Objective To investigate the pathogens and resistance of stroke-associated lower respiratory tract infection in elderly patients. Methods All the clinical isolates from sputum were analyzed retrospectively. Results There were 51 (79.7%) strains of Gram-negative bacilli, 11 (17.2%) strains of Gram-positive bacteria and 2 (3.1%) strains of fungi. The most important Gram-negative pathogens were Escherichia coli, Pseudomonas aeruginosa, Alcaligenes, Klebsiella, Acinetobacter baumanii, Stenotrophomonas maltophilia. Strains of Gram-negative bacteria were susceptible to imipenem, ceftazidime and amikacin, all strains of Gram-positive pathogens were susceptible to norvancomycin. Conclusion Gram-negative bacilli are the major pathogens in stroke-associated lower respiratory tract infection in elderly patients and the dominant is conditional pathogen.

OBJECTIVE: To investigate the potential anticancer effect of combretastatin A4 liposomes (SSL-CA4) in destruction of vascular mimicry (VM) in MDA-MB-231 breast cancer cells in vitro. METHODS: The in vitro inhibitory effect and blocking woundhealing effect of SSL-CA4 were investigated. The VM destruction of SSL-CA4 was evaluated in three dimensional matrigel culture model in MDA-MB-231 cells. The in vitro inhibitory test showed that the maxium inhibition ratio of SSL-CA4 on MDA-MB-231 cells was close to 50%. SSL-CA4 blocked the wound-healing of MDA-MB-231 cells, which was similar to free CA4. RESULTS: SSL-CA4 could inhibit the formation of VM in vitro via inhibition on the VM channel indicators including hypoxia-inducible factor (HIF-α), vascular endothelial- cadherin (VE-Cad), and matrix metallopeptidases (MMP-2). The inhibition on indicators of SSL-CA4 was significantly higher than CA4 treatment groups (P <0.05). CONCLUSION: SSL-CA4 has significant anticancer activity via inhibition of VM in MDA-MB-231 cell line.

Objective: To compare setup errors between patients using the customized Klarity AccuCushion® with a thermoplastic fixation mask and patients using a thermoplastic fixation mask or vacuum fixation cushion alone while receiving radiotherapy. Methods: A total of 66 patients with head and neck (H&N) tumors (n=27) or thoracic and abdominal tumors (T&N) tumors (n=39) were included during Jaurnary 2018 to December 2019. 15 H&N cancer patients using only a single head-neck-shoulder mask were categorized into group A; 12 patients using a customized Klarity AccuCushion® and head-neck-shoulder mask were categorized into group B. Among T&A cancer patients, 19 patients using only a vacuum fixation cushion were classified into group A; the remaining 20 patients using a customized Klarity AccuCushion® and thermoplastic fixation mask were classified into group B. Cone-beam computed tomography was performed, and the setup errors were evaluated. The setup errors in the left-right (LR) direction, superior-inferior (SI) direction, anterior-posterior (AP) direction, and for rotation were compared between groups A and B. Results: Among H&N cancer patients, the setup errors in group B in the LR direction, SI direction, and for rotation were 0.06±0.06 cm, 0.08±0.07 cm, and 0.12±0.17°, respectively, which were smaller than those in group A (0.10±0.11 cm, 0.13±0.14 cm, and 0.25±0.47°, respectively). The differences in setup errors in the LR direction, SI direction, and for rotation were significant between the two groups (P<0.05), while no significant difference was found in setup errors in the AP direction (P>0.05). For T&A cancer patients, significant differences were found in setup errors between the two groups (P<0.05) in the LR direction (group B vs. group A: 0.10±0.08 cm vs. 0.14±0.12 cm) and for rotation (group B vs. group A: 0.09 ± 0.18° vs. 0.22 ± 0.39°). No significant differences were observed in the setup errors in the SI and AP directions. Conclusions: Compared with the immobilization techniques using only a thermoplastic mask and only a vacuumed fixation cushion, the technique using a customized Klarity AccuCushion® with a thermoplastic fixation mask can improve repeatability, stability, and setup errors in radiotherapy.

Objective: To explore the application and choice of latissimus dorsi musculocutaneous flap and thoracodorsal artery perforator flap in different wound repair. Methods: From March 2012 to February 2018, 8 cases of different wounds were repaired with island latissimus dorsi myocutaneous flap pedicled with dorsal thoracic artery, free latissimus dorsi myocutaneous flap, or thoracodorsal artery perforator flap combined with scapular flap. The patients includes 4 cases of trauma, 2 cases of tumor and 2 cases of osteomyelitis. Among them, 5 cases received pedicled grafting, 2 cases had anastomotic vascular free grafting combined with antibiotic bone cement chain bead, 1 case had thoracodorsal artery perforator flap combined with scapular flap. Results: All 9 flaps of 8 patients survived. The size of the flaps ranged from 22.0 cm×7.5 cm to 28.0 cm×21.0 cm. All the donor and recipient areas healed well. After 2 months to 2 years follow up, all flaps have good blood supply, and the limbs′ function was normal. The appearance of flaps were satisfactory, with fully treated osteomyelitis, and no recurrence of the tumor was observed. Conclusions According to wound characteristics, selective application of thoracodorsal artery perforator flap, pedicled or free latissimus dorsi myocutaneous flap is effective for the repair of muscle, skin and soft tissue defects, as well as osteomyelitis, after tumor resection.

The study is to investigate the brain pharmacokinetics change of nasal tetramethylpyrazine phosphate (TMPP) pH-sensitive in situ gel in normal and model rats. Acute cerebral ischemia rat model was successfully established by middle cerebral artery occlusion (MCAO) method. Both normal and model rats were given nasal TMPP pH-sensitive in situ gel (10 mg x kg(-1)). Perfusates of brain striatum area were collected at each time point by microdialysis. The content of TMPP was determined by HPLC. The pharmacokinetics parameters were calculated by Kinetica 4.4 software at each time point of the brain drug concentration. The main pharmacokinetics parameters of TMPP were fitted with compartments 2. After nasal TMPP pH-sensitive in situ gel the values of C(max) and AUC of both components in brain showed as follows: the value of model group > that of normal group. Significant difference can be observed in the process of brain pharmacokinetics in normal and model rats after giving nasal TMPP pH-sensitive in situ gel.
Administration, Intranasal ; Animals ; Area Under Curve ; Brain ; metabolism ; pathology ; Brain Ischemia ; metabolism ; Chromatography, High Pressure Liquid ; Gels ; Hydrogen-Ion Concentration ; Infarction, Middle Cerebral Artery ; Male ; Microdialysis ; Phosphates ; administration & dosage ; pharmacokinetics ; Pyrazines ; administration & dosage ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

OBJECTIVE To discuss the management methods of sputum sample retained clinically based on the praxiology,and aim at improving the quality of the sputum retained. METHODS Through investigating the quality of sputum sample retained routinely from the department of internal medicine in a general hospital at the duration from Sep 2004 to Feb 2005,the intervention effect was evaluated by carrying out the measure of praxiology intervention. RESULTS The qualification rate was 23.7% for the sputum sample retained routinely from the hospital at the duration from Sep 2004 to Feb 2005,after carrying out the measure of praxiology intervention,the qualification rate was 30.1% at the duration from Apr 2005 to Aug 2005.Statistic data showed that there was no significant difference. CONCLUSIONS The quality of the sputum sample retained routinely is poor,and the measure of praxiology intervention failed to improve the quality of the sputum sample.Microscopy is the most important measure to ensure the quality of the sputum sample for the cytology test before cultivating the sample,and should be a routine test in hospital.The study on praxiology intervention will be further carried out in the future.

Objective To explore the application conditions of 22 S rule (one of the Westgard rules) in single concentration quali‐ty control .Methods The application scope of 22 S rule was used into the same batch detection of single‐concentration quality control materials .Results The 22 S rule improved the detection rate of system errors .Conclusion 22S rule should be applied to two detec‐tions within a batch when using one quality control material ,as to improve the detection of system error more efficiency .

Objective To investigate the effects of transplantatation human endothelial progenitor cells onneurological functional recovery from spinal cord injury model in rats,survival of transplanting cells and differentia-tion. Method The human endothelial progenitor cells were provided by Shanghai Developmental Biology Labora-tory.Forty SD rats were made for the animal model of spinal cord complete transection.Thirty survival SD rats wererandomly divided into three groups:sham operation gronp(group A, n = 10),operation/cell group(greup B, n =10) and operation/DMEM group (group C, n = 10).Suspension containing (hEPCs 6×106) was transplanted in-to the vertebral canal around injured spinal cord. In group C, equal volume of DMEM was injected insbead in the same way as in the group B. The BBB score was obtained 2,4,6,8 weeks after injection, Immunohistochemistry andin-situ hybridization were used to observe the cells survival and differentiation in the spinal cord. The BBB test wasperformed to study the functional improvement of cells. The SAS version. 1.3 software for statistics was to studyethology and functional improvement. The sum of ranks was checlced with Kruskal-Wallis Test and Nemenyi test.Results There were statistically significant differences in BBB scoring between group A and group B as well asgroup C after operation (P<0.05). The BBB score in group B was higher than that in group C after 2,4,6 and8 weeks,but lower than in group A. The hybridization in-situ and immunohistochemistry showed that transplantedcells survived for 8 weeks after transplantation and expressed specific characteristics for ancestral cell and differentiated into vascular endothelial cell (VEC). Conclusions After transplantation, hEPCs can survive, differenti-ate into vascular endothelial cell,and improve spinal cord function as compared with control group.

OBJECTIVE This objective of this study was to investigate intranasal anatomic abnormalities in cases of contact point headaches caused by contact between the nasal septum and the lateral nasal wall,as well as the clinical outcomes in these cases treated by endoscopic sinonasal surgery. METHODS A retrospective review was performed on 58 cases that met the criteria of having contact points between the septum and the lateral nasal wall, as demonstrated by CT scans of the sinuses and endoscopic examinations. These patients underwent surgical intervention in order to correct the contact points. They were re-evaluated for clinical parameters three months after the surgical correction of their anatomic abnormalities. RESULTS Abnormal nasal septa, enlarged turbinates and other anatomic abnormalities were the most common findings in contact point headaches. Fifty-eight patients underwent surgical correction of intranasal anatomic abnormalities. After follow-up periods of 3-18 mouths, 32 patients were cured, 23 were relieved to an extent, and 3 did not benefit. A significant decrease in the severity and frequency of headaches was noted after surgery. CONCLUSION Pressure from mucosal contact between the septum and lateral nasal wall mucosa is the key cause of contact point headaches, as seen in CT scans of the sinuses and endoscopic examinations. Clinically significant pain may improve after surgical correction of intranasal anatomic abnormalities.

Objective To establish a learning evaluation indexes systen of flipped teaching method,and provide the basis for evaluating academic performance of each student who majors in nursing.Methods The indexes were determined by Delphi method of two rounds of consultation involving 15 experts,and the weight of every index was set up by analytic hierarchy process.Results The response rates of questionnaire investigation for the two rounds of consultation were 13/15 and 12/13 respectively.The authority value of experts was 0.847.The Kendall concordance coefficients for the indexes of first-level,second-level and third-level were 0.373,0.258 and 0.595 respectively,P＜0.05.Finally,the evaluation indexes system including 3 first-level indexes,5 second-level indexes,and 6 third-level indexes was set up.Conclusions The results of the two rounds of expert consultation are reliable.The consistency of expert opinions is good.The study provides a scientific and systematic evaluation tool for evaluating nursing undergraduates' performance under flipped teaching.