Objective To determine the independent risk factors for sepsis in patients with large area burns.Methods The study enrolled 307 patients with large area burns treated from June 2014 to June 2015.Related variables included age,gender,visit time,emergency eschar open,burn index,tangential excision of eschar during shock stage,delayed resuscitation during shock stage,oxygen pressure(PaO2),carbon dioxide pressure (PaCO2),assisted ventilation mode,mechanical ventilation time,inhalation injury,prophylactic tracheotomy,continuous lactic acid rise,refractory hypernatremia,heart-lung disease history,and diabetes history.Correlation of the variables with the incidence of sepsis was observed.Independent predictors of sepsis in patients with large burns were differentiated using the Logistic regression analysis.Results Delayed resuscitation during shock period (OR =1.747,95％ CI 1.822-7.431,P ＜ 0.05),continuous lactic acid rise (OR =1.758,95％ CI 1.137-4.002,P ＜ 0.05),refractory hypernatremia (OR =2.985,95％ CI 1.074-6.782,P ＜ 0.05),moderate and severe inhalation injury(OR =14.764,95％ CI 0.892-47.323,P ＜ 0.05) and burn index (OR =5.017,95％ CI 1.075-23.572,P ＜ 0.05) were found be independently associated with sepsis in patients with large burns.Conclusions These independent risk factors for sepsis in large area burn patients deserve more attention.Early and timely treatment measures may reduce the incidence of sepsis.

Objective To observe the effects of seawater immersion at different temperatures on survival time and mortality and physiological state of non-anesthetized rats.Methods Totally 100 SD male rats(The abdominal cavity was implanted with a temperature sensor in advance)were randomly divided into five groups which were immersed in 20 ℃,17 ℃,15 ℃,13 ℃ and 10 ℃ seawater,respectively.Each group contains 20 rats.The changes of respiration,heart rate and muscle fibrillation within 2 hours were observed and the survival time and mortality of each group were counted in 24 hours.The decrease trend of intraperitoneal temperature in rats was analyzed retrospectively within 2 hours.Results Soaking for 10 minutes,the respiratory and heart rate of each group were significantly increased,but there was no significant difference among groups(P>0.05).The respiratory and heart rate decreased rapidly between 10 and 40 minutes,and the decline was slower relatively between 40 and 80 minutes.Soaking for 80 minutes,the respiration rate of rats among groups had significant difference(P<0.05).Immersing for 100 minutes,the heart rates of rats in each group were significantly different(P<0.05).Soaking for 20 minutes,the muscle fibrillation of 15 ℃,13 ℃ and 10 ℃ group reached the peak,and there were significant differences among groups(P<0.05),then disappeared.However the rats in 20 ℃ and 17 ℃ group reached the peak at 30 minutes,but there was no significant difference between two groups(P>0.05),hereafter the muscle fibrillation was maintained at a certain level.The mean survival time of 20 ℃ group,17 ℃ group,15 ℃ group,13 ℃ group and 10 ℃ group in 24 hours were(23.6±1.23)hours,(15.0±4.16)hours,(7.7±3.21)hours,(2.4±0.91)hours and (1.1±0.39)hours,respectively,and the survival curve of each group was statistically significant(P<0.05).The intraperitoneal temperature of rats showed a decline in the cliff,the lower the water temperature,the faster the descending.Soaking for 40 minutes,the difference of intraperitoneal temperature of each group was statistically significant(P<0.05).Conclusion The effects of seawater immersion at different temperatures on the physiological state and survival time and mortality of rats are significantly different.With the decrease of water temperature,the physiological state changes more obviously,the survival time is shorter and the mortality rate is higher.

OBJECTIVEThis study aimed to explore the differences of membrane thickness and pressure on the paranasal sinus membrane in goats and analyze their causes. The results can provide theoretical basis and guidance for the issues of the maxillary sinus floor augmentation related to the membrane.

METHODSThe membrane was cut into two sizes from every sinus membrane. The membrane was fixed in formalin to obtain tissue specimens for the membrane thickness study and pressure study. The correlation between the two parameters was then analyzed, and appropriate statistical methods and software were selected.

RESULTSThe top of maxillary sinus, the bottom of maxillary sinus and the frontal sinus membrane thickness were (410.03 ± 65.97), (461.33 ± 91.37), (216.90 ± 46.47) µm. The pressure were (260.08 ± 80.12), (306.90 ± 94.37), (121.72 ± 31.72) kPa. The mean differences of the membrane thickness between the top of the maxillary sinus and the frontal sinus, bottom and frontal, and top and bottom were statistically significant (P < 0.05). The mean differences in membrane pressure were also statistically significant (P < 0.05).

CONCLUSIONThe membrane thickness and pressure of the top and bottom of the maxillary sinus are higher than those of the frontal sinus membrane. However, the thickness and pressure of the bottom membrane are slightly higher than those of the top membrane. Pressure and membrane thickness are positively correlated in the sinus membrane.

Animals ; Goats ; Maxillary Sinus ; Sinus Floor Augmentation ; Software

OBJECTIVE Based on the methods of microdialysis,HPLC-MS/MS and gene chip tech-nology,the mechanism of Baicalin and Geniposide(BC/GP)against excitatory amino acid toxicity in ce-rebral ischemia was studied. This will provide guidance for the clinical application of BC/GP and the study of excitatory amino acid toxicity in cerebral ischemia.METHODS (1)Microdialysis technique and HPLC-MS/MS was performed to study the pharmacodynamics of BC/GP against cerebral ischemia. ①18 SD rats with body weight of(280±20)g were randomly divided into control group,treatment groups with BC/CP at low dose,medium dose and high dose(equal to the dosage of crude drugs for 30 mg·kg-1, 45 mg·kg-1and 60 mg·kg-1respectively).Rats in each group were given intragastric administration for seven days to establish cerebral ischemia model. Then, microdialysis probe was applied to collect cerebrospinal fluid from hippocampus before and after cerebral ischemia. ② First, we established the HPLC-MS/MS method for measuring drugs and excitatory amino acids.Then we detected the microdi-alysis samples and observed their changes in animals.(2)The mechanism of BC/GP against excitatory toxicity of cerebral ischemia were observed at gene level by chip technique. ① 16 SD rats with body weight of 240±20 g were randomly divided into sham group, model group, treatment group of BC(60 mg·kg-1),treatment group of GP(60 mg·kg-1)and treatment group of BC/GP(7:3)(60 mg·kg-1).Rats in eachgroup were given intragastric administration for seven days to establish cerebral ischemia model. Then the rats were sacrificed,and the hippocampus were rapidly harvested and stored at-80℃for further detection. ②After the quality inspection of the hippocampal,the qualified samples were subjected to detect the levels of neurotransmitter receptor gene in the ischemic of rats by gene chip technology.Finally,the results were analyzed by the method of Δ ΔCt.RESULTS (1)Only three compounds includ-ed GP,glutamic acid and aspartic acid were detected in microdialysis samples by HPLC-MS/MS.The concentration of GP increased and lasted for 120 min with a significant dose-dependent after cerebral ischemia.Compared with low dose group,the AUC(0-t),MRT(0-∞),Cmaxand t1/2zin high-dose group showed significant difference(P<0.01).Compared with the model group,the levels of glutamic acid and aspartic acid in the treatment groups decreased significantly,especially in the middle and high dose groups.(2) 89 genes in the neurotransmitter receptor gene signaling pathway were detected by gene chip technol-ogy. There were 22 genes with |Fold Regulation|>1.5 in the model group, compared with the sham group.Five of the 22 genes showed statistically significant differences,including Grin2c(2.9026),Chrna7 (-1.5877), and Tacr2 (-1.7695). Htr3a (-1.8172) and Grm6 (-2.3527). There were 5 genes with |Fold Regulation|>1.5 in the BC group, compared with the model group, Two of them exhibited statistically significant differences,including Brs3(1.797)and Grin2c(-1.7979).There were 14 genes with|Fold Reg-ulation|>1.5 in the GP group, compared with the model group. Three of them displayed statistically significant differences,including Hcrtr2 (-1.6584), Sctr (-3.8524) and Grin2c (-4.8408). Compared with model group, the genes of |Fold Regulation|>1.5 in BC/GP (7:3) group are 5, and only one of them showed a significant differences. CONCLUSION (1)After administration of BC and GP,GP can cross the blood-brain barrier and reduce the release of excitatory amino acids in the hippocampus. (2) BC/GP can inhibit the interaction between excitatory amino acids and excitatory amino acid receptors and attenuate the toxicity of excitatory amino acids by down-regulating the expression of glutamic acid receptor Grin2c gene.(3)BC/GP may exert their brain protection effect by reducing the release of excit-atory amino acids and inhibiting the expression of excitatory amino acid receptors.

OBJECTIVETo investigate the safety and feasibility of dose dense chemotherapy in the postoperative adjuvant treatment for breast cancer.

METHODSThe data of 114 breast cancer patients treated with adjuvant dose dense chemotherapy was retrospectively analyzed.

RESULTS114 breast cancer patients received postoperative adjuvant dose dense chemotherapy from Jan. 2004 to March 2005. The patients were treated with different regimens according to their recurrence risk: 43 with paclitaxel + epirubicin (PE), 8 with taxotere + epirubicin (TE), 36 with cyclophosphamide + epirubicin + 5-Fu ( CEF) and 27 with epirubicin +5-Fu (EC). Totally, 111 patients except 3 completed the dose dense chemotherapy smoothly. Major toxicities severer than grade III included: neutropenia in 6.3% of the patients, nausea and vomit in 11.7%, peripheral neuropathy in 3.6%.

CONCLUSIONPostoperative adjuvant dose dense chemotherapy for breast cancer patient is feasible and safe, but the long-term outcome still needs further observation.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Cyclophosphamide ; administration & dosage ; Disease-Free Survival ; Dose-Response Relationship, Drug ; Epirubicin ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Liver Neoplasms ; secondary ; Lymphatic Metastasis ; Mastectomy ; methods ; Middle Aged ; Nausea ; chemically induced ; Neutropenia ; chemically induced ; Paclitaxel ; administration & dosage ; Postoperative Period ; Retrospective Studies ; Taxoids ; administration & dosage

OBJECTIVETo explore efficacy of modified funnel method for transpedicular bone grafting in treating thoracolumbar vertebras fracture.

METHODSFrom May 2006 to November 2011, 35 patients (19 males and 16 females, ranged in age from 21 to 66 years with an average of 34.6 years) with thoracolumbar vertebras fracture were treated by posterior pedicle screw fixation, reduction and modified funnel method for transpedicular autogenous iliac bone grafting. Of the 35 cases, 9 cases were severe compression fracture and 26 cases were burst fracture. The anterior body height and Cobb's angle of injured vertebral were measured by X-ray; the effect of implantation bone and CT value were assessed by radiograph CT scan; Nerve function were evaluated according to Frankel's neurological function classification and back pain were evaluated by visual analogue scale (VAS).

RESULTSThirty-two patients were followed up from 18 to 37 months with an average of 19.7 months. No nerve injuries aggravated, and 11 patients with partial nerve injuires preoperatively were improved at least 1 level recovery postoperatively; Breakage or loosen of screws were not found. Vertebral bone grafting filled well, bone fusion were got after 6 months' treatment and without cavity gap in grafting bone area. The anterior vertebral height was improved respectively from preoperative (50.17 +/- 8.26)% to postoperative (90.79 +/- 4.85)%, and (90.34 +/- 4.03)% at the final follow-up. The Cobb's angle improved from preoperative (28.7 +/- 6.24) degrees to postoperative (7.26 +/- 3.79) degrees, with (7.34 +/- 4.05) degrees at the final follow-up. CT value of injured vertebras at the final follow-up were significantly higher than adjacent vertebras'. The average VAS was 1.06.

CONCLUSIONPosterior pedicle screw fixation, reduction and modified funnel method for transpedicular autogenous iliac bone grafting is a feasible and safe method for the treatment of thoracolumbar vertebras fracture. It can effectively prevent bone loss of injured vertebral height, progressive deformity of kyphosis, and keep spinal movement function at the maximum.

Adult ; Aged ; Bone Transplantation ; methods ; Female ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; injuries ; surgery ; Male ; Middle Aged ; Recovery of Function ; Spinal Cord ; physiopathology ; Spinal Fractures ; diagnostic imaging ; physiopathology ; surgery ; Thoracic Vertebrae ; diagnostic imaging ; injuries ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

In order to reveal the cause of disease occurred in the process of Coptis chinensis growth, this paper studied the bacterial species diversity index of different aged rhizospheric and non-rhizospheric soil planting normal or sick C. chinensis by using PCR-DGGE technique. The representative DGGE bands were chosen to be cloned, and sequenced, the phylogeny were constructed. The results showed that the bacterial communities were very different between the normal and diseased soil samples of C. chinensis, and the diversity index (H) of diseased soil samples were higher than that of normal soil samples. Sequencing analysis of representative cloned DGGE bands showed that the unculturable bacteria were the dominant groups, and bacteria belonged to genus Bacillus, Acidovorax, Acinetobacter, uncultured Kluyvera, and uncultured Comamonas were also existing, but the reported plant pathogenic bacteria were not found in the C. chinensis planting soil. The density and brightness of clone band d in diseased soil samples was higher than that in normal soil sample, and sequencing analysis showed that it belonged to genus Acidovorax. Obviously, during the process of C. chinensis growth, the rhizospheric bacteria population changed, and the quantity of bacteria belong Acidovorax increased, which probably resulted in the disease occurred during C. chinensis growth.
Bacteria ; classification ; genetics ; isolation & purification ; Biodiversity ; Coptis ; growth & development ; microbiology ; Denaturing Gradient Gel Electrophoresis ; Molecular Sequence Data ; Phylogeny ; Polymerase Chain Reaction ; Rhizosphere ; Soil Microbiology

Amino Acid Sequence ; Base Sequence ; Genes, Bacterial ; Humans ; Molecular Sequence Data ; Polymerase Chain Reaction ; Staphylococcus epidermidis ; enzymology ; genetics ; beta-Lactamases ; chemistry ; genetics

Objective:To explore the influencing factors of HIV-1 DNA and its clinical value.Methods:The relationship between HIV-1 DNA and CD4 + T cell count, CD4/CD8, HIV viral load and subtype was analyzed in 304 patients with HIV/AIDS in order to explore the factors affecting HIV-1 DNA and the value of clinical application. Results:There was no statistically significant difference in HIV-1 DNA levels between the different CD4 + T cell level groups (Z=1.194, P>0.05). HIV-1 DNA levels were higher in the CD4/CD8≤0.5 group than in the CD4/CD8>0.5 group (Z=-2.788, P<0.01). HIV-1 DNA levels were higher in the HIV viral load >100 copies/ml group than in the ≤100 copies/ml group (Z=-2.953, P<0.01). HIV-1 DNA levels were higher in those with CD4 + T cell counts ≤200 at diagnosis than in those with CD4 + T cell counts >200 at diagnosis (Z=-2.175, P<0.05). HIV-1 DNA levels were higher in patients with CD4/CD8 ≤0.2 at diagnosis than in those with CD4/CD8 between 0.2 and 0.5, but there was no significant difference between the two groups (Z=-0.893, P>0.05). HIV-1 DNA levels were higher in both groups than in the CD4/CD8≥0.5 group (Z=-2.568, Z=-1.960, P<0.05). Higher HIV-1 DNA levels were found in people with an HIV viral load >100, 000 copies/ml at diagnosis than in people with an HIV viral load ≤100, 000 copies/ml at diagnosis (Z=-3.520, P<0.001). The level of HIV-1 DNA was higher in the CRF01_AE group than in the non-CRF01_AE group, and the difference was statistically significant (Z=-2.848, P<0.01). CD4/CD8 seemed to be a protective factor for HIV-1 DNA>500 copies/ml. (OR=0.214(95%CI: 0.056~0.822, P<0.05) Conclusion:CD4 + T lymphocyte count, CD4/CD8, viral load and subtype are factors that influence HIV-1 DNA levels, while HIV-1 DNA may be informative for immune status assessment and disease progression determination.

Objective To establish a hypothermic pleural effusion model with SD rats,and to observe the relationship between hypothermic pleural effusion production and cold water immersion duration.Methods Sixty male Sprague-Dawley rats of(290.3 ± 7.5) g were randomly divided into experimental group(n =50) and control group(n =10).The experimental group was divided into group A1,A2,A3,A4 and A5 according to the different immersion time with 10 rats in each group.The experimental group was placed in a self-made cylindrical erected rat holders and then immersed in cold water at (20 ±0.2) ℃.The soaking depth was the level of clavicle of the rats.Group A1 and A2 were respectively removed and anesthetized after immersing 12 hours and 24 hours,and the serum and pleural effusion were collected to detect total protein and lactate dehydrogenase concentration.The remaining rats of experimental group were rewarmed by incubating at 37 ℃ for 1 hour.Group A3,A4 and A5 were respectively anesthetized at 12 hours,24 hours and 36 hours after the initiation of rewarming for detecting the serum and pleural effusion.The control group was directly anesthetized to collect serum to detect total protein,lactate dehydrogenase concentration.The pleural effusion quality was analyzed by Light standard.Results There was no obvious pleural effusion in normal rats.The amount of pleural effusion in the group A2 was higher than that in the group A1.After the rewarming,the amount of pleural effusion gradually decreased with the prolongation of time,and disappeared 36 hours later.Pleural effusion total protein/serum total protein was about 50％ in group A1,while it was more than 50％ in the group A2,A3 and A4.Pleural effusion lactate dehydrogenase/serum lactate dehydrogenase were all less than 60％ in each experimental group.The pleural effusion lactate dehydrogenase of experimental group was 2 times greater than that of the control group.Conclusion The method of establishing hypothermia pleural effusion SD rats model by immersing in 20 ℃ water is stable and reliable.The pleural effusion increased with the prolongation of the cold water immersing.After rewarming,the pleural effusion was gradually absorbed and then dispeared.