Objective Focusing on the diagnosis, treatment and prevention of central venous catheter (CVC)-related bloodstream infections(CRBSI) in clinical practice, to provide clinical evidences for reducing the incidence of central venous catheter-related bloodstream infections Methods The related articles within the latest 5 years were reviewed, and the related monitoring data of the hospital were analyzed. Results ( 1 )The pathogens of CRBSI invaded bloodstream through the puncture point/hub, and the pathogens of the secondary CRBSI came from the infections in other sites, invading bloodstream and adhering the catheter tip. (2)Highlights on the diagnosis of CRBSI: For the patients with CVC, the possibility of the CRBSI should be considered when severe fever not due to non-infectious causes occurred. Infection occurring time and pathogen are different between the general catheters and the anti-infective catheters. The effect of antiinfection of the anti-infective catheters are limited. To pull out the catheters is the most effective treatment measures. Routine puncture point culture should be rejected. ( 3 ) Prevention of CRBSI: The indications of CVC intubation should be undisputed. Silicone catheter should be used. The catheter should not be indwelled more than 5 days. Conclusions Invasive operation, the lasting time of catheterization and using a lot of antibiotics are the susceptible factors for CRBSI. Hospital should establish suite intervention methods and operation procedures,strengthen education of the medical staff and proceed with targeted monitor for decreasing the rate of infectious.

Objective To compare the pharmacodynamics of rocuronium intermittently administered according to body surface area and real body weight and individual differences. Method Forty-two patients undergoing elective surgery under general anesthesia were enrolled into the body surface area group (BSA group) and the real body weight group (RBW group), with 21 patients in each group. The patients in the two groups were induced with 2ED95 of rocuronium according to body surface area and real body weight (16.64 mg/m2 in BSA group; 0.6 mg/kg in RBW group). Whenever T1 recovered to 10%, a dosage of 0.5ED95 was administred repeatedly for 30 min before the end of the operation. The time of neuromuscular blockade and recovery of muscle relaxation were recorded, and the dosage of rocuronium was also recorded. Results No significant difference in each index of neuromuscular block time-effect was found between the two groups (P > 0.05). The single dosage and maintainance amount of muscle relaxation were less in the BSA group than that in RBW group (P < 0.05). Compared with the RBW group, the single dosage, dosing intervals, pharmacological duration and the time TOFr recovered to 0.7 between the different individuals were less in the BSA group (P < 0.05). Conclusion The intermittent administration of rocuronium can maintain the same clinical efficacy according to body surface area as that according to real body weight , with significantly less dosageand reducing the differences of individuals in blockade time-effect of muscle relaxation.

BACKGROUND: There are fewer reports about estrogen effects on bone marrow stromal cells (BMSCs). OBJECTIVE: To study the effect of diethylstilbestrol on the osteogenic differentiation of rabbit BMSCs. METHODS: Rabbit BMSCs cultured in vitro were intervened with 0, 10-7, 10-6, 10-5 mol/L diethylstilbestrol, and BMSCs cultured with dexamethasone 10-8 mol/L, β-sodium glycerophosphate 10 mmol/L, and vitamin C 50 mg/L were used as positive controls. RESULTS AND CONCLUSION: 10-6 mol/L diethylstilbestrol significantly improved the proliferative ability of BMSCs at 24, 48, and 72 hours after intervention (P < 0.01). 10-5 mol/L diethylstilbestrol significantly inhibited the proliferation of BMSCs at 48 hours after intervention as well as 10-7 mol/L diethylstilbestrol at 72 hours (P < 0.01). Mineralized nodular structures formed at 25 days after intervention with 10-7 mol/L diethylstilbestrol. Alkaline phosphatase activities were remarkably increased at 14 and 21 days after intervention with 10-7, 10-6 mol/L diethylstilbestrol. It has been proved that diethylstilbestrol has an enhancing effect on the osteogenic differentiation of rabbit BMSCs.

In order to investigate the effects of phenylalanine, tyrosine and tyramine on the growth of Lycoris radiata suspension cells and the accumulation of alkaloids, the growth quantity of the cells as well as the content of alkaloids in cells were determined, which were treated with above three kinds of precursors alone and phenylalanine combined with tyrosine respectively. The results indicate that the addition of phenylalanine alone and addition of phenylalanine on the basis of tyrosine at high concentration (200 micromol/L) had no significant effect on the growth of Lycoris radiata suspension cells and the content of alkaloids in cells; whereas tyrosine and tyramine promoted the growth of the cells and alkaloids accumulation. Treated with tyrosine at high concentration (200 micromol/L), the content of alkaloids of the cells was 2.56-fold higher than that of the control group, the amounts of lycoramine (3.77 mg/g) and galanthamine (4.46 mg/g) were 6.61-fold and 6.97-fold higher than that of the control group, respectively. When treated with tyramine (200 micromol/L), the amount of alkaloids in Lycoris radiata suspension cells was 2.63-fold higher than that of the control group, and the amounts of lycoramine (4.45 mg/g) and galanthamine (5.14 mg/g) were 9.08-fold and 9.18-fold higher than that of the control group, respectively. The above results demonstrate that adding tyrosine and tyramine in the media significantly promoted the growth of the Lycoris radiata suspension cells and alkaloids accumulation in the cells.
Amaryllidaceae Alkaloids ; chemistry ; Cells, Cultured ; Culture Media ; chemistry ; Galantamine ; chemistry ; Lycoris ; chemistry ; growth & development ; Phenylalanine ; chemistry ; Plant Cells ; chemistry ; Plant Extracts

Objective To explore the relationship between the levels of Cu, Fe, Mn, Zn in serum and Parkinson disease (PD). Methods A total of 40 patients with PD (PD group) and 40 control subjects (control group)were enrolled in this study. Serum levels of Mn were measured by graphite atomic absorption, and Cu ,Fe, Zn were measured by inductively coupled plasma(ICP)mass spectrometry. Resudts There were significantly increase in the levels of Mn and Fe in PD group than those in control group [(0.269±0.326) μ mol/L vs (0.125±0.054) μmol/L, P< 0.05, (1.512±0.949) μmol/L vs (0.676±0.111) μmol/L, P< 0.01)]. There were no significant difference in the levels of Cu and Zn between two groups (P> 0.05). Condusion Micreelements may play important roles in pathogenesis and development of PD, especially Fe and Mn.

Objective:To investigate the effect and molecular mechanism of tumor necrosis factor-α-inducible protein 8-like 2(TIPE2)on lipopolysaccharide(LPS)or interleukin-4(IL-4)-induced phenotypic switch of adipose tissue macrophages(ATM).Methods:The expression levels of TIPE2, inducible nitric oxide synthase(iNOS), monocyte chemoattractant protein 1(MCP-1), CD206, and arginase 1(Arg-1)in the visceral adipose tissue of obese mice, TIPE2-knockout(KO)mice, and control mice were detected by immunohistochemistry, Western blotting, and real-time PCR(RT-qPCR). Peritoneal macrophages isolated from KO and wild-type mice and RAW 264.7 mouse macrophage cell line were cultured, and then stimulated with LPS(100 ng/mL)or IL-4(20 ng/mL)for 6 hours. The expression levels of TIPE2, iNOS, MCP-1, CD206, and Arg-1 were detected by Western blotting and RT-qPCR.Results:Obese mice showed down-regulated TIPE2 expression, up-regulated pro-inflammatory markers iNOS and MCP-1 expressions, and down-regulated anti-inflammatory markers CD206 and Arg-1 expressions. LPS decreased the expression of TIPE2 in RAW 264.7 cells and peritoneal macrophages from mice, increased the expression of the classically activated macrophages(M1 phenotype)markers iNOS and MCP-1, and decreased the expression of the substituting activated macrophages(M2 phenotype)markers CD206 and Arg-1. IL-4 increased the expression of TIPE2 in RAW 264.7 cells and peritoneal macrophages, decreased the expression of iNOS and MCP-1, and increased the expression of CD206 and Arg-1. During the M1 polarization of macrophages, LPS increased toll-like receptor(TLR4)expression as well as nuclear transcription factor κBα suppressor protein(IκBα) and NF-κB phosphorylations in macrophages. Knockout of TIPE2 further increased the expression of the TLR4/IκBα/NF-κB signaling pathway and M1 macrophage markers, and further reduced the expression of the M2 macrophage markers.Conclusion:TIPE2 regulates ATM phenotypic transformation through inhibition of the TLR4/IκBα/NF-κB signaling pathway, which ameliorates adipose tissue inflammation in obese states.

Objective To investigate whether the median(50%)effective effect-concentration(EC50)of propofol inducing loss of consciousness (LOC) varies. Methods 56 patients undergoing gastroscopy under general anaesthesia were enrolled on the study. Anaesthesia was conducted with a target-controlled infusion(TCI) of propofol. The initial target effect-site propofol concentration (Ceprop) was 5.00 μg/mL and was adjusted stepwise by 0.50μg/mL by an up-down sequential method to reach no-movement. Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety(6.46μg/mL vs. 5.75μg/mL,P<0.05). Conclusions During general anaesthesia ,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety. Differences in preoperative anxiety levels may reduce anaesthetic effects.

Objective To investigate the effect of preoperative anxiety on propofol EC50 for nomovement during Painless gastroscopy.Methods Thirty-one patients (without anxiety) and twenty-seven patients (with anxiety) undergoing gastroscopy under general anesthesia were enrolled on the study.Anesthesia was conducted with a target-controlled infusion (TCI) of propofol.The initial target effect-site propo fol concentration (Ceprop) was 5.0 μg/ml and was adjusted stepwise by 0.5 μg/ml by an up-down sequential method to reach no-movement.Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety (5.32 μg/ml,95％ CI:4.75-5.88 μg/ml vs 4.75 μg/ml,95％ CI:4.48-5.01 μg/ml,P ＜ 0.05).Conclusions During painless gastroscopy,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety when intravenous injected of fentanyl 0.1 μg/kg.

Objective:To establish a data middle platform for data assets of medical consumables,to provide open data sharing services for the management and application development of medical consumables,and to reduce the risk of data silos.Methods:Based on the data resource management model of data middle platform,data aggregation and big data development technology were adopted to realize data loading,integration and quality control between multi-business systems.A hierarchical data management system was established through data warehousing and object modeling methods.A data assets management system was built based on the data governance process to provide functions of data standards and data lineage maintenance,metadata management,data permission control,and data lifecycle management for medical consumables data resources.A microservice architecture was adopted to provide functions such as data service generation,registration,discovery and subscription for medical consumables management.The front-end data application development workload of business data and application operation time before and after the application of data middle platform service of medical consumables were compared in the South Campus of the Fifth Medical Center of PLA General Hospital from March to May 2020.Results:The medical consumables data middle platform realized the connection between the front-end application interface and the back-end data service,and provided synchronized data services for the front-end pages.The workload of front-end data application development for data middle platform data services decreased from 64 person-months of traditional data warehouses to 6 person-months,and the operation time for testing applications reduced from 430 minutes to 16 minutes.Conclusion:The data middle platform management mode is helpful to improve the information management capabilities and efficiency of medical consumables management,and provides reference for the digital transformation of medical consumable management.

Objective: To investigate the effect of hepatitis B vaccine immune response after liver transplantation in children under 5 years old and assess the necessity of multiple vaccination. Methods: A retrospective collection of children who had liver transplantation from February 2014 to December 2018 in the same liver transplantation group in the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University were analyzed. In accordance with the requirements of the doctor, 170 children under 5 years old injected with over 4 doses were enrolled, including 75 males and 95 females, aged from 4 months to 5 years old. After every dose of vaccination, the blood were collected to detect hepatitis B following regular review in liver transplantation clinic, observe the effect of HBsAb (hepatitis B surface antibody) after postoperative hepatitis B vaccination.Count data were represented by cases and percentage (%), and comparison between groups were analyzed by chi-square test. Results: After the first course of treatment, in total children under 5 years old who completed the first course of treatment, 121 cases got successful immune responses(HBsAb≥100 IU/L) and 49 cases got the responses failure (HBsAb<100 IU/L). After the second course of treatment, 29 cases got successful immune responses, and only 20 cases finally failed to response (HBsAb<10 IU/L)to 8 injections namely two courses. The factors affecting the immune effect of hepatitis B vaccination were not related to gender, primary disease, liver feeding mode, and postoperative vaccination time, and were related to age, place of residence, and preoperative level of HBsAb titer (100 IU/L). The immune responses rate of children averagly aged over 2 years old was significantly higher than that of children under 1 year old after the first course of postoperative vaccination. Children with preoperative hepatitis B vaccination and >100 IU/L anti-HBs titer had a higher immune response rate after the first course of postoperative vaccination (84.72%), and the immune response rate of children with anti-HBs titers <100 IU/L after the first course of hepatitis B vaccine was slightly lower(60.71%). Conclusions Most post-liver transplantation children can obtain protective antibodies to prevent re-infection of hepatitis B virus by inoculation with hepatitis B vaccine. Multiple inoculation can effectively induce hepatitis B antibody production and improve immune response level economically. The hepatitis B vaccination proved to be indispensable and is one of the current methods promoted and applied to post-liver transplantation.