Objective:To carry out preoperative nutritional risk screening for inpatient to understand their nutritional risk status,and to explore the relationship between postoperative nutritional support and related clinical outcomes.Methods:A total of 378 patients in the Third Ward of Department of General Surgery,the Second Affiliated Hospital of Shantou University,completed NRS 2002 scoring within 48 h after admission.The patients with NRS scores more than 3 points were judged to have nutritional risk,and they were divided into nutrition support group (114 cases) and non-nutrition support group (60 cases) according to whether or not to accept the nutrition support.According to the doctor's advice,the data of nutrition support were obtained,the related clinical outcomes were recorded twice a week,and the relationship between them was analyzed.The influencing factors of hospitalization costs and infectious complications were analyzed.Results:Among the 378 inpatients,the nutritional risk rate was 50.53％.Of the 174 patients enrolled in the cohort study,the nutritional support rate was 65.52％ (114/174).The difference of hospitalization time between the nutrition support group and the non-nutrition support group was statistically significant (P=0.028).There was no significant difference between the two groups in the hospitalization costs.The incidence of infectious complications (P=0.034) and the total complication rate (P=0.012) in the nutrition support group were lower than those in the non-nutrition support group.Disease score and nutrition support were the influencing factors of the incidence of infectious complications (P＜0.10).Hospitalization days,disease score and nutrition score were the influencing factors of hospitalization costs (P＜0.10).Conclusions:General surgery patients have higher nutrition risks,and nutrition support can reduce infectious complications,total complications and shorten hospital stay.NRS 2002 has a superior ability of predicting clinical outcomes.

OBJECTIVETo study the protective effect of the Mixture of Shengmai Powder and Danshen Decoction (, abbreviated as the Mixture) in the rat model with type 2 diabetic cardiomyopathy in the rat model with type 2 diabetic cardiomyopathy, abbreviated as the Mixture) in the rat model with type 2 diabetic cardiomyopathy (DCM).

METHODSForty-two SD rats with DCM model, established by the combination of insulin resistance by a high-fat diet with the damage of pancreatic islet β cells by intraperitoneal injection of high dose streptozotocin (50 mg/kg) once, were evaluated in the damage of the myocardium by electrocardiogram at the end of 12 weeks of grouping and intervention administration; the extent of damage in the myocardial subcellular structure was observed by electron microscopy; the content of myocardial collagen in the left cardiac ventricle was quantified by Masson staining test; the myocardial cell apoptosis was determined by TUNEL; the changes in the mRNA expression levels of thrombospodin-1 (TSP-1) and tribbles homolog 3 (TRB-3) by real-time quantitative PCR, the expression levels of myocardial TSP-1, tumor growth factorβ1 (TGF-β1), TRB-3, and chymase were detected by immunohistochemistry, and the changes in the expression levels of myocardial TSP-1, active-TGF-β1 (A-TGF-β1) and latent-TGF-β1 (L-TGF-β1) protein were tested by Western blotting.

RESULTSCompared with the control group, the myocardial tissue was less damaged, and the extent of damage in the myocardial subcellular structure was less; the collagen fiber content and the cell apoptosis were reduced; the expression levels of TSP-1mRNA and TRB-3 mRNA, the expression levels of myocardial TSP-1, TGF-β1, TRB-3, and chymase, as well as the average expression levels of the myocardial TSP-1, A-TGFβ1, and L-TGF-β1 protein were decreased in the Mixture group.

CONCLUSIONThe Mixture of Shengmai Powder and Danshen Decoction could inhibit the process of myocardial fibrosis in the rat myocardium of DCM through multiple pathways and significantly delay the genesis and progress of DCM in hyperglycemic rats.

Animals ; Cytoprotection ; drug effects ; Diabetes Mellitus, Experimental ; complications ; drug therapy ; Diabetic Cardiomyopathies ; pathology ; prevention & control ; Disease Models, Animal ; Drug Combinations ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Heart ; drug effects ; Male ; Myocardium ; cytology ; pathology ; Rats ; Rats, Sprague-Dawley ; Streptozocin

OBJECTIVETo observe the clinical effect of the combined use of amiodarone and Wenxin Granule (WXG) in auricular fibrillation (AF) conversion and its safety.

METHODSTwo hundred and twenty-four patients, in whom AF lasted for less than 1 year, were enrolled and randomly assigned into two groups, 112 in each group. Patients in the treated group were treated with WXG and amiodorane and the others in the control group were orally administered with amiodarone alone. The accumulative conversion rate of AF and adverse reaction were monitored during the 6-month observation period.

RESULTSSix-month observation was completed in 109 cases in the treated group and 107 in the control group, while 3 cases and 5 cases in the two groups were dropped out respectively. The difference of accumulative AF conversion rates between the two groups become significant early after one month medication (P < 0.05), and was 65.1% and 47.7% respectively after 6-month of treatment (P < 0.05). Inter-group significant difference was also shown in the aspects of average conversion time, dosage of amiodarone required and the occurrence of adverse reaction (P < 0.05).

CONCLUSIONCombined use of WXG and amiodarone has a better effect in improving conversion rate of AF, shortening conversion time and decreasing the required dosage of amiodarone in treating AF as compared with the treatment with amiodarone alone, and by which the adverse reaction of long-term using amiodarone could be avoided.

Aged ; Amiodarone ; adverse effects ; therapeutic use ; Anti-Arrhythmia Agents ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Safety

BACKGROUNDFor patients with severe endometriosis, the spontaneous pregnancy rates have been reported to be near 0 due to extreme distortion of normal pelvic anatomy. Surgery is one of the treatment options; however, if patients failed to conceive after surgery, in vitro fertilization (IVF) is effective. The objective of this retrospective study was to determine the clinical characteristics of IVF/intracytoplasmic sperm injection (ICSI) in patients with stage III/IV endometriosis, and to determine the impact of the interval from surgery to IVF/ICSI on outcome.

METHODSOne hundred and sixty patients who were diagnosed with stage III/IV endometriosis underwent IVF/ICSI cycles between February 2004 and June 2009 were enrolled. The mean interval from surgery to IVF, number of oocytes retrieved, fertilization rate, implantation rate, embryos transferred, and good embryos transferred were compared between two age groups (35 years).

RESULTSThe mean interval from surgery to IVF was (37.9+/-28.9) months for the group35 years of age. Twenty-five IVF/ICSI cycles (12.8%) were performed during the first year after surgery, and 34.9% IVF/ICSI cycles were performed 2 years after surgery. No significant differences existed between the two groups with respect to the fertilization rate, implantation rate, number of embryos transferred, number of good embryos, clinical pregnancy rates, live birth rates, and cumulative clinical pregnancy rates (P>0.05). The probability of cumulative clinical pregnancies was 75%, 50%, and 25% ((29.0+/-4.8), (61.0+/-7.6), and (120.0+/-16.9) months after surgery, respectively).

CONCLUSIONSFor infertile patients with stage III/IV endometriosis, the optimal time to conceive by IVF/ICSI is <2 years after surgery; nevertheless, most of the patients took a longer time to conceive.

Adult ; Endometriosis ; surgery ; Female ; Humans ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Time Factors

BACKGROUNDTo serially observe the pathologic changes in livers of tree shrews and macaca assamensises infected with HHBV.

METHODS10 adult tree shrews and 28 macaca assamensises were inoculated with HBV rich human sera. The liver of the animals were regularly biopsied. The liver samples were examined histopathologically by HE staining. Some samples were stained for HBsAg by immunohistochemistry (IH), and HBV DNA by in situ hybridization (ISH).

RESULTSHBsAg in 80% of tree shrews infected with HHBV can be detected by IH, HBV DNA in 50% of those can be found by ISH.The positive rates of HBsAg in macaca assamensises' livers were 25% by IH, none HBV DNA was detected.

CONCLUSIONThe tree shrew model seems to be applicable for the research of human hepatitis B.

Animals ; Antibodies, Viral ; immunology ; Disease Models, Animal ; Female ; Hepatitis B ; immunology ; pathology ; virology ; Hepatitis B virus ; immunology ; physiology ; Humans ; Liver ; pathology ; virology ; Macaca ; Male ; Tupaiidae

Objective To evaluate the safety and effcacy of intracomnary autologous bone marrow mononuclear cells(BM-MNCs)transplantation in patients with dilated cardiomyopathy(DCM).Methods On top of standard therapy,DCM patients received BM-MNCs transplantation(n=71)or saline injection (n=187).The baseline clinical characteristics of two groups were comparable.Data on echocardiography,Holter,six-minute-walk test,cardiac SPECT and annual hospital days were obrained in all patients at baseline,1,3,6,12 and 24 months after transplantation.Results Six-minute-walk distance was significantly longer at one month[(345±76)m vs. (286±104)m,P<0.05]and thereafter(all P<0.05)in BM-MNCs group compared with saline group.Left ventricular ejection fraction(LVEF)at one month in BM-MNCs group was significantly higher compared with saline group[(41.5±9.4)%vs.(37.3± 6.6)%,P<0.05]and with pre-transplantation value[(41.5±9.4)%vs.(32.4±8.5)%,P<0.05] while LVEF was similar at 24 months after transplantation between the two groups[(43.6±6.3)%vs.(43.2±6.0)%.P>0.05 ].Three months after transplantation,the number of ischemic segments of BM-MNCs group wag significantly reduced compared with that of saline group(2.0±1.0 vs.3.1 ±1.4,P<0.05)and with baseline(2.0±1.0 vs.3.1±1.2,P<0.05)while the number of necrotic segments were similar in both groups during the follow-up.There were no significant difference in survival between two groups during 2 years follow·up(95.4%vs.94.9%,P>0.05)but the aflnual hospitalization days of BM-MNCs group was significantly lower than that of saline group[(23.6±13.4)d vs.(33.0±14.0)d,P>0.05].Conclusions Intracoronary transplantation of autologous BM.MNCs was safe and could increase LVEF and the six-minute-walk distance and reduce hospitalization days for patients witIl dilated cardiomyopathy.

This article reports the treatment of a patient suffered from acute radiation burn covering 41% TBSA, with deep partial-thickness and full-thickness injury, produced by exposure to a large-scale industrial electron accelerator. An open wound began to appear and enlarged gradually 10 weeks after the exposure. Serious wound infection with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, pneumonia, respiratory failure, systemic inflammatory response syndrome, nephropathy and hypoproteinemia developed successively since 3 weeks after the wound formation. Skin grafts failed to survive, resulting in enlargement of the wound. After being treated with proper measures, including parenteral nutrition, respiratory support with a ventilator, appropriate antibiotics, steroid administration for nephropathy, deep debridement for wounds followed by skin grafting, the patient was cured and discharged after undergoing 15 operations in 500 days. The clinical condition of an extensive acute radiation burn is complicated. We should pay close attention to the changes in functions of organs, and strengthen the therapeutic strategies to support the function of organs to reduce the incidence of systemic complications. The control of the infection and the timely and effective repair of the wound are still the key points of the treatment of an extensive local radiation injury.
Acute Disease ; Adult ; Burns ; complications ; microbiology ; therapy ; Humans ; Male ; Radiation Injuries ; complications ; therapy ; Wound Infection ; therapy

OBJECTIVETo investigate the characteristics of New Delhi metallo-beta-lactamase-1 (NDM-1) gene of Klebsiella pneumoniae (K. pneumoniae) emerging in Hunan, and its relationship to antibiotic resistance.

METHODSThe clinical strain was isolated from a sputum sample of a child with severe pnemonia and toxic myocarditis who was admitted into a general hospital of Hunan Province. VITEK-2 compact instrument was used for bacterial identification and antibiotic susceptibility test. Modified Hodge test was used for the screening of carbapenemase. EDTA-synergy test and combination disk diffusion test were used for detection of metallo-β-lactamase (MBL). PCR was performed for amplification of NDM-1 genes and the positive products were sequenced and analyzed with BLAST. Conjugation was also performed to analyze mechanisms of antibiotic resistance. The results of antibiotic susceptibility tests were compared before and after conjugation.

RESULTSThe isolated strain was identified as K.pneumoniae. Modified Hodge test, EDTA-synergy test and combination disk diffusion test were all positive for the strain. The homology between gene sequence of PCR amplification products and NDM-1 gene FN396876.1 in the GenBank was 100%. Transconjugant DNA was used as template for the amplification of NDM-1 gene. The amplification products were sequenced and found to be the same as the NDM-1 gene amplification product of the donor strain. The MIC of transconjugant E.coli J53 (NDM-1) to all the β-lactams increased significantly compared with the recipient strain E.coli J53. The MIC of ertapenem and imipenem increased by more than 8 times, while the MIC of ceftazidime and ceftriaxone increased by more than 64 times.

CONCLUSIONSThis study first identified a strain of K. pneumoniae carrying NDM-1 in mainland China. NDM-1 gene can be transmitted among different strains and causes extensively drug-resistance to β-lactams.

Base Sequence ; China ; Drug Resistance, Bacterial ; Klebsiella pneumoniae ; drug effects ; enzymology ; genetics ; Molecular Sequence Data ; Polymerase Chain Reaction ; beta-Lactamases ; biosynthesis ; genetics

To investigate the existence of tick-borne pathogens infection of rodents at the border of China and the Demo-cratic People's Republic of Korea(DPRK).PCR was used to detect the spotted fever group rickettsiae(SFGR)ompA gene,Ehrlichia chaffeensis(Ec)and Anaplasma phagocytophilum(Ap)16S rRNA,Candidatus Neoehrlichia mikurensis(CNm)groEL gene,Bartonella(Ba)rpoB gene,and Francisella tularensis(Ft)fopA gene in rodents samples collected from Ji'an of Jilin province and Kuandian of Liaoning Province.The positivity rates of 132 wild rats spleen samples,SFGR,Ec,Ap,CNm,Ba,and Ft were 9.85％,12.88％,5.30％,3.79％,51.52％,and 6.06％,respectively,with statistical differences in in-fection rates(x2=149.236,P=0.000).The infection rate of Ba was the highest in wild rats in this area.There was no signifi-cant difference in the infection rate of SFGR,Ec,Ap,CNm,and Ft among different rats species,but there were significant differences in the infection rate of Ba(x2=13.36,P=0.010).The infection rate of Apodemus agrarius was the highest.A-mong 132 wild rats specimens,the coinfection rate of the two pathogens was 15.9％(21/132),with Ba as the main species(15/132),and two cases of coinfection with three pathogens were detected.The infection of six tick-borne pathogens is common in wild rats at the China/DPRK border.Co-infection of two or three pathogens indicates a risk of multiple tick-borne pathogens and mixed natural foci of multiple tick-borne infec-tious diseases.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Logistic Models ; Lung Diseases, Interstitial ; diagnostic imaging ; Male ; Radiography, Thoracic ; methods ; Tomography, X-Ray Computed ; methods