Brain Diseases ; etiology ; therapy ; Heat Stroke ; complications ; therapy ; Humans ; Hyperbaric Oxygenation ; Male ; Middle Aged ; Occupational Diseases ; complications ; therapy

Objective To investigate the characteristics and treatment effects in patients with spinal fractures associated with dural tears.Methods A retrospective analysis was made on 185 patients with spinal fractures presenting to hospital from February 2013 to February 2015.There were 103 males and 82 females,aged 17-73 years (mean,58 years).Causes of injury were high falls in 72 patients,traffic collisions in 58,hitting by heavy objects in 41,ground-level falls in 12,and collision events in two.Cervical spine fractures were seen in 65 patients,thoracic vertebra fractures in 51,and lumbosacral vertebral fractures 69.Neurologic deficit was assessed using the American Spinal Injury Association (ASIA) score,including grade A in 24 patients,grade B in 22,grade C in 26,grade D in 37 and grade E in 76.Eighty patients were managed by simply anterior surgery,97 by posterior surgery,and eight by anterior-posterior surgery.Twenty-one patients were found with dural tears (group A) and 164 patients without dural tears (group B).Incidence of dural tears in cervical,thoracic and lumbosacral vertebral fractures were recorded and compared.Preoperative neurologic deficit,laminar fracture and spinal canal encroachment rate were compared between groups.Neurological function and complications associated with dural repair were detected.Results In group A,ten patients were rated ASIA grade A,five grade B,three grade C,one grade D and two grade E.In group B,14 patients were rated ASIA grade A,17 grade B,23 grade C,36 grade D and 74 grade E.Group A accounted for 11％ (7/65) of cervical,10％ (5/51) of thoracic,and 13％ (9/69) of lumbosacral spine fractures (P ＞ 0.05).Nineteen patients (91％) in group A were complicated with neurological deficit,compared to ninety patients (54.9％) in group B (P ＜ 0.01).Eighteen patients (86％) in group A had laminar fractures,compared to fifteen patients (9.1％) in group B (P ＜ 0.01).In group A,rate of spinal canal encroachment was (62.3 ± 12.1)％ and 17 patients (81％) showed spinal canal encroachment of greater than 50％.While in group B,rate of spinal canal encroachment was (36.2 ± 15.6)％ and 25 patients (15.2％) showed spinal canal encroachment of greater than 50％ (P ＜ 0.01).For dural tears in group A,11 patients were treated by direct suturing,four by thoracolumbar fascia repair,three by artificial dural coverage and three by fibrin glue sealing.In group A,19 patients were followed up and one of them presented persistent cerebral spinal fluid leak that necessitated an irrigation and debridement to cure.ASIA score was improved from grade A to B in two patients,grade B to C in one,grade C to D in one and grade D to E in one at the final follow-up.Conclusions Majority patients with spinal fractures associated with dural tears exist severe neurologic deficit,spinal canal encroachment and laminar fractures.Incidence of dural tear in cervical,thoracic and lumbosacral vertebral fractures is similar.Incidence of complications related to dural tear repair is low,but the neurological function recovery is poor after operation.

OBJECTIVETo explore the relevance between chronic benzene poisoning and ABO blood type.

METHODS1014 benzene-exposed workers chosen from Shanghai and 4196 non-benzene-exposed workers chosen from Yangpu district were accepted the ABO blood type identification, and two groups of workers compared with the Han population of Shanghai and China for the ABO blood type distribution; the 71 cases of chronic benzene poisoning were compared with the group of benzene-exposed workers for the ABO blood type distribution.

RESULTSThere were no significant differences of the ABO blood type distribution among the Han population of China, the Han population of Shanghai and the group of non-benzene-exposed workers (x(2)=7.95, P>0.05). The A type blood distribution frequency in the group of chronic benzene poisoning patients was 42.25%, significantly higher than the group of benzene-exposed workers (29.48%), and there was statistically significant difference (x(2)=5.11,P<0.05). The B type blood distribution frequency in the group of chronic benzene poisoning patients was 12.68% , significantly lower than the group of benzene-exposed workers (25.15%), and there was statistically significant difference (x(2)=5.61, P0.05).

CONCLUSIONThe people with A type blood are susceptible to chronic benzene poisoning, however, the people with B type blood are not susceptible to chronic benzene poisoning.

ABO Blood-Group System ; genetics ; metabolism ; Benzene ; poisoning ; China ; Disease Susceptibility ; Female ; Humans ; Male ; Occupational Exposure

BACKGROUND:Animal model of infection is established using bioluminescent gene-labeled bacteria, which stimulate local environment of spine infection and reveal the pathophysiological mechanism of spine infection.
OBJECTIVE:To evaluate the feasibility and safety of anterior one-stage debridement, autogenous iliac bone grafting and titanium plate internal fixation in the management of pyogenic spinal infections in spine.
METHODS:Total y 24 Chinese dogs were adopted in the study to develop a canine model of acute pyogenic spondylodiscitis using a bioluminescent strain of Staphylococcus aureus Xen29. The animal models were detected by X-radiography, CT and MRI examinations. After 4 weeks of modeling, al the animals underwent one-stage debridement, autogenous iliac bone grafting and anterior titanium plate internal fixation. Antibiotics contained Cefazolin and Gentamicin were administrated daily since perioperative period to 4 weeks after surgery. The titanium plate and adjacent vertebra were removed surgical y at various postoperative time points (4, 8, 12, 24 weeks) when the dogs were kil ed. The excised tissues and retrieved implants were cultured with conventional bacteria, bacteria 16S rRNA and specific Nuc gene of Staphylococcus aureus. PCR and bioluminescence imaging technique were used to detect the presence of bacteria.
RESULTS AND CONCLUSION:The surgical wound was healed uneventful y. Gross observation and MRI examination of the specimens showed that there was no abscess formation or signs of infection recurrence. The infection rate was 41.7%(10/24) and 75%(18/24) in the procedure of conventional bacteria and bacteria 16S rRNA cultivation. The results showed that the sensibility of PCR technique used to detect the presence of bacteria by amplifying the highly conservative gene sequence of 16S rRNA was significantly higher than that of conventional bacterial cultivation procedure (P<0.05). The PCR detection of specific Nuc gene of Staphylococcus aureus showed the existence of Staphylococcus aureus (1/24). However, Staphylococcus aureus Xen29 with genetic marker was not detected around the implant by bioluminescence imaging technique (0/24). Al of the results showed that bacterium adhering to prosthesis in vivo is an universal phenomenon. The bacteria identified from prosthesis which was taken during the surgery and the bacteria by which the spine was infected before the surgery was not homologous. The one-stage debridement, autogenous bone grafting and anterior titanium plate internal fixation is safe and effective in the management of pyogenic spinal infections. Using of internal fixator can not lead to recurrence or persistence of infection.

Critical Care ; Critical Illness ; Emergencies ; Female ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male ; Retrospective Studies ; Transportation of Patients

ngthen cellular immunity, especially Th1-type immune response to HPV11-E7 DNA vaccine in mice.

OBJECTIVETo develop an HPLC method for the determination of serum level of Crebanine (Cre) and study on the pharmacokinetics of Cre injection in rabbits.

METHODTo sample blood serum from the rabbits' ears which were injected the Cre by 2.0 mg x kg(-1) at different time and use HPLC to determine the concentration of Cre in it, the pharmacokinetic parameters were accessed by the DAS software.

RESULTCre was fitted to a two compartment open pharmacokinetic model in rabbits. There was no signifiant difference between the male and female rabbits'pharmacokinetic by t-test. The mainly pharmacokinetic parameters were: t1/2alpha = (3. 246 +/-0.222) min, t1/2beta = (36.67+/-5.52) min, Cmax = (1.401 +/- 0.062) mg x L(-1), Vd = (5.928 +/- 0.877) L x kg(-1), Cl = (0. 051 +/-0.003) L x min(-1) x kg(-1).

CONCLUSIONThis experiment can objectively show the pharmacokinetics regularity of Crebanine injection in rabbits. Crebanine injection was a speeding disposition drug (t1/2 <1 h) and disposed extensively and rapidly in rabbits.

Animals ; Aporphines ; administration & dosage ; blood ; pharmacokinetics ; Chromatography, High Pressure Liquid ; Female ; Injections ; Male ; Metabolic Clearance Rate ; Plants, Medicinal ; chemistry ; Rabbits ; Stephania ; chemistry

Objective To report our experience with retroperitoneoscopic nephroureterectomy with excision of a bladder-cuff for renal pelvic and ureteral tumors.Methods Thirty-five patients (21 women and 14 men;mean age,67 years;age range,49 -82 years) with upper urinary tract tumors underwent retro- peritoneal laparoscopic nephrourcterectomy with excision of a bladder-cuff.Of the 35 cases,15 had pelvic tumors and 20 had ureteral tumors;19 cases had the tumors on the right side and 16 on the left.Two cases had ureteral tumors combined with bladder tumors.One case had bilateral ureteral tumors then concomitantly had bladder tumors.The needle electrode was used to circleround incise the bladder thoroughly 0.5 cm away from the ureterostoma.Three trocars in the waist were used for dissecting the kidney;and the ureter was dis- sected as far distally downward.Then an incision of 5-9 cm was created in the lower abdomen to allow dis- section of the distal ureter and bladder-cuff and intact specimen extraction.Results The operation was successful in all 35 patients.The mean operative time was 3.1 h ( range,1.5-6.0h).The mean estimated blood loss was 166 ml (range,20-1600 ml).Four cases received blood transfusion.The patient's activity re- covered in 20-32 h after operation.Postoperative pathology showed transitional cell carcinoma in 30 cases, poorly differentiated adenocareinoma in 2 (ureter),squamous cell carcinoma in 1 (ureter),leiomyosarcoma in 1 (ureter),xanthogranulomatous pyelonephritis in 1.Duodenal leakage occurred in 1 patient who had had dialysis a drainage catheter was placed on the third d after operation,and the patient died of heart failure af- ter 2 months.Postoperative vesical irrigation was performed to prevent tumor recurrence.The mean hospital stay was 11 d.During a mean follow-up of 14 months(range,1-32 months),1 patient developed pelvic me- tastasis and was alive with the tumor.The other 33 patients survived free of tumor to date.No patient had re- current transitional cell carcinoma of the bladder.Conclusions Our data demonstrate that retroperitoneo- scopic nephroureterectomy for renal pelvic and ureteral tumors has shorter incision and more rapid postopera- tive recovery compared with open surgery.Using resectoscope to resect the termination of ureter allows more complete excision of the ureter.

Objective To investigate the clinical significance of a new method,axis-line-distance technique(ALDT),in scoliosis measurement.Methods Thirty cases with idiopathic scoliosis were measured on two separate occasions by six observers with the Cobb technique and the ALDT on PACS workstation.The interval time between two measurement occasions were three weeks.The data were analyzed statistically with the paired-sample t-test.Results(1)Concerning intraobserver variance in two measurement occasions,the minimum variance,the maximum variance and the average variance were 0, 24.00?,5.71??1.54?for Cobb technique and 0,12.00 mm,(1.95?0.58)mm for ALDT.There were significant measurement differences for four observers with Cobb method 39.00??10.69?versus 36.50?? 10.63?,31.73??10.96?versus 37.30??9.65?,32.03??7.49?versus 27.86??9.00?,29.77??8.87? versus 34.20??7.26?,all P0.05].(2)Concerning interobserver variances in six observers,the average measurement variance was 5.07??0.35?for Cobb method,and(2.32?0.26)mm for ALDT. There were significant measurement differences for every observer using with Cobb method(36.63??10.30? versus 33.27??10.10?,39.00?10.69?versus 31.73??10.96?,32.03??7.49~ versus 29.78?? 8.87?,36.63??10.30?versus 39.00??10.69?versus 32.03??7.48?,39.00??10.69?versus 32.03?? 7.49?,all P

Objective To detect the distribution of resistance-nodulation (RND)efflux pump system of Acineto-bacter baumannii (AB),and explore the relationship between its’expression and antimicrobial resistance.Methods Fifty-nine strains of multidrug-resistant AB isolated from clinical specimens in The First Affiliated Hospital of Nan-chang University were identified and performed antimicrobial susceptibility analysis,distribution of RND efflux sys-tem of AB was detected by polymerase chain reaction(PCR),expression of efflux pump genes in different drug-re-sistant phenotypes of AB was compared,relationship between the expression level and drug resistance was analyzed, amplified products of RND efflux system were sequenced.Results Resistance rates of AB to ampicillin/sulbactam, imipenem,gentamicin,ciprofloxacin,and levofloxacin were 93.2%,94.9%,88.1%,96.6%,and 52.5% respec-tively.PCR detection results of efflux pump and integron genes of 59 AB strains revealed that the carrying rates of adeR,adeS,adeB,adeJ,and adeG genes were 81.4%,91.5%,93.2%,100.0%,and 61.0% respectively.The expression of efflux pump genes in different strains was different,expression levels of ade B and adeJ genes among gentamicin,imipenem,ampicillin/sulbactam resistant AB group and non-resistant AB group were significantly dif- ferent (all P＜0.05).There was no mutation or insertion sequence in the base sequences of regulatory genes ade R and ade S of adeABC efflux pump.Conclusion RND efflux pump system is universally present in AB,the expres-sion upregulation of ade B and ade J genes in RND efflux pump system is related with antimicrobial resistance of bacteria to gentamycin,imipenem,and ampicillin-sulbactam.