Objective To observe the outcome of an absorbable bioactive bone-inducing material for the treatment of osteonecrosis of the femoral head (ONFH).Methods Thirty rabbits were randomly,evenly divided into three groups,experience group with bioactive bone-inducing material planted into bone collapse,control group 1 with oral ShengMaiJiaoNang and control group 2 with no implantation in the bone necrosis.Results In experiment group,bone necrosis was halted and the collapse was repaired.Meanwhile,cancellous bone and cortical bone were regenerated,necrotic bone was basically healed,and bioactive bone-inducing material was gradually degraded and absorbed.In control group 1,part of the bone marrow vascular was repaired and regenerated,and a little new bone grew,which delayed the process of necrosis.In control group 2,there was no bone tissue regeneration in the bone collapse and further deterioration was observed.Conclusions The bioactive bone-inducing material can not only replace autologous cancellous bone,but also halt the progress of osteonecrosis,which may become an alternative treatment for the stage Ⅱ and early stage of ONFH.

OBJECTIVETo explore the clinical and radiological features of severe acute respiratory syndrome (SARS).

METHODSAnalysis of the clinical presentation, chest radiographs, course of disease and features of severe pneumonia in 45 SARS patients diagnosed at our hospital in Beijing between April 5 - 20, 2003. Also included is a summation of the clinical features of SARS.

RESULTS(1) SARS appears to have high infectivity; (2) the most common symptom is fever; (3) the count of leukocyte is normal or decreased; (4) most patients (35/45, 77.8%) had experienced a 24-hour fever prior to the abnormal chest X-ray changes which showed progression of pulmonary infiltrates within 48 hours in 71.1% (32/45) of the patients and, (5) the percentage of patients who developed severe pneumonia (24.4%) is higher than those who developed typical pneumonia.

CONCLUSIONSARS is a disease with high infectivity and has its own clinical and radiological features. Early recognition, prompt isolation, and appropriate therapy are the key to combat this infection.

Adult ; Female ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Severe Acute Respiratory Syndrome ; diagnosis ; mortality ; therapy

BACKGROUNDThe extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae has increasingly become a major contributor to nosocomial infections and can exhibit multiple antibiotic resistance. Previous studies have focused on the resistance genes in ESBL-producing strains, and the resistance-associated genetic environment of non-ESBL-producing strains has been ignored until now. Here, we investigated the occurrence and characteristics of non-ESBL-producing K. pneumoniae, which potentially carries unexpressed resistance genes.

METHODSK. pneumoniae strains were collected from five medical institutions in China from February 2010 to August 2013. The VITEK-2 ESBL detection system was used as a primary screen to identify the ESBL-producing phenotype, and the three primary types of ESBL-associated genes (CTX, SHV, and TEM) were detected by polymerase chain reaction (PCR) to confirm the strains presenting with a non-ESBL-producing phenotype. mRNA expression in the non-ESBL-producing strains was further screened by reverse-transcription PCR (RT-PCR) to validate their transcriptional efficiency.

RESULTSOut of 224 clinically isolated antibiotic-sensitive K. pneumoniae strains with a non-ESBL-producing phenotype, 5 (2.2%) were identified to carry inactivated ESBL blaSHV genes with intact upstream promoter regions and resistance gene sequences. Interestingly, three of the five antibiotic-sensitive K. pneumoniae strains containing ESBL blaSHV genes still exhibited mRNA transcription of blaSHV, while the other two exhibited no mRNA transcription.

CONCLUSIONThese findings suggest that inactivated ESBL genes exist in non-ESBL-producing antibiotic-sensitive K. pneumoniae strains, which have the potential to transform the strain into an ESBL phenotype if an inappropriate application or overdose of antibiotics is implemented during clinical management.

Anti-Bacterial Agents ; pharmacology ; China ; Drug Resistance, Multiple, Bacterial ; genetics ; Humans ; Klebsiella pneumoniae ; drug effects ; enzymology ; genetics ; Microbial Sensitivity Tests ; beta-Lactamases ; genetics