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.

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

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

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

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.

BACKGROUNDThe Red Cross of China and Ministry of Health jointly started a pilot program of organ donation after cardiac death to overcome the shortage of available organs since 2010. The purpose of this qualitative study were to compare the consent rate of organ donation between young donor families and adult donor families; to explore and determine factors associated with differences in willingness to donate organs between them. Research objective was to provide a rationale for further preparation of professionals involved in this sensitive work.

METHODSBetween March 2010 and June 2012, 24 young deceased patients including donors and non-donors and 96 potential adult donors were collected, and consent rates of young donors' families and adult donors' families were calculated. A χ(2) test analysis to compare the consent rates of the two groups was conducted. We studied through semistructured interviews 15 parents of young donors and 15 relatives of old donors who were interviewed for petition of consent. Data collection and analysis of the overall study were performed according to the grounded theory methodology. Factors that influenced the families' decisions were identified and classified. We found the differences in willingness to donate organs between the two groups.

RESULTSThe consent rate of young donor families was 66.67%, while the consent rate of adult donor families was 26.04%. Young donor families easily consented to organ donation than adult donor families (P < 0.005). The donors' families had been affected by various factors throughout the process of deciding to give consent for donation. The findings led to the formulation of an empirically based model of interlinking categories that influence families' decision-making process in organ donation. These factors are grouped into five main categories: (1) personal factors, (2) conditions of organ request, (3) interpersonal factors, (4) ethical factors, and (5) traditional views. The funeral tradition influenced the young donor parents' consent to donation, but had no relation with family decision of adult donors. And the family members of young donors are relatively less, who are more likely to reach a consensus.

CONCLUSIONSYoung donor families influenced by traditional funeral beliefs are easier to consent to organ donation than adult donor families. Family members of young donors are relatively less who are more likely to reach a consensus. Acceptance of the expanded criteria donors may improve the organ donation rates, especially those of the advanced age.

Adolescent ; Adult ; Age Factors ; Aged ; Cadaver ; China ; Family ; psychology ; Humans ; Middle Aged ; Tissue and Organ Procurement