OBJECTIVE:To analyze the distribution of the common pathogenic bacteria and drug resistance in urinary tract infection for clinical reference of rational use of antibacterials. METHODS:The medical records of patients hospitalized in urinary surgery in our hospital from Jan. to Oct. in 2008 were retrospectively collected for analyses of the results of mid-stream urine culture and antibiotic resistance,meanwhile,the current utilization of antibacterials in urinary surgery was analyzed. RESULTS:Gram negative bacilli were the major pathogenic bacteria in urinary tract infection(61.82%),of which,escherichia coli represented 58.82%,and the resistant rates of the gram negative bacilli to imipenem,amikacin,cefoperazone/sulbactam and piperacillin/tazobactam were 8.82%,8.82%,11.76% and 11.76%,respectively. CONCLUSION:The antibiotics should be used rationally according to the result of susceptibility test in treating patients with urinary tract infection.

Clinical data of 899 patients,who received colposcopic examination,were retrospectively analyzed.Both Reid's colposcopic index(RCI)score and biopsy were performed.The study showed that the value of RCI score was positively related to the severity of cervical lesions(F=2.043,P=0.03).The specificity of RCI for cervicitis,cervical intraepithelial neoplasia(CIN)Ⅰ were 98.8%,95.7% respectively;while sensitivity and negative predictive value for CIN Ⅱ,CIN Ⅲ were 77.7%,70.0%and 96.8%.97.4%,respectively.So RCI scoring can increase the diagnostic value of colposcope.

Objective:To investigate the changes of gene or protein expression and activity of matrix metalloprotein9 (MMP9) and tissue inhibitor ofmetalloproteinasel (TIMP1) in the carotid artery (CA) of 4 wk hindlimb unweighted rat.Methods:A 4 weeks(wk) hindlimb unweighted (HU) rat model was used to simulate the effect of weightlessness on the cardiovascular system.Transmission electron microscopy was used to detect the content of ECM.Reverse transcriptase polymerase chain reaction(RT-PCR) was conducted to measure the mRNA content MMP and TIMP1.Immunohistochemistry and Western blot technique were used to measure the protein abundance.Gelatin zymography was carried out to detect the activity of MMP9.Results:Compared to the control group (CON),the area of ECM was enhanced (P＜0.05) and the content of collage fiber was increased (P＜0.05) in the CA of HU rats;moreover,HU did not affect the mRNA expression of MMP9,but significantly reduced the protein content (P＜0.05) or enzymatic activity (P＜0.05).Accordingly,the mRNA or protein expression of TIMP1 in the CA was significantly increased by HU (P＜0.05).Conclusion:Simulated weightlessness caused imbalance between MMP and TIMP1 expression,which might contribute to the ECM aggregation and stiffness of CA.

OBJECTIVETo evaluate the efficacy and safety of transcatheter closure of perimembranous ventricular septal defects (VSD) in children following transthoracic echocardiography (TTE).

METHODSFrom September 2002 to December 2005, eighty-nine children (47 males and 42 females) with perimembranous (VSD) underwent an attempt of transcatheter interventional occlusion. Among the 89 children, one of them was diagnosed with patent ductus arterious (PDA) and six with VSD leakage after the surgical repair (three with leakage after the surgical repair of tetralogy of Fallot and three with leakage after the surgical repair of VSD). The mean age of patients was (6.4 +/- 3.9) years (ranged from 1 to 18 years). The mean body weight of patients was (22 +/- 11 )kg (ranged from 9 to 78 kg). The mean diameter of VSD measured by TTE was (4.3 +/- 1.5) mm(ranged from 2 to 8.5mm). The path of artery to vein was established following X-rays and TTE. Occluder was released through the right heart system. All patients were followed up in 1, 3, 6 and 12 months after procedure of TTE, X-ray and electrocardiography.

RESULTThe devices were deployed successfully in 85 patients, the rate of success was 95.5%. No death occurred during and after the procedure. There was trivial residual shunt in 12 patients immediately after the closure by TTE and angiography. Twenty-four hours later, only 3 patients had trivial residual and no shunt existed after 6 months follow-up. Convulsion occurred in 1 case due to serious cardiac arrhythmias. Hemolysis was found in 2 cases. Other complications included 2 cases of complete left bundle branch block, 1 cases of left anterior fascicular block and 3 cases of incomplete right bundle branch block. They recovered after 3 to 7 days of corticosteroid treatment. After 1 to 36 months (mean 9 months) follow-up, none of occluders displacement occurred and no valve was involved.

CONCLUSIONTranscatheter closure of membranous VSD using occluder would be safe and effective for children, and the results of short-term was satisfied. Transcatheter closure of VSD following TTE is a feasible method. TTE has the potential benefit of avoiding general anesthesia and esophageal intubation in children.

Adolescent ; Cardiac Catheterization ; methods ; Cardiovascular Surgical Procedures ; methods ; Child ; Child, Preschool ; Female ; Heart Septal Defects, Ventricular ; diagnostic imaging ; surgery ; Humans ; Infant ; Male ; Prostheses and Implants ; Prosthesis Implantation ; methods ; Treatment Outcome ; Ultrasonography, Interventional

BACKGROUND: The technology of biodegradable materials covering growth factors can be used to make sustained-release microspheres, which provides the feasibility for the efficient utilization of growth factors. OBJECTIVE: To prepare nano/micron-sized spheres using recombinant human bone morphogenetic protein 2/poly(lactic-co-glycolic acid) (rhBMP-2/PLGA)copolymer and to compare their release behaviors by in vivo and in vitro release experiments. METHODS: The rhBMP-2/PLGA nano/micron-sized spheres were prepared by emulsion solvent evaporation method to control the rate of pulp mixing.(1)In vitro release experiment:Prepared nano/micron-sized spheres were dissolved in PBS for 70 days,and then ELISA method was used to detect the rhBMP-2 concentration in the supernatant at different time.(2)In vivo release experiment:Forty-four New Zealand rabbits were divided into two groups, and rhBMP-2/PLGA nano/micron-sized spheres were respectively implanted into trochanteric defects. The concentration of rhBMP-2 in the defect site was detected by ELISA within 70 days after implantation. RESULTS AND CONCLUSION:In vitro sustained release experiment:There was a sudden release of nanospheres in the former 3 days,and the cumulative release nearly reached 41%, followed by a steady and slow release, and then the cumulative release was up to approximately 83% at 70 days. The initial release of micron-sized spheres was less than that of nanospheres, and the cumulative release was about 20% within the former 3 days and reached to 70% at 70 days.In vivo sustained release test:There was a sudden release of the nanospheres,the cumulative release was nearly 35%, followed by a steady and slow release, and then the cumulative release was up to approximately 72% at 70 days. The initial release of micron-sized spheres was less than that of nanospheres, and the cumulative release was about 21% in the former 3 days and increased to about 63% at 70 days.In both in vivo and in vitro release experiments,the release duration of micron-sized spheres was longer than that of nanospheres in the former 3 days. To conclude, the release time of rhBMP-2/PLGA micron-sized spheres fulfills the need of bone growth cycle, therefore, rhBMP-2/PLGA micron-sized spheres are more favorable than rhBMP-2/PLGA nanospheres for bone defect repair in clinical practice.

Humanin(HN,its analogue [Gly14]-Humanin,HNG)was originally identified as an endogenous peptide that protects neuronal cells from apoptosis induced by various types of Alzheimer's disease-related insults.But the relative low content of this peptide in its natural sources limits its further characterization.An expression vector pET32a/HNG was corstructed and transformed it into E.coli BL21 trxB(DE3).HNG was expressed as a fusion protein in the soluble fraction and was purified by nickel affinity chromatography.Subsequently,the purified fusion protein was cleaved by enterokinase and was further purified by reverse-phase HPLC.A 23 mg recombinant HNG(rHNG)from 1 L bacterial culture was purified.The molecular weight of rHNG determined by ESI-MS was 2876.5 Da which was the expected size for correctly processed peptide.The N-terminal amino acid sequence of rHNG determined by Edman degradation method is identical to the theoretical sequence.Neuroprotective bioassay studies of rHNG exhibited its potential neuroprotective effect comparable to that of the natural HNG peptide.

OBJECTIVETo assess the effect of the balloon valvuloplasty for congenital valvular aortic stenosis (AS) in children.

METHODSA total of twenty one children with AS accepted the treatment of percutaneous balloon aortic valvuloplasty (PBAV). One of them complicated with PDA underwent PDA closure by using Amplatzer occluder in the mean time. PBAV could not be accomplished in 3 cases because the catheter could not be advanced into left ventricle and PBAV was not performed in 2 cases due to the gradient pressures across aortic valves less than 50 mm Hg (1 mm Hg = 0.133 kPa). The procedure was completed in 16 cases. The ratios of balloon/valve were 0.98 +/- 0.04 (0.92 - 1.10).

RESULTS13 cases had more than 50% gradient reduction (81.25%), 2 had 40% - 50% gradient reduction. The follow up period ranged from 3 months to 5 years. The gradient pressures rose to more than 50 mm Hg after follow up in 3 cases and they underwent repeat balloon valvuloplasty procedure or were operated successfully. There was no moderate to severe aortic insufficiency (AI).

CONCLUSIONThe result of balloon aortic valvuloplasty showed the significant hemodynamic improvement with relative safety in pediatric patients. PBAV provides another choice in comparison with surgery.

Adolescent ; Aortic Valve Stenosis ; congenital ; therapy ; Catheterization ; methods ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male

Objective KV-CBCT was utilized to evaluate the setup errors in lung SBRT with R624-SCF immobilization equipment,quantitatively analyze the percentage of all types of errors in the cumulative errors and unravel the main sources of setup errors.Methods The CBCT data weekly and QA data monthly from 32 patients diagnosed with lung neoplasms were collected to quantitatively analyze the setup errors.The cumulative errors were calculated by statistical model.The proportion and source of each type of setup error was analyzed.Results All 32 patients received a total of 420 times of CBCT.The setup errors of immobilization equipment in the lateral,supine-inferior,anterior-posterior directions were (0.03±0.72) mm,(0.73± 1.16) mm and (0.21±0.95) mm,respectively.The errors of tumor motion in three directions were (0.71±2.61) mm,(-0.80±2.60) mm and (0.075± 1.77) mm,respectively.According to the calculation formula proposed by Vance Keeling,the proportion of the cumulative error was 54.55％,9.21％ for immobilization equipment,12.97％ for tumor motion,2.55％ for couch sagging,5.70％ for Gantry radiation isocenter,4.73％ for Collimator radiation isocenter,4.61％ for couch radiation isocenter and 5.70％ for Xray field isocenter,respectively.Conclusions The main factors of setup errors during SBRT treatment for lung cancer are setup random,tumor motion,immobilization equipment,couch sagging and machine isocenter.During radiotherapy,targeted control of tumor motion is of significance for minimizing the cumulative errors.

Humanin (HN, its analogue [Gly14]-Humanin, HNG) was originally identified as an endogenous peptide that protects neuronal cells from apoptosis induced by various types of Alzheimer's disease-related insults. But the relative low content of this peptide in its natural sources limits its further characterization. An expression vector pET32a/HNG was corstructed and transformed it into E. coli BL21 trxB (DE3). HNG was expressed as a fusion protein in the soluble fraction and was purified by nickel affinity chromatography. Subsequently, the purified fusion protein was cleaved by enterokinase and was further purified by reverse-phase HPLC. A 23 mg recombinant HNG (rHNG) from 1 L bacterial culture was purified. The molecular weight of rHNG determined by ESI-MS was 2876.5 Da which was the expected size for correctly processed peptide. The N-terminal amino acid sequence of rHNG determined by Edman degradation method is identical to the theoretical sequence. Neuroprotective bioassay studies of rHNG exhibited its potential neuroprotective effect comparable to that of the natural HNG peptide.

BACKGROUND: Hypothermia is associated with poor outcome in trauma patients; however, hemorrhagic shock (HS) model with anesthetized swine was different from that of clinical reality. To identify the effects of environmental hypothermia on HS, we investigated hemodynamics and oxygen dynamics in an unanesthetized swine model of HS under simulating hypothermia environment.METHODS: Totally 16 Bama pigs were randomly divided into ambient temperature group (group A) and low temperature group (group B), 8 pigs in each group. Venous blood (30 mL/kg) was continuously withdrawn for more than 15 minutes in conscious swine to establish a hemorrhagic shock model. Pulmonary arterial temperature (Tp), heart rate (HR), mean arterial pressure (MAP), pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure (PAWP), central venous pressure (CVP), cardiac output (CO), hemoglobin (Hb), saturation of mixed venous blood (SvO2) and blood gas analysis were recorded at the baseline and different hemorrhagic shock time (HST). The whole body oxygen delivery indices, DO2I and VO2I, and the O2 extraction ratio (O2ER) were calculated.RESULTS: Core body temperature in group A decreased slightly after the hemorrhagic shock model was established, and environmental hypothermia decreased in core body temperature. The mortality rate was significantly higher in group B (50％) than in group A (0％). DO2I and VO2I decreased significantly after hemorrhage. No difference was found in hemodynamics, DO2I and VO2I between group A and group B, but the difference in pH, lactic acid and O2ER was significant between the two groups.CONCLUSION: Environmental hypothermia aggravated the disorder of oxygen metabolism after hemorrhagic shock, which was associated with poor prognosis.