Objective To explore the correlation between fibrinogen,D-dimer and carotid atberosclerosis plaque in patients suffering acute cerebral infarction. Methods The present study enrolled 120 patients with acute cerebral infarction who had sought medical treatment in our department from April 2009 to April 2011 (group A),60 contemporary patients with carotid atherosclerosis plaque (group B) and 80 healthy adults who had undergone health check-ups at the same period (group C).The level of serum D-dimer was detected by double antibody sandwich method,the fibrinogen content was detected by an automatic hemagglutination analyzer (STA-COMPACT,STAGO),carotid atherosclerotic plaques and the carotid interior and medial thickness (IMT) were measured by carotid artery color Doppler ultrasound. Comparisons were made between the 3 groups. Results The serumal level of fibrinogen,D-dimer content and carotid IMT in the 3 groups decreased significantly from group A to B toC (P＜0.05).The serumal levels of fibrinogen and D-dimer in the patients with progressive stroke were significantly higher than in the patients with non-progressing stroke (P＜0.05).In patients with acute cerebral infarction, the severity of carotid atherosclerotic plaque was positively correlated with the serumal levels of fibrinogen and D-dimer (r=0.426, P=0.006; r=0.535,P=0.001). Conclusions Fibrinogen and D-dimer may have a role in the occurrence and development of acute cerebral infarction and may be closely associated with the progression of the condition.Since D-dimer and fibrinogen are reactants at the acute phase, inflammation may be more related to atherosclerosis than is hypercoagulation.

Objective To study the distribution of pathogens,the positive time and drug resistance of pathogenic bacteria by blood culture of adult patients,in order to provide the basis for the early clinical discovery and treatment of bacteremia. Methods 3 537 specimens of adult blood culture were collected from July 2016 to December 2016,then identified the posi-tive bacteria strains,and analysed the antimicrobial susceptibility.Results In 3 537 specimens of adult blood culture,485 positive samples were detected,and the positive rate was 13.7%(485/3 537).Including 203 cases(41.9%)of both aerobic and anaerobic positive bottles,220 cases(45.3%)of aerobic positive bottles,and 62 cases(12.8%)of anaerobic positive bottles.About pathogens,229 specimens were gram-negative bacteria strains,accounting for 47.2%.The great majority of bacteria was E.Coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and they all showed sensitivity to imipenem.202 specimens were gram-positive bacteria strains,accounting for 41.7%,mainly on Staphylococcus aureus and Staphylococcus epidermidis,they all showed sensitive to vancomycin.54 strains were Fungi,accounting for 11.1%.For analysis of 203 ca-ses of aerobic and anaerobic both positive bottles,the results showed that:there were 121 cases of gram-negative bacteria strains,95(78.5%)specimens anaerobic jar to positive time earlier than aerobic bottle to positive time,26(21.5%)speci-mens aerobic bottle jar to positive time earlier than anaerobic bottles to positive time.78 cases of gram positive bacteria,an-aerobic jar to earlier than aerobic bottle to positive time had 45 strains,accounting for 57.7%.Aerobic bottle to positive time earlier than anaerobic bottles to positive time had 33 strains,accounting for 42.3%.Fungi,a total of 4 strains,50% each. Positive pathogens were mainly distributed in I,emergency surgery,respiratory medicine department.Conclusion Pathogen-ic bacteria isolated from the adult blood culture was given priority to gram-negative bacteria,pathogenic bacteria species and drug susceptibility difference was obviously.Clinicians should be combined with blood culture and drug susceptibility results of use of antimicrobial drugs to patients.

OBJECTIVETo study the role and effect of Schwann cells (SCs) remyelination in contused spinal cord.

METHODSGreen fluorescence protein expressing-SCs were transplanted into the epicenter, rostral and caudal tissues of the injury site at 1 week after the spinal cords were contused. At 6 weeks, the spinal cords were removed for cryosections, semithin sections and ultrathin sections, and then immunocytochemical staining of myelin basic protein (MBP), P0 protein (P0) and S100 protein (S100) was carried out on the cryosections. Qualitative and semiquantitative analyses were performed on the cryosections and semithin sections. Ultrastructure of myelinated fibers was observed on the ultrathin sections under electron microscope.

RESULTSTransplanted SCs and myelinated fibers immunocytochemically labeled by MBP, P0 as well as S100 distributed in whole injured area. The quantity of myelinated fibers labeled by the three myelin proteins showed no statistical difference, however, which was significantly larger than that of controls. On the semithin sections, the experimental group demonstrated more myelinated fibers in the injured area than the controls, but the fibers had smaller diameter and thinner myelin sheath under electron microscope.

CONCLUSIONSCs can promote regeneration of injured nerve fibers and enhance remyelination, which may be histological basis of SCs-mediated functional repair of injured spinal cords.

Animals ; Immunohistochemistry ; Microscopy, Electron ; Myelin Basic Protein ; metabolism ; Myelin P0 Protein ; metabolism ; Nerve Regeneration ; physiology ; Rats ; Rats, Sprague-Dawley ; S100 Proteins ; metabolism ; Schwann Cells ; physiology ; ultrastructure ; Spinal Cord Injuries ; metabolism ; physiopathology

OBJECTIVETo investigate the analgesic and sedative effects of inhaling a mixture of nitrous oxide and oxygen on burn patient during and after dressing change.

METHODSA total of 240 burn patients hospitalized in the Institute of Burn Research of Changhai Hospital Affiliated to the Second Military Medical University, Department of Burns of the First People's Hospital in Zhengzhou, and Department of Burns and Plastic Surgery of General Hospital of Ningxia Medical University from October 2011 to September 2012 were enrolled in our study, and they were all in accordance with the inclusion criteria. The 240 patients were divided into control group (n = 60, treated with inhalation of oxygen during dressing change) and treatment group (n = 180, treated with inhalation of a mixture of 65% nitrous oxide and oxygen during dressing change) according to the computer-generated list of random number. The other treatments in control group and treatment group were the same. Before, during, and after dressing change, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation (SO2), and adverse effects were observed. The degree of pain and anxiety felt by the patients were respectively evaluated with the visual analogue scale (VAS) and Chinese version of the burn specific pain anxiety scale (C-BSPAS) at the same time points as above. Data were processed with analysis of covariance, chi-square test, analysis of variance, and rank sum test.

RESULTSThere were no significant differences between control group and treatment group in the levels of HR, SBP, DBP, and SO2 before dressing change (with F values respectively 0.76, 0.06, 1.11, 0.70, P values all above 0.05). Compared with those of control group, the levels of HR, SBP, DBP, and SO2 in treatment group were significantly ameliorated during dressing change (with F values respectively 81.78, 146.36, 226.44, 205.62, P values all below 0.01). After dressing change, the levels of DBP in the two groups were close (F = 0.31, P > 0.05), but the levels of HR, SBP, and SO2 showed statistical differences (with F values respectively 7.02, 8.69, 12.23, P < 0.05 or P < 0.01). Before dressing change, the VAS scores were approximate between control group and treatment group (Z = 0.21, P > 0.05). Compared with those in control group (9.4 ± 0.7, 1.7 ± 2.5), the VAS scores were significantly lowered in treatment group during and after dressing change (1.6 ± 1.3, 0.7 ± 1.1, with Z values respectively 11.84, 3.35, P values all below 0.01). There was no significant difference in C-BSPAS score between control group and treatment group before dressing change (Z = 0.62, P > 0.05). Compared with those in control group (75 ± 13, 73 ± 12), the C-BSPAS scores in treatment group were decreased during and after dressing change (9 ± 15, 9 ± 14, with Z values respectively 11.91, 12.28, P values all below 0.01). There were no obvious adverse effects in two groups before, during, and after dressing change.

CONCLUSIONSA mixture of nitrous oxide and oxygen seems to have obvious analgesic and sedative effects on burn patients during dressing change, and it can be widely used.

Administration, Inhalation ; Adolescent ; Adult ; Aged ; Analgesia ; methods ; Bandages ; Burns ; surgery ; Female ; Humans ; Hypnotics and Sedatives ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Nitrous Oxide ; administration & dosage ; therapeutic use ; Oxygen ; administration & dosage ; therapeutic use ; Young Adult

OBJECTIVETo summarize the experience of minimally invasive robotic coronary bypass on beating heart using da Vinci S in China.

METHODSFifty-six patients underwent selected robotic coronary bypass on beating heart from April 2007 to December 2008. All the patients had history of angina and the coronary arteriography showed severe stenosis in the left anterior descending artery (LAD), of which 10 cases had right coronary artery or left circumflex coronary (LCX) stenosis. The age was 33 to 74 years old, with a mean of (55.8 +/- 9.4) years old. The weight was (71.4 +/- 13.2) kg. All the patients had good lung function and had no medical history of pleurisy and thoracic surgery. CT scan of double internal thoracic artery (ITA) was routinely checked preoperatively. The procedures included: (1) The robotically assisted endoscopic atraumatic coronary artery bypass surgery. The approach was via a small left anterior thoracotomy (6 to 8 cm) after robotic ITA was taken down. The ITA was manually anastomosed to the LAD or LCX on beating heart. (2) Totally endoscopic coronary bypass graft on beating heart. After ITA harvesting, the endo stabilizer was inserted via the fourth port in the xiphoid area under endoscopic vision. The left ITA to the LAD grafting was done using U-clips on beating heart in a totally endoscopic manner using da Vinci S system through 4 ports. For all patients the ITA flow was checked by the Doppler flowmeter after anastomosis was completed. After the surgery was completed, the thoracic port was checked carefully to avoid bleeding. The operating procedures and a variety of clinical parameters were recorded and analyzed. (3) Stent placement after robotic surgery in a hybrid manner. The graft patency rate was evaluated by CT or arteriography.

RESULTSAll patients successfully accepted robotic minimally invasive coronary bypass on the beating heart using da Vinci S surgical system without complications. The mean graft flow was (23.2 +/- 16.7) ml/min. And there was no surgical conversion and surgical death. Fifty-three patients received ITA to LAD grafts and 3 patients received double coronary artery bypass grafts as well. Ten cases received stent placement in separate session. The CT scan and angiography revealed patent grafts in all patients. There were no post-operative complications. All patients were discharged from hospital.

CONCLUSIONSAs a new advanced approach of revascularization, robotic ITA harvesting and coronary anastomoses can be safely performed with the da Vinci S system. The procedure is minimally invasive and can offer enhanced ability to control precise and stable operative manipulations.

Adult ; Aged ; Coronary Artery Bypass, Off-Pump ; instrumentation ; methods ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Robotics

OBJECTIVETo observe the survival and the number of olfactory ensheathing cells (OECs) transplanted in the contused spinal cord, so as to provide a basis for further studying the biological action of OECs.

METHODSThe rat spinal cords were contused with NYU-impactor II at T10 level by dropping a 10 g rod from a height of 25 mm. At the 1st week after injury, OECs isolated freshly from green fluorecense protein (GFP) of the rats were transplanted into the spinal cord at injured site and other two sites 1 mm apart from the caudal and rostral ends with the OECs number of 30000/μl x 3 = 90000. The survival and the number of OECs were qualitatively and semi-quantitatively observed under the fluorescense microscope from 1 week to 13 weeks after transplantation. The motor function of the cord was evaluated with BBB score.

RESULTSGFP-OECs could survive at least for 13 weeks within the contused spinal cord. Their arrangement was from tight to loose and their number was decreased from 1 week to 13 weeks after injury. The average number of GFP-OECs was 536 at the 1st week, which was less than 1% of the number as compared with original transplantation. After then, the number of GFP-OECs was continually decreased, but the most obvious decrease was found during 1 week to 2 weeks. The extent of decrease at other time points was relatively mild. In contrast to the cell number, motor function of the cord was gradually recovered after transplantation.

CONCLUSIONSThe survival and the number of GFP-OECs are different between the animals and are affected by the pathological reaction of the host cord. Also it is related to the motor function recovery of the contused cord.

Animals ; Cell Count ; Cell Survival ; Cell Transplantation ; Motor Activity ; Nerve Degeneration ; Olfactory Bulb ; cytology ; transplantation ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; physiopathology ; Spinal Cord Injuries ; physiopathology ; surgery

OBJECTIVETo summary the first 14 cases undergoing internal mammary artery (IMA) harvest using da Vinci S system and minimally invasive direct coronary artery bypass grafting (MIDCAB) on beating heart.

METHODSThe average age of patients was (60.4 +/- 10.1) years old. One case was female and 13 male. All the patients had a history of angina. The coronary angiography showed severe stenosis of anterior descending branch in all patients, of which 2 cases had diagonal and circumflex branch stenosis. Four case had myocardial infraction history. All the patients had good lung function and had no medical history of pleurisy. Without sternotomy, the camera cannula was placed in the left, 3 cm lateral to nipple in the 4th intercostal space (ICS). Da Vinci instrument arms were inserted through two 1 cm trocar incisions. The right instrument generally was positioned 4 to 6 cm cephalad to camera cannula in the 2nd or 3rd ICS. The left instrument arm was positioned 4 to 6 cm caudal to the camera cannula in the 5th or 6th ICS. Arm trocar sites were maintained 6 cm apart at chest entry. The internal mammary artery was harvested in routine methods. Thirteen cases underwent left internal mammary artery harvest, one case underwent right internal mammary artery harvest, one case underwent double internal mammary harvest. MIDCAB was performed on beating heart in 14 cases and 1 case accepted the totally endoscopic coronary artery bypass (TECAB).

RESULTSAll cases were accomplished successfully without complications. The average time of ICU was 20 hours. Robotic surgery had less draining than the conventional coronary bypass.

CONCLUSIONSTotally robotic internal mammary artery harvest and beating heart coronary artery bypass is less invasive, more precise, safe and efficient.

Adult ; Aged ; Coronary Artery Bypass, Off-Pump ; methods ; Female ; Humans ; Male ; Mammary Arteries ; surgery ; Middle Aged ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Robotics ; Treatment Outcome

Objective To establish methods for isolating and culturing the olfactory ensheathing cells (OECs) from young adult GIT rat to lay the foundation for repair of the spinal cord injury.Methods The OECs were dissociated from the first outer layer of the olfactory bulb of the young adult GFP rat (2.5 months old) under anatomical microscope; enzymatic digestion was performed on these cells and then they were inoculated into DMEM/F12 with 20% fetal calf serum. The morphology of OECs was regularly observed and photographied under light and electronic microscope. On the 10th culture day, the OECs were identified by the immunocytochemistry staining of S-100 and NGFRp75 and the purity (the positive rate) was calculated. Results The OECs showed strong green fluorescence under fluorescent microscope and presented morphological types of bipolar and bearing multipolar. More than 95% of the cultured cells were identified to be OECs, which expressed S-100 and NGFR p75. The cell structure revealed by electron microscope was much accordance with that by light microscope. Conclusion This method is easy to perform and high purity of GFP-OECs can be harvested with the same morphological characteristics and biological activity as general OECs. Therefore, OECs derived from the GFP transgenic rat can be effective tool cells, and widely used in studying the role of OECs in the repair of spinal cord injury

Objective To assess vitamin D levels in eastern China by a standard measurement. Methods The data were from a 2014 Survey on the Prevalence in East China for Metabolic Diseases and Risk Factors-China data base. There were 12662 subjects included in this cross-sectional study from February 2014 to June 2016. We assessed the vitamin D levels of natural population by a standard classification in which serum 25-hydroxy vitamin D (25-OHD)<50 nmol/ L was defined as vitamin D deficiency. Results The average serum 25-OHD level was (40. 5 ± 12. 5)nmol/ L, and there were 80. 3% subjects who would be classified as vitamin D deficiency; The average serum 25-OHD level of women was significantly lower than that of men (P< 0. 05); The serum 25-OHD concentrations of the <30, 30-39, 40-49, 50-59, 60-69, ≥70 age groups were 37. 81(31. 98-43. 52)nmol/ L, 39. 46(33. 87-45. 72) nmol/ L, 41. 17(34. 10-48. 65) nmol/ L, 40. 67(34. 20-49. 02) nmol/ L, 44. 00 (35. 67-53. 93) nmol/ L, 44. 14 (34. 61-55. 85)nmol/ L for males, and 36. 86 (30. 52-43. 75) nmol/ L, 37. 11 (31. 68-43. 23) nmol/ L, 36. 94 (30. 72-43. 71) nmol/ L, 38. 42(32. 08-46. 41) nmol/ L, 38. 58(31. 04-46. 21) nmol/ L, 37. 31(29. 34-47. 17) nmol/ L for females in corresponding subgroups. Conclusion The prevalence of vitamin D deficiency of natural population in eastern China was common, the levels of vitamin D in women were lower than those of men. However, the vitamin D levels were tended to be increasing with the advance of age.

PURPOSEWe once reported blast-induced traumatic brain injury (bTBI) in confined space. Here, bTBI was studied again on goats in the open air using 3.0 kg trinitrotoluene.

METHODSThe goats were placed at 2, 4, 6 and 8 m far from explosion center. Trinitrotoluene (TNT) was used as the source of the blast wave and the pressure at each distance was recorded. The systemic physiology, electroencephalogram, serum level of S-100 beta, and neuron specific enolase (NSE) were determined pre and post the exposure. Neuroanatomy and neuropathology were observed 4 h after the exposure.

RESULTSSimple blast waveforms were recorded with parameters of 702.8 kPa-0.442 ms, 148.4 kPa-2.503 ms, 73.9 kPa-3.233 ms, and 41.9 kPa-5.898 ms at 2, 4, 6 and 8 m respectively. Encephalic blast overpressure was on the first time recorded in the literature by us at 104.2 kPa-0.60 ms at 2 m, where mortality and burn rate were 44% and 44%. Gross examination showed that bTBI was mainly manifested as congestive expansion of blood vessels and subarachnoid hemorrhage, which had a total incidence of 25% and 19% in 36 goats. Microscopical observation found that the main pathohistological changes were enlarged perivascular space (21/36, 58%), small hemorrhages (9/36, 25%), vascular dilatation and congestion (8/36, 22%), and less subarachnoid hemorrhage (2/36, 6%). After explosion, serum levels of S-100b and NSE were elevated, and EEG changed into slow frequency with declined amplitude. The results indicated that severity and incidence of bTBI is related to the intensity of blast overpressure.

CONCLUSIONBlast wave can pass through the skull to directly injure brain tissue.

Animals ; Blast Injuries ; complications ; Brain ; pathology ; Brain Injuries, Traumatic ; etiology ; pathology ; Electroencephalography ; Goats ; Male ; Phosphopyruvate Hydratase ; blood ; S100 Calcium Binding Protein beta Subunit ; blood