clinical presentations were psychomotor retardation and metabolic crisis. Multi-organ damage, including hematological abnormalities, pulmonary hypertension, kidney damage, were found. MMACHC, MUT, MMAA, MMAB, HCFC1, SUCLG1, SUCLA2 mutations were found in 631 patients (96.6%) out of 661 patients who accepted gene analysis. MMACHC mutations were detected in 460 patients (94.7%) out of 486 cases of methylmalonic acidemia combined with homocysteinemia. MUT mutations were found in 158 (90.3%) out of 169 cases of isolated methylmalonic acidemia. The development of 59 patients detected by newborn screening were normal; 918 cases (97.2%) were diagnosed after onset accepted the treatment. Forty-five of them completely recovered with normal development. Twenty-six patients (2.7%) died; 873 (92.5%) patients had mild to severe psychomotor retardation. Methylmalonic acidemia were found in 35 out of 165 fetuses by metabolites assay of amniotic fluid and amniocytes gene analysis. Conclusion Combined methylmalonic acidemia and homocysteinemia is the common type of methylmalonic acidemia in the mainland of China. CblC defect due to MMACHC mutations is the most common type of methylmalonic acidemia combined with homocysteinemia. MUT gene mutations are frequent in the patients with isolated methylmalonic acidemia. Newborn screening is key for the early diagnosis and the better outcome. Combined diagnosis of biochemical assays and gene analysis are reliable for the prenatal diagnosis of methylmalonic acidemia.

Objective To study the effect of electroacupuncture and psychological rehabilitation on internet addiction disorder (IAD).Methods 111 IAD patients were divided into electroacupuncture group, psychology group and comprehension group (both electroacupuncture and psychological rehabilitation). They were measured with frequency and entropy of alpha competitive structure before and after treatment. Results The frequency increased and the entropy decreased in the comprehension group after treatment (P<0.05), and was significantly different from the other groups (P<0.05). There was no significant difference between the other 2 groups (P>0.05). Conclusion The combination of electroacupuncture and psychological rehabilitation may be effective on IAD.

Objective To assess the risk of public health incidents in the Hankou River Beach during the 7th World Military Games, and to provide reference for risk early warning and emergency preparedness. Methods An expert consultation meeting was held to determine the evaluation index and risk scores. Based on the Kaiser model, a public health risk assessment system suitable for Hankou River Beach was established, and the risk value of each risk event was calculated by the method of risk value calculation. The risk matrix method was used to evaluate the risk levels of different risk events in different areas of Hankou River Beach. Then, according to the calculated Borda values and order values of risk events in different regions, the different risks were ranked in each area. Results The calculation revealed that the risk values of schistosomiasis in the first, second, third and fourth stages of the river beach were 8.43%, 14.68%, 25.26% and 27.56%, respectively; the risk values of vector infectious diseases in each stage were 13.42%, 16.40%, 18.67% and 19.22%; the risk values of accidental injury and other events were 20.34%, 22.94%, 19.00% and 16.53%. According to the risk matrix, the first and second stages of schistosomiasis and vector borne infectious diseases, as well as the fourth stage of accidental injuries were located in the low-risk zone, while the other risk events were in the medium risk zone. The ranking results of Borda sequence value showed that the highest risk public health events in the first and second phases of the river beach were accidental injuries and others, in the third phase was schistosomiasis and accidental injuries, and in the fourth phase was schistosomiasis. Conclusion Considering the results of each evaluation method, the public health events with the highest risk in phase I and phase II of the river beach were accidental injuries, while in phase III and phase IV were schistosomiasis. It is suggested that relevant departments should formulate different strategies and take targeted measures to ensure the public health and safety of Hankou river beach during the Military Games.

Diagnosis, Differential ; Humans ; Lung Neoplasms/genetics* ; Neoplasm Metastasis ; Neoplasms, Multiple Primary/diagnosis*