Objective To study the feasibility and clinical significance of internal tourniquet (temporary arterial lumen blood flow occlusion by balloon catheter) for controlling the hemorrhage from traumatic neck and adjacent trunk arteries by temporarily occluding the arterial lumen blood flow.Methods The study involved 35 patients with traumatic neck and near trunk arteries who were firstly managed by internal tourniquet during operation to temporarily occlude the proximal aorta blood flow from May 1987 to February 2009.Each blocking time ranged from 30 to 70 minutes and the blocking was performed at an interval of 15 to 20 minutes.Then,surgical therapy was taken.Results After temporary proximal aorta blood flow occlusion with internal tourniquet,the operation presented few bleeding,with a clean operating field and clear anatomic structures.The total intraoperative blood loss was 100-400 ml.All patients were healed without ischemia of brains and limbs or relapse during the 3-14 years of followup.Conclusion Internal tourniquet,which can effectively reduce intraoperative blood loss and improve operation safety by temporarily occluding the proximal aorta blood flow,is an auxiliary approach for treating hemorrhage from traumatic neck and adjacent trunk arteries.

Objective To evaluate the possible mechanism of traumatic brain injury (TB1) affecting the speed of bone fracture healing.Method TBI combined with unilateral tibial fracture (group A) was used to build multiple injury model and simple unilateral tibial fracture (group B),and the FOS,JUN,bFGF,and VEGF protein expression in different time points between the two groups were compared,and roentgenogram was used for the evaluation of bone healing.Results The expression of FOS,JUN,bFGF,and VEGF protein of the cerebral tissue was low in the normal rats,but was slightly enhanced in group B.There was consistence of development for FOS and JUN expression in the brain tissue in group A,reaching peak at post-TBI 3 hours,and then reducing to control level after 12 hours.The bFGF and VEGF reached peak at post-TBI 12 hours and 24 hours and reduced to control level after 72 hours,respectively.In group A and group B,an increase in the FOS,JUN protein expression around the fracture site was observed at 3 hours after injury,which reached the peak at 6 hours,and reduced to the control level after 24 hours;the comparison between group A,group B and the control group at 3 hours,6 hours and 12 hours had significant difference (P

Objective To evaluate the efficacy and risk of endovascular thrombolysis with Urokinase and Tirofiban in patients with cerebral venous sinus thrombosis (CVST).Methods Nine patients with severe CVST were performed selective intravenous sinus Urokinase and Tirofiban thrombolysis combined with mechanical thrombus maceration in our hospital from January 2009 to January 2011; their clinical data and treatment efficacy were analyzed.Results Normal cerebrospinal fluid (CSF) pressure was noted in 8 patients before discharging from the hospital; DSA indicated that 7 achieved complete recanalization of main branch of the venous sinus,cortical veins and deep vein.Only 1 achieved reeanalization of sinuses partly,and partial compensation was noted in the cortical veins.No operation-related complication was noted during and after the surgery.After thrombolysis,symptoms and signs of 8 patients improved obviously,and headache disappeared in 7 of them with only mild degree in 1; 1 patient died.Conclusion Intravenous sinus Urokinase and Tirofiban thrombolysis is an effective and safe method for patients with potentially catastrophic intracranial dural sinus thrombosis.

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Carcinoma, Large Cell ; metabolism ; pathology ; Diagnosis, Differential ; Histiocytic Sarcoma ; metabolism ; pathology ; surgery ; Hodgkin Disease ; metabolism ; pathology ; Humans ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; Male ; Melanoma ; metabolism ; pathology ; Receptors, Cell Surface ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery

The safety and efficacy of combined low dose aspirin and warfarin therapy in patients with atrial fibrillation after mechanical heart valve replacement were evaluated. A total of 1016 patients (620 females, mean age of 36.8±7.7 years) admitted for cardiac valve replacement and complicated with atrial fibrillation after surgery were randomly divided into study (warfarin plus 75-100 mg aspirin) or control (warfarin only) groups. International normalized ratio (INR) and prothrombin time were maintained at 1.8-2.5 and 1.5-2.0 times the normal values, respectively. Thromboembolic events and major bleedings were registered during the follow-up period. Patients were followed up for 24±9 months. The average dose of warfarin in the study and control groups was 2.91±0.83 mg and 2.88±0.76 mg, respectively (P>0.05). The incidence of overall thromboembolic events in study group was lower than that in control group (2.16% vs. 4.35%, P=0.049). No statistically significant differences were found in hemorrhage events (3.53% vs. 3.95%, P=0.722) or mortality (0.20% vs. 0.40%, P=0.559) between the two groups. Combined low dose aspirin and warfarin therapy in the patients with atrial fibrillation following mechanical heart valve replacement significantly decreased thromboembolic events as compared with warfarin therapy alone. This combined treatment was not associated with an increase in the risk of major bleeding or mortality.
Adult ; Anticoagulants ; administration & dosage ; Aspirin ; administration & dosage ; Atrial Fibrillation ; blood ; drug therapy ; etiology ; Female ; Fibrinolytic Agents ; administration & dosage ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; adverse effects ; Humans ; International Normalized Ratio ; Male ; Postoperative Complications ; blood ; drug therapy ; Prothrombin Time ; Warfarin ; administration & dosage

Be subjected to study the application in the hypersaline organic wastewater treatment,A moder-ately halophilic bacterium YS-1 was isolated from the salty water of a Ludaokou salina of Weihai in China.The polyphasic taxonomy study was processed through identifying its morphological features by AFM,researched the features of culture and measured physiologic-biochemical index,analyzed 16S rDNA se-quence homology Phylogenetic analysis based on 16S rDNA gene sequences showed that the closest relative of the strain was Halomonas sp.(AB167061).Experimented of intensifying hypersaline organic wastewater treatmented processing in the SBR demonstrate a significant result.The wastewater salt content of initial wastewater was 12% and initial CODcr was 1494 mg/L.After 72 h,the removal efficiency of CODcr achieved 90.0% and after 120 h,it achieved 98.1%.The experiments also showed the hypersaline organic wastewater treatment and presented the feasibility of acclimating of halophilic bacteria and running of proc-essing system.

Abstract: Objective To investigate the epidemiological characteristics of pathogens causing bloodstream infection in hematology patients during treatment and to compare the effects of allogeneic hematopoietic stem cell transplantation (HSCT) on them, so as to provide evidence for the diagnosis and treatment of bloodstream infection. Methods A total of 292 cases with bloodstream infection in hematology wards of the PLA General Hospital were collected from 2017 to 2021, which were divided into HSCT group and N-HSCT group according to whether performed HSCT or not. The epidemiological characteristics and influence of pathogenic bacteria in blood stream infection were analyzed and compared between the two groups. Results A total of 362 strains of pathogenic bacteria were collected from 292 cases, including 106 strains in HSCT group (84 cases) and 256 strains in N-HSCT group (208 cases). Bloodstream infections were more common in acute myeloid leukemia (130/392, 44.52%), followed by non-Hodgkin's lymphoma (74/292, 25.34%). The rate of once bloodstream infection in HSCT group was higher than that in N-HSCT Group, but the rate of twice bloodstream infections in N-HSCT group was higher. Gram-negative Bacilli were the most common pathogens (56.08%), with Escherichia coli being absolutely dominant (109/362, 30.11%), followed by Klebsiella pneumoniae (39/362, 10.77%). Coagulase-negative staphylococci (CoNS) (107/362, 29.56%) were the most common Gram-positive cocci. The detection rate of fungi in HSCT group (10/106, 9.43%) was significantly higher than that in N-HSCT Group (3.52%). The drug resistance rate of the common pathogenic bacteria was at a high level, and there was a certain proportion of multi-drug resistant strains (except for Pseudomonas aeruginosa). The resistance rates of CoNS to penicillin, gentamicin, moxifloxacin, clindamycin and rifampicin in HSCT group were higher than those in N-HSCT Group. The resistance rate of Escherichia coli to piperacillin/tazobactam, cephalosporins and etapenem in HSCT group was significantly higher than that in N-HSCT group. Conclusions The pathogens of blood stream infection in hematology patients are complicated and various. It is difficult for clinical diagnosis and treatment to detect multiple infections and multiple pathogens. HSCT patients have a higher risk of fungal bloodstream infection and more multi-drug resistant strains detected. Therefore, the identification of bloodstream infection and multi-drug resistant strains associated with HSCT patients should prompt surveillance.

In patients who have sustained traumatic brain injury with associated extremity fracture, there is often a clinical perception that the rate of new bone formation around the fracture site increases.(1) An overgrowth of callus is observed and ectopic ossification even occurs in the muscle,(2) but the mechanism remains unclear. Whether this rapidly-formed new bone is fracture callus or a variant of heterotopic ossification, a common complication of traumatic brain injury, is the subject of some debates.(3) It is generally believed that the process of fracture healing is a recapitulation of normal embryonic osteogenesis,(4) i.e. ,a series of changes in the intracellular and extracellular matrix, which start from the injury of cells, blood vessels and bone matrix to a complete reconstruction of the bone.(5) It is a complex process influenced by multi-level and multi-route regulations of the general and local environments in the body, and many growth factors participate in this process, which is the base of bone healing;(6) whatever methods are used to promote bone healing, they are based on accelerating the changes of growth factors.(7) So it is worth making a thorough study on the mechanism, by which traumatic brain injury influences the expression levels of growth factors and consequently affects the speed of bone healing.
Animals ; Brain ; metabolism ; Brain Injuries ; physiopathology ; Fibroblast Growth Factor 2 ; physiology ; Fracture Healing ; Gene Expression ; physiology ; Humans ; Oncogene Protein p65(gag-jun) ; metabolism ; Oncogene Proteins v-fos ; metabolism ; Vascular Endothelial Growth Factor A ; physiology

OBJECTIVECleidocranial dysplasia (CCD) is a dominantly inherited skeletal dysplasia caused by mutations in the osteoblast-specific transcription factor-encoding gene, core binding factor α1 (CBFA1). Over 90 mutations in CBFA1 gene have been published to date in 500 independent cases of CCD, including missense mutations, deletions, insertions, frameshift, and splice mutations. However, mutational screening of the CBFA1 gene is still far from saturation, and more novel mutations will be identified to enrich the insights into the molecular basis for the pathogenesis of CCD. The aim of this study was to explore the clinical and image features and detect the mutations of CBFA1 gene in two CCD families.

METHODIn this study, the clinical features were investigated in two CCD families, radiological and CT examinations regarding osseous malformation were carried out over the entire body of these patients with CCD. Blood (2 ml) was drawn from all affected individuals, unaffected family members and one hundred unrelated normal controls, Genomic DNA was extracted from whole blood with PureGene DNA extraction kit and PCR was performed with eight pairs of PCR primers for exons 0 to 7 of the CBFA1 gene. The mutations of CBFA1 gene were screened in these two CCD families.

RESULT(1) The clinical features of patients with CCD include delayed closure of fontanelles, frontal bossing, dysplasia of clavicles, late tooth eruption, and other skeletal anomalies. X-ray and CT examination showed the bulging calvarium, patent fontanelles, wide cranial sutures, multiple Wormian bones, dental dysplasia or aplasia of clavicles. (2) Two mutations were identified, one is novel missense mutation (c.1259C > T[p.T420I]) in CBFA1 gene exon 7, other (c.577C > T[p.R193X]) was reported in Chinese cases with CCD for the first time.

CONCLUSION(1) The clinical and image features of patients in two CCD families include delayed closure of fontanelles, frontal bossing, dysplasia of clavicles, late tooth eruption, and other skeletal anomalies. (2) The T420I and R193X mutations of CBFA1 were reported, expanding the spectrum of CBFA1 mutations causing CCD.

Child ; Child, Preschool ; Cleidocranial Dysplasia ; genetics ; pathology ; Core Binding Factor Alpha 1 Subunit ; genetics ; DNA Mutational Analysis ; Exons ; Female ; Humans ; Male ; Mutation ; Pedigree ; Phenotype

Objective To evaluate the efficacy of mechanical thrombectomy on embolic cerebral infarction with magnetic resonance diffusion weighted imaging (DWI). Methods Forty New Zealand white rabbits were performed carotid artery injection of blood clot emboli to induce the animal models of acute cerebral infarction; these models were equally randomized into 4 groups (n=10);non-treatment group was given no treatment; mechanical thrombectomy via femoral artery was performed under DSA 6, 8 and 12 h after the inducement in the 3 treatment groups, respectively. MR-DWI, T1WI and T2WI were performed and the apparent diffusion coefficient (ADC) and infarct volume were calculated in each group 6, 8, 12 and 24 h after the inducement. Results DWI demonstrated the ischemic area in all the 40 rabbit models at hyper-acute stage (within 6 h of inducement) with hyperintensity, while T1WI and T2WI showed normal signals. MR-DWI, T1WI and T2WI had significant difference in the relevance ratio of cerebral infarction in these rabbit models at acute stage (within 24 h of inducement, P＜0.05). The DAC value was gradually decreased and the ischemic area was gradually increased at acute stage in the rabbit models of non-treatment group and group of performing mechanical thrombectomy at the 12thh of inducement, however, rabbit models of groups of performing mechanical thrombectomy at the 6th and 8th h of inducement enjoyed the opposite position. The DAC value was higher and the ischemic area was lower 24 h after the inducement in the rabbit models of groups of performing mechanical thrombectomy the 6th and 8th h of inducement as compared with those in the non-treatment group and group of performing mechanical thrombectomy at the 12th h of inducement. Conclusion Mechanical thrombectomy at early stage enjoys significant good results; MR-DWI is a sensitive way in dynamic observing the treatment efficacy of acute cerebral infarction.