OBJECTIVE:To provide reference for rational use of carbapenem antibiotics in the clinic. METHODS:Enterobac-teriaceae bacteria were collected from our hospital during Jan. 2014-Dec. 2015;semiautomatic microbiological assay instrument was used for strain culture,identification and drug sensitive tests. Modified Hodge test and K-B test were adopted to confirm Klebsiella pneumoniae carbapenemases (KPC)-producing and ESBLs-producing drug resistant strains. RESULTS:During 2014-2015,1 035 strains of Enterobacteriaceae bacteria were detected in our hospital,among which there were 732 strains of Escherichia coli,157 strains of K. pneumonia,136 strains of Enterobacter cloacae and 10 strains of Serratia marcescens. Citrobacter freundii was not found. E. coli and K. pneumonia were highly sensitive to amikacin and carbapenems,but slightly sensitive to most cephalosporin. A total of 64 strains of carbapenems-resistant Enterobacteriaceae bacteria(6.18%)were detected,among which there were 31 strains of carbapenems-resistant E. coli(4.23%),30 strains of carbapenems-resistant K. pneumonia(19.11%),1 strain of carbapenems-re-sistant E. cloacae(0.74%)and 2 strains of carbapenems-resistant S. marcescens(20.00%). The samples were mainly from sputum and urine specimens,which were mainly from neonatal department and ICU. Of 64 drug resistant strains,there were 59 KPC-pro-ducing strains (92.19%) and 3 ESBLs-producing strains (4.69%). CONCLUSIONS:E. coli occupies high proportion among En-terobacteriaceae bacteria,and the number of carbapenems-resistant E. coli and carbapenems-resistant K. pneumoniae is in high lev-el. Drug resistance of Enterobacteriaceae bacteria to carbopenems may be associated with KPC and ESBLs producing. Carbapenem antibiotics should be selected rationally in accordance with medication indications and the results of drug sensitivity test.

OBJECTIVETo explore the effect of half circle external fixation for the treatment of open tibial fractures.

METHODSFrom March 2005 to March 2011, 94 patients with open tibiofibula fractures were treated by closed manipulative or Kirschner-wire poking reduction with half circle groove external fixation including 63 males and 31 females with an average age of 39 years old ranging from 17 to 65 years old. Among these patients, 5 cases were cross shaped fractures, 19 were oblique form and spiral fractures, 70 cases were comminuted fractures. According to the fracture Gustilo classification, 49 cases were type IIIA, 45 were type IIIB. The incidence of wound infection, fracture healing time were observed. The function was evaluated according to the Johner-Wruhs standard.

RESULTSAll patients were followed up for 14 to 63 months (averaged 29 months). The wound healing time was from 16 to 39 weeks (means 21.4 weeks). No fracture nonunion, osteomyelitis and calf compartment syndrome occurred. The wounds of 81 cases were healed at the first period,deep wound infection occurred in 2 cases. According to the function Johner-Wruhs evaluation criteria:the result was excellent in 52 cases, good in 37 cases, fair in 5 cases.

CONCLUSIONClosed manipulative or Kirschner-wire poking reduction and half circle groove external fixation can reduce the infection rate of open tibiofibula fractures. For open tibiofibula comminuted fractures, after the half circle groove external fixation for 3 to 6 weeks, a middle Kirschner-wire was removed according to fracture end healing situation to make fixation dynamic and promote fracture healing.

Adolescent ; Adult ; Aged ; Bone Wires ; External Fixators ; Female ; Fracture Fixation ; instrumentation ; Fractures, Comminuted ; surgery ; Fractures, Open ; surgery ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery ; Young Adult

0.05). CONCLUSION Obesity was an influential factor of snoring. The PS and OSAHS have the same effect on children growth and their clinical features.

Objective To further research the urinary monitoring of the maternal thyroid functional status ,the levels of urine thyroid hormones were analyzed during pregnancy .Methods This study recruited 30 cases of healthy pregnant women at 9-12 ges-tational weeks .Their random urine specimens were collected every four weeks until delivery .The concentrations of urine thyrotro-pin(uTSH) ,urine free triiodothyronine(uFT3) and urine free tetraiodothyronine(uFT4) were detected by electrochemical lumines-cence immunoassay(ECLIA) .The urine retinol binding protein(uRBP) was detected by enzyme immunoassay (EIA) .After correc-ted by uRBP ,the statistical analysis was done to analyze the variation of the ratio of uTSH and uRBP (uTSH/uRBP) ,the ratio of uFT3 and uRBP(uFT3/uRBP)and the ratio of uFT4 and uRBP(uFT4/uRBP)during pregnancy .Results The median levels of u-rine thyroid hormone parameters were obtained from the healthy pregnant women every four weeks and were compared among dif-ferent stages .The difference of uFT3/uRBP and uFT4/uRBP was statistically significant (F= 6 .222 ,P< 0 .05 ;F= 5 .078 ,P<0 .05) ,and the levels of them varied linearity during pregnancy (F=27 .480 ,P<0 .05 ;F=23 .959 ,P<0 .05) .The difference of uT-SH/uRBP had no statistical significance(F=2 .731 ,P=0 .054) .Conclusion After corrected by uRBP ,the levels of uFT3 and uFT4 of healthy pregnant women decreased linearity among different gestational stages ,and the levels of uTSH had no noticeable change .

Objective To investigate the MR imaging technique and features of acute radiation- induced hepatic injury with superparamagnetic iron oxide(SPIO)enhancement in a rabbit model.Methods On the 10th day after half-liver single 40 Gy X-ray irradiation,MR imaging before and after SPIO administration and pathologic study of 12 adult rabbits were performed.Results On the 10th post-irradiation day,TSE T_2 WI before SPIO enhancement,the irradiated liver of two rabbits showed relatively higher signal, and 1 showed slightly lower signal.With SPIO enhancement,the irradiated livers of 9 rabbits were found to be abnormal,manifesting as higher or slightly higher areas on multiple MR imaging sequences,especially the TFE T_1 WI sequence.Histological specimen with HE stain under light microscopy revealed occlusive injury of central veins(veno-occlusive disease,VOD)in each irradiated liver to some extent.Electron microscopy investigation of the irradiated liver disclosed intracellular edema,fibrin deposition,and widening of the Disse-space.Conclusion The early pathologic feature of the irradiated liver is occlusive injury of the central vein.MR imaging with SPIO enhancement is effective to valuate the early irradiation-induced liver injury.

The growth characteristics and ginsenosides isolation of the suspension-cultured crown gall of Panax quinquefolium were studied. The result showed that the maximum biomass of cultures was 18.6 g/L (dry weight) and the content of ginsenosides reached its maximum level of 620.4 mg/L on the 27th day. The utilization rates of sugar, phosphorus, nitrogen in NH4+ and nitrogen in NO3- were 91.8%, 100%, 81% and 97%, respectively. Four compounds were isolated from the suspension-cultured crown gall and their structures were elucidated as pseudoginsenoside F11 (I), ginsenoside Rd (II), ginsenoside Rb1 (llI) and ginsenoside Rb3 (IV).
Culture Media ; Culture Techniques ; methods ; Ginsenosides ; biosynthesis ; isolation & purification ; Panax ; growth & development ; metabolism ; Plants, Medicinal ; growth & development ; metabolism

To evaluate the efficacy of an ultrasound-based quantitative method to diagnose liver fibrosis using a rat model. Ultrasonography was performed on the livers of 90 Sprague-Dawley rats with or without thioacetamide-induced fibrosis. The liver capsule thickness and 13 texture parameters of gray level co-occurrence matrix were extracted from the standard sonograms. After sacrifice, severity of liver fibrosis (S0-S4 classification) was diagnosed by histopathology. Analysis of variance and correlation statistical tests were used to analyze the differences between groups and determine the relationships between each of the 14 quantitative ultrasound index points and the histological results, respectively. Discriminant analysis models were developed for quantitative diagnosis of liver fibrosis, and the leave-one-case-out method was used to verify the efficiency of models. All 14 indices were significantly correlated with the histological stages of fibrosis (P less than 0.05). The accuracy of the discriminant model for S0, S1, S2, S3 and S4 was 83.3%, 84.2%, 70.0%, 50.0% and 88.2%, respectively. In addition, 73.3% of cross-validated rats were accurately classified. Grouping S0 as no fibrosis, S1 as mild fibrosis, S2 with S3 as moderate to severe fibrosis and S4 as early cirrhosis increased the accuracy of the discriminant model for these four groups (respectively, 91.7%, 84.2%, 69.0% and 88.2%) and allowed for 78.9% of cross-validated rats to be correctly identified. Ultrasonography combined with texture analysis was a novel and accurate method to diagnose liver fibrosis in a rat model; further studies may provide insights into its applicability for quantitating liver fibrosis in other animal models or in clinic.
Animals ; Liver ; diagnostic imaging ; pathology ; Liver Cirrhosis, Experimental ; diagnostic imaging ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Ultrasonography

OBJECTIVETo explore clinical efficacy of closed reduction and external fixation under local anesthesia for the treatment of high-risk elderly patients with intertrochanteric fracture.

METHODSFrom March 2013 to March 2015, 10 patients with intertrochanteric fractures treated with closing reduction and external fixator under local anesthesia were analyszed, including 4 males and 6 females, aged from 69 to 88 years old with an average of 75.2 years old. All fractures were caused by injury and classified to type I (5 cases), II (3 cases), and V (2 cases) according to Evans classification. According to American Society of Anesthesiologists (ASA), 6 cases were type III and 4 cases were type IV. Blood loss,operative time,hospital stays, postoperative complications, ambulation time and fracture healing time were observed, and Harris scoring were used to evaluate hip joint function.

RESULTSAll patients were followed up from 3 to 23 months with an average of 13.1 months. One patient with chronic obstructive pulmonary disease died for non-operation reason at 4 months after operation, the other fractures were healed at stage I, the mean fracture healing time was 5.6 months. There were no coxa vara, lower limb venous thrombosis, loosen and remove of needle passage. The average operative time was 46 min, blood loss was (35.00 ± 8.46) ml without blood transfusion. One patient was occurred pulmonary infection and stent-tract infection on the 2 nd and 3 rd day after operation, and improved with active anti-infection and dressing change; the other patients gone to ground activity at 4.2 d after operation. The patients stayed hospital for 10.6 d on average. According to Harris scoring at final following-up, the total score was 83.42 ± 3.27, 3 cases obtained excellent results, 5 cases good and 1 case poor.

CONCLUSIONClosed reduction and external fixation under local anesthesia in treating high-risk elderly patients with intertrochanteric fracture,which has advantages of shorter operative time, less blood loss, good recovery of postoperative function, is a safe, stable and economic method.

Aged ; Aged, 80 and over ; Anesthesia, Local ; Bone Nails ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fracture Fixation, Intramedullary ; Fractures, Closed ; surgery ; Hip Fractures ; surgery ; Humans ; Male ; Treatment Outcome

OBJECTIVETo investigate the role of EPHA2 in regulating apoptosis, proliferation and vasculogenic mimicry of osteosarcoma cells, by gene silencing through RNA interference.

METHODSEPHA2-siRNA plasmids were achieved by gene cloning. The plasmids were transfected into human osteosarcoma cells (MG63). The expression level of EPHA2 protein was measured by Western blotting. The proliferation, apoptosis and vasculogenic mimicry features of osteosarcoma MG63cells were assessed by light microscopy, MTIP assay, flow cytometry, annexin V-FITC/PI and HE staining, respectively.

RESULTSThe EPHA2-siRNA plasmid was confirmed by DNA sequencing. After treatment with Sequence-specific siRNA targeted EPHA2, the protein level of the transfected group decreased significantly. As compared to non-siRNA transfected cells, the transfected group showed lower proliferation, higher and earlier apoptosis and less osteosarcoma-generated vasculogenic mimicry.

CONCLUSIONEPHA2 gene may be involoved in apoptosis and proliferation of osteosarcoma cells, and may be necessary for vasculogenic mimicry. Down-regulation of EPHA2 expression by sequence-specific siRNA may be considered as a new option in the treatment of EPHA2 over-expressing cancer including osteosarcoma in future.

Apoptosis ; Bone Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Neovascularization, Pathologic ; pathology ; Osteosarcoma ; metabolism ; pathology ; Plasmids ; RNA Interference ; RNA, Small Interfering ; genetics ; Receptor, EphA2 ; genetics ; metabolism ; Transfection

AIMTo investigate the lattice mechanisms involved in the increased dissolution effect of polyethylene glycol (PEG 6,000) dispersion system on poorly soluble drug silymarin (SILY).

METHODSFusion method was used to prepare the solid dispersions of SILY with PEG 6,000. Evaluation of the improvement of dissolution was performed with dissolution studies in vitro. X-ray powder diffraction combined with diffraction peak pattern-fitting procedure were applied to quantitatively analyze the changes of lattice parameters. The interaction of SILY and PEG 6,000 was also determined with Fourier transform-infrared (FT-IR) spectroscopy.

RESULTSThe dissolution rate of SILY was considerably increased when formulated in solid dispersion of PEG 6,000 as compared to pure SILY. The datum from the X-ray diffraction showed the changes in the lattic spacings and particular diffraction peaks (position and the intensity) of PEG 6,000 and SILY. These could explain the increased rate of SILY released from solid dispersion system. The information of FT-IR spectroscopy showed the absence of well-defined drug-polymer interaction.

CONCLUSIONThe dissolution improvement of poorly soluble SILY from solid dispersion of PEG 6,000 can be illuminated by the changes of the lattice parameters of PEG 6,000 and the drug.

Chemistry, Pharmaceutical ; Crystallization ; Crystallography, X-Ray ; Drug Carriers ; Polyethylene Glycols ; chemistry ; Silymarin ; administration & dosage ; chemistry ; Solubility