Adult ; Female ; Gas Poisoning ; drug therapy ; Glycoproteins ; therapeutic use ; Humans ; Male ; Middle Aged ; Quinuclidines ; therapeutic use ; Treatment Outcome ; Young Adult

Adult ; Aged ; Elbow ; innervation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nerve Compression Syndromes ; physiopathology ; surgery ; Recovery of Function ; Ulnar Nerve ; physiopathology ; surgery

Objective To understand the prevalence and risk factors of healthcare-associated infection(HAD,and provide evidence for prevention and control of HAI.Methods A cross-sectional survey was adopted,bedside survey and medical record reviewing method was combined to investigate and analyze the prevalence of HAI in a tertiary first-class hospital in 2012-2015.Results A total of 4 725 hospitalized patients were surveyed,the prevalence rates in 2012-2015 were 6.00％,4.77％,3.93％,and 3.05％ respectively,difference was significant(P＜0.05);antimicrobial usage rates were 30.56％,33.82％,32.84％,and 34.48％ respectively,difference was not significant (P＞0.05);the main infection site was lower respiratory tract (43.00 ％),followed by surgical site (16.43 ％);the risk factors for HAI were age ≥65 years,chronic systemic diseases(diabetes,cirrhosis,chronic renal failure,chronic lung disease),immunodeficiency(white blood cell＜1.5 × 109/L),coma,tracheotomy,and mechanical ventilation.Conclusion Survey on HAI prevalence can promote continuous improvement of HAI management,surveillance on surgical site infection and risk factors of HAI should be strengthened.

Aged ; Humans ; Male ; Urinary Diversion ; adverse effects ; Urinary Fistula ; diagnosis ; etiology

OBJECTIVETo analyze the clinical effect of minimal extracorporeal circulation (MECC) in blood conservation perioperatively coronary artery bypass graft (CABG).

METHODSThe data of 120 cases received simple CABG since August 2006 to October 2009 was analyzed retrospectively. All the patients were divided to three groups according to the mode of circulation support in-operation: MECC, conventional extracorporeal circulation (cECC) or off-pump, 40 cases in each group. Jostra MECC system with normal temperature was used in MECC group, and common membrane oxygenator with moderate hypo-temperature was used in cECC group. Collect the data of coagulation and the blood cytological examination perioperatively, the draining volume during the first 24 h after operation, and consumption of blood products perioperatively.

RESULTSStandard and logistic EuroSCORE were higher in MECC group than the others (P < 0.01). The operative time and the number of distal anastomosis of off-pump group were less than MECC and cECC groups (P < 0.05), while no difference between MECC group and cECC group. Intrinsic coagulation (activated partial thromboplastin time) were much more prolonged early postoperatively in cECC group, and higher than in MECC group and off-pump group at 2 h, 6 h and 12 h postoperatively (P < 0.05), but no difference in extrinsic coagulation (prothrombin time) among three group. Adjusted by hematocrit of the same sample, free hemoglobin level rose up during the ECC procedure and reached the maximum at the end of ECC in cECC group and MECC group, but the levels were more higher in cECC group than in MECC group (P < 0.05). The draining volume during the first 24 h after operation of cECC group was larger than MECC group and off-pump group (P < 0.05). Although the decreased platelet count perioperatively and more consumed of the blood products in cECC group, but no difference among the three groups.

CONCLUSIONMECC could reduce the ruin to blood cell and interfere to coagulation function during the conventional ECC procedure, decrease the postoperative draining volume and requirement of blood products.

Aged ; Coronary Artery Bypass ; methods ; Extracorporeal Circulation ; methods ; Follow-Up Studies ; Humans ; Middle Aged ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo analysis comparatively the primary clinic outcomes between minimal extracorporeal circulation (MECC) and conventional extracorporeal circulation (cECC).

METHODSForty cases accepted coronary artery bypass grafting from August to October at 2006 were divided into MECC group and cECC group at random, 20 cases for each group. Record and analysis of the general information, clinic data perioperatively, and complications postoperatively for each group were performed.

RESULTSThere were no deference between groups in gender, anamnesis and preoperative cardiac function, while age (P < 0.05), standard EuroSCORE and logistic EuroSCORE were much more higher in MECC group than in cECC group (P < 0.01). Similarly, there were no deference in operative time, bypass time, ischemic time and graft number between two groups. Contrasted with cECC group, the values of cTNI were lower in MECC group at 2 h, 6 h and 12 h post-ECC (P < 0.01), oxygen index were higher post-operatively and there was a statistic deference at 12 h post-ECC (P < 0.05). The valves of ALT and TBIL in cECC group were higher abnormally at early post-ECC, and significant higher than in MECC group at 2 h, 6 h post-ECC of ALT (P < 0.05), and at termination, 2 h post-ECC of TBIL (P < 0.05). The values of activated partial thromboplastin time were almost at physiological status in MECC group, but were significantly prolonged in cECC group at early post-ECC, and were statistically longer than in MECC group at 2 h, 6 h, 12 h post-ECC (P < 0.05). The concentration of free hemoglobin in cECC group were higher than in MECC group peri-operative, and there was a statistic deference at 2 h post-ECC (P < 0.05). There were no deference between the two group in Cr, PLT and WBC.

CONCLUSIONSCompared with cECC, MECC carries more biocompatibility, more safe and credible. MECC system can alleviate the organ injury postoperatively and decrease the incidence of complications, especially in high-risk patients.

Aged ; Coronary Artery Bypass ; methods ; Extracorporeal Circulation ; methods ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome

OBJECTIVETo explore the inflammatory cascade mechanism through Toll like receptor 2 (TLR2) pathway after cerebral ischemia/reperfusion, and to study molecular mechanisms of Guanmaitong (GMT) Tablet for protecting brain damage.

METHODSWe used bolt-line method to block/release the middle cerebral artery, causing cerebral ischemia/reperfusion (I/R) injury model. GMT Tablet was given by gastrogavage. Rats were then divided into the high dose GMT group (1200 mg/kg), the middle dose GMT group (600 mg/kg), the low dose GMT group (300 mg/kg), the positive control group (Tanakan, 20 mg/kg). Their right brain tissues were fixed in 10% neutral formalin. TLR2 expressions were detected by immunofluorescence staining. The total protein was extracted from right brain tissues by ultrasonica- tion. Expression levels of extracellular regulated protein kinases (ERK), phospho-extracellular regulated protein kinases (p-ERK), p38-mitogen activated protein kinases (p-ERK), phospho-p38-mitogen activated protein kinases [p-p38-MAPKs(p-p38)] were assessed by Western blot. Abdominal aortic blood was withdrawn. IL-6 and IL-1β levels were detected by ELISA in brain tissues and serum.

RESULTSCompared with the sham-oepration group, expression levels of TLR2, ERK, p-ERK, p38, p-p38 protein were up-regulated (P < 0.05, P < 0.01), and contents of IL-6 and IL-1β in brain tissues and serum were increased in the model group (P < 0.01). Expression levels of TLR2, ERK, p-ERK, p38, p-p38 were down-regulated (P < 0.05, P < 0.01), and contents of IL-6 and IL-1β were reduced in brain tissues and serum in middle and high dose GMT groups (P < 0.05, P < 0.01).

CONCLUSIONSTLR2 pathway was involved in cerebral I/R injury. GMT protected neurons by down-regulating protein expressions of TLR2, ERK, p-ERK, p38, p-p38 and contents of IL-1β and IL-6.

Animals ; Blotting, Western ; Brain Ischemia ; metabolism ; Cerebral Infarction ; Down-Regulation ; Drugs, Chinese Herbal ; therapeutic use ; Interleukin-1beta ; Interleukin-6 ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; Tablets ; Toll-Like Receptor 2 ; metabolism ; Up-Regulation ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective:To investigate the clinical effect of the proximal interphalangeal kite flap in repairing the wound of the posterior web of the split toe.Methods:A retrospective case series study was used to analyze the clinical data of children with syndactyly after toe web wounds were repaired with proximal kite flap between toe webs in the Yidu Central Hospital of Weifang from May 2010 to March 2019. The satisfaction of flap repair effect (the total score is 5-10) and the operation effect according to toe function, toe web slope, and depth were evaluated. The measurement data of normal distribution were expressed in Mean±SD and analyzed by paired sample t-test. Results:A total of 10 children with syndactyly were included, including four males and six females, aged from 6 months to 9 years. Seven cases were on the right side, and there were on the left. All were soft tissue connexions, incomplete syndactyly 6 feet, complete syndactyly 4 feet. All flaps survived and were followed up for an average of 13 months (range, 6-24 months). The score of satisfaction was 8.6±2.7. The appearance, color, elasticity, and texture of the reconstructed web are similar to those of the uninjured side. At the last follow-up, there was no significant difference between the abduction of the separated toe and that of the healthy side (43.57 ± 3.82)° and (44.39 ± 4.25)°( P=0.64). There was no significant difference between the two groups ( P=0.66). The reconstruction depth of the toe web was (1.19 ± 0.23) cm, which was not significantly different from that of the healthy side (1.21 ± 0.27) cm ( P=0.85). Conclusions:The proximal interphalangeal kite flap is one of the ideal methods to repair the wounds of the posterior web of the congenital syndactyly. However, the number of cases in this study is small, and the follow-up time is short. The curative effect of the children with the growth and development process needs further research.

Objective:To investigate the clinical effect of the proximal interphalangeal kite flap in repairing the wound of the posterior web of the split toe.Methods:A retrospective case series study was used to analyze the clinical data of children with syndactyly after toe web wounds were repaired with proximal kite flap between toe webs in the Yidu Central Hospital of Weifang from May 2010 to March 2019. The satisfaction of flap repair effect (the total score is 5-10) and the operation effect according to toe function, toe web slope, and depth were evaluated. The measurement data of normal distribution were expressed in Mean±SD and analyzed by paired sample t-test. Results:A total of 10 children with syndactyly were included, including four males and six females, aged from 6 months to 9 years. Seven cases were on the right side, and there were on the left. All were soft tissue connexions, incomplete syndactyly 6 feet, complete syndactyly 4 feet. All flaps survived and were followed up for an average of 13 months (range, 6-24 months). The score of satisfaction was 8.6±2.7. The appearance, color, elasticity, and texture of the reconstructed web are similar to those of the uninjured side. At the last follow-up, there was no significant difference between the abduction of the separated toe and that of the healthy side (43.57 ± 3.82)° and (44.39 ± 4.25)°( P=0.64). There was no significant difference between the two groups ( P=0.66). The reconstruction depth of the toe web was (1.19 ± 0.23) cm, which was not significantly different from that of the healthy side (1.21 ± 0.27) cm ( P=0.85). Conclusions:The proximal interphalangeal kite flap is one of the ideal methods to repair the wounds of the posterior web of the congenital syndactyly. However, the number of cases in this study is small, and the follow-up time is short. The curative effect of the children with the growth and development process needs further research.

Heishui county, located in northwest Sichuan province, southwestern China, is an endemic area of zoonotic visceral leishmaniasis (VL) and is the most intractable area. VL is never destroyed in it. Asymptomatic dogs (Leishmania parasites have been diagnosed but clinically healthy) are considered to be a potential reservoir host in zoonotic VL area, and most can lead to infection of individuals, that is a new challenge for controlling VL in humans. The present study aimed to assess the Leishmania infection rate of asymptomatic dogs in Heishui county. Total 105 asymptomatic domestic dogs were gathered from 4 districts in Heishui county to investigate the infection rate with serological and molecular methods based on ELISA and kinetoplast minicircle DNA(kDNA) PCR, respectively. Out of 105 dogs, 44 (41.9%) were positive by more than 1 method; 21 (20.0%) were positive by ELISA, and 30 (28.6%) were positive by kDNA-PCR. Our study showed that Leishmania infection of domestic dogs which is clinically healthy is prevalent in the studied district, and the asymptomatic dogs infected by Leishmania may be the primary reason for the prevalence of visceral leishmaniasis in the area.
Animals ; China* ; Dogs* ; Enzyme-Linked Immunosorbent Assay ; Epidemiology ; Humans ; Leishmania* ; Leishmaniasis, Visceral* ; Methods ; Parasites ; Polymerase Chain Reaction ; Prevalence