Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; External Fixators ; adverse effects ; Female ; Fracture Fixation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo investigate the effect of Qianjin Fubao (QJFB) on behavior and estradiol level in femal chronic stress model rats.

METHODTwenty four female Wistar rats (2 month old) were evenly randomized into normal control, animal model and QJFB (0.7 g x kg(-1) x d(-1)) group. The QIFB group and the stress group were exposed to a chronic unpredictable stress for 21 days. Rats of the QJFB group received perfusion of Qianjin Fubao, and rats of stress and control group were perfused with normal saline. The behavior of three groups were determined with the method of Open-field before and after right stress respectively. Serum level of estradiol was detected with radioim munoassay.

RESULTThe behavioral score and the serum level of estradiol of the stressed group were significantly lower than those of the control group after stress (P < 0.05). There were no significant differences of behavioral score and the serum level of estradiol between QJFB group and control group.

CONCLUSIONThe chronic unpredictable stress can induce the stressful change of behavior, and QJFB may recover the rats'abnormal behavior and improve the serum level of estradiol. QJFB may have protective effect on stress.

Animals ; Behavior, Animal ; drug effects ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Estradiol ; blood ; Female ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar ; Stress, Psychological ; blood ; physiopathology

OBJECTIVEHaemophilus (H.) influenzae is a gram-negative bacillus that is a common commensal organism of the human upper respiratory tract and an important cause of human diseases such as pneumonia, meningitis, septicemia, epiglottitis and cellulitis. Strains of H. influenzae are classified according to their capsular polysaccharide. There are six serotypes, designated as a through f. In addition, there are nonencapsulated strains. Although the type of infectious diseases caused by H. influenzae has changed considerably in recent years because of the widespread and routine immunization of children against type b H. influenzae (Hib), Hib remains an important pathogen. Ampicillin is the drug of choice for treating many infections caused by H. influenzae, but its usefulness has been compromised by the increasing prevalence of ampicillin-resistant strains. The continued monitoring of resistant strains by using genotyping methods may provide insights into the epidemiology of transmission. A molecular epidemiological study of ampicillin-resistant H. influenzae derived from nasopharyngeal swabs specimens of children less than 5 years of age with respiratory tract infection were investigated in this study.

METHODSA total of 899 isolates were collected from Beijing, Shanghai, and Guangzhou during 2000-2003. Susceptibility to ampicillin was determined by using E-test. Ampicillin-resistant H. influenzae strains were selected according to National Committee for Clinical Laboratory Standards (NCCLS) 2002 breakpoints. Nested PCR method with primers specific for bexA gene and b capsulate type-specific gene was established. Genotyping by pulsed-field gel electrophoresis (PFGE) and multiplex PCR assay was performed for all ampicillin-resistant H. influenzae strains.

RESULTSSeventy-four ampicillin-resistant H. influenzae strains were obtained. Two strains were positive by nested PCR, characterized as b genotype. The incidence of Hib in ampicillin-resistant H. influenzae strains was 2.7%; 38 genotypes were detected by PFGE. Detection of five types strains of clonal dissemination by PFGE accounted for 55.4% in all ampicillin-resistant H. influenzae strains. Among them eighteen H. influenzae strains belonged to one type, accounted for 24.3% in all ampicillin-resistant H. influenzae strains. Thirty one genotypes were identified by multiplex PCR assay for ampicillin-resistant H. influenzae. The identity ratio of PFGE and multiplex PCR was 63.5%.

CONCLUSIONIn Beijing, Shanghai and Guangzhou areas 55.4% of ampicillin-resistant H. influenzae strains had clonal dissemination during the 4 years.

Ampicillin Resistance ; genetics ; Anti-Bacterial Agents ; pharmacology ; Child, Preschool ; China ; epidemiology ; DNA, Bacterial ; genetics ; Drug Resistance, Bacterial ; genetics ; Electrophoresis, Gel, Pulsed-Field ; Genotype ; Haemophilus Infections ; epidemiology ; microbiology ; Haemophilus influenzae ; classification ; genetics ; isolation & purification ; Humans ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Nasopharynx ; microbiology ; Polymerase Chain Reaction ; Respiratory Tract Infections ; microbiology

OBJECTIVEFrom the 1970s, group B streptococci (GBS) have been widely recognized as an important pathogen in neonatal infectious disease, and it emerged as the leading cause of neonatal morbidity and mortality in the Western world. However, there are few data on the prevalence of neonatal GBS infections in China. The aim of this retrospective study was to estimate whether GBS is an important pathogen in severe neonatal pneumonia, and to develop a method for detection of GBS infections in fatal neonatal pneumonia.

METHODSA total of 234 neonatal cases (0 - 28 days) died in Beijing Children's Hospital from 1953 to 2004 were enrolled in this study. They were divided into two groups. Two hundred cases diagnosed as neonatal pneumonia were assigned to study group and the remaining 34 cases died of neonatal hemolysis or surgical operation without any confirmed infectious diseases were designated as control group. Formalin-fixed, paraffin-embedded lung tissues were used as source for total genomic DNA extraction. PCR and Southern blot analyses were applied to detect GBS specific cfb gene target sequence. And the clinical data of these cases were reviewed as well.

RESULTSIn the study group, 52 cases were detected positive for GBS DNA by PCR (26%), 130 cases were positive by Southern blot (65%). In the control group, 1 case was detected positive GBS DNA by PCR (3%), and 6 cases were positive by Southern blot (18%). The positive rate was significantly lower in the control group than that in the study group (PCR, chi(2) = 8.82, P < 0.01; Southern blot, chi(2) = 26.77, P < 0.01). The positive rate in the neonates younger than 7 days (early-onset) was significantly higher than that in neonates older than 7 days (late-onset) (PCR: 37% vs. 13%, chi(2) = 15.537, P < 0.01; Southern blot: 72% vs. 52%, chi(2) = 4.37, P < 0.05). In the positive early-onset cases, 39% of whom were born prematurely (29/74). Out of the 200 cases, 75 had complete clinical data. Neither blood nor lung culture for GBS was performed in any of these cases. But risk factors were identified for 35 cases, such as premature delivery, low birth weight, premature rupture of the membrane and abnormal amniotic fluid. GBS was positive in all these cases. Severe apnea appeared to be a common symptom and was present in most of the early-onset GBS-positive cases, while cough and wheezing were found in most of the late-onset GBS-positive cases. In the control group, one PCR positive case was suffered from malignant teratoma. The other 5 positive cases confirmed by Southern blot were diagnosed as kernicterus, hepatoma, aproctia complicating with cysti-urethral fistula, neonatal physio logical bleeding and aproctia complicated with archo-perineal fistula.

CONCLUSIONGroup B Streptococcus is an important pathogen in fatal neonatal pneumonia, especially in early-onset cases. southern blot may be a sensitive method to detect GBS infection in archival tissues. In the clinical work, more attention should be paid to the neonates with GBS risk factors. And GBS detection and prevention in neonates should be put into clinical practice.

China ; epidemiology ; Humans ; Infant, Newborn ; Pneumonia, Staphylococcal ; epidemiology ; Prevalence ; Retrospective Studies ; Streptococcus agalactiae ; isolation & purification

BACKGROUNDThe optimal endpoint for catheter ablation of persistent atrial fibrillation (AF) remains ambiguous. This study investigated the impact of AF termination as a procedural endpoint and the termination mode on long-term clinical outcome.

METHODSTwo hundred and ninety-three patients who underwent stepwise ablation for persistent AF were categorized into the AF termination by ablation group and into the electrical cardioversion (CV) group. Subgroups were also analyzed based on different termination modes. Follow-up assessment included early recurrence and sinus rhythm (SR) maintenance.

RESULTSDuring initial ablation, 33 patients (11.3%) were directly converted to SR, 166 patients (56.7%) were converted to atrial tachycardia (AT) that subsequently restored SR with further ablation in 98 patients (33.4%), and a total of 162 patients (55.3%) underwent cardioversion due to persistent atrial arrhythmias. Comparison between termination by ablation and termination by cardioversion in patients exhibiting AF or AT revealed that no significant difference was observed in early recurrence (38.2% vs. 43.8%, P = 0.328) and SR maintenance (67.2% vs. 59.8%, P = 0.198) during the (23 ± 7) months follow-up. Even after repeat ablation, the SR maintenance continued to exhibit no statistical difference in above two groups (72.5% vs. 70.4%, P = 0.686). Further analysis of subgroups, however, demonstrated that patients with AF terminated directly to SR experienced better clinical outcomes than other subgroups (P < 0.05). Furthermore, atrial arrhythmias present during ablation have been implicated in prediction of recurrence mode: AF or AT (P < 0.05).

CONCLUSIONSTermination as a procedural endpoint is not associated with favorable long-term SR maintenance in persistent AF. AF methods that convert arrhythmia directly to SR have, however, been linked with improved clinical outcomes, although conversions to AT may not be correlated. Atrial arrhythmias observed during the ablation may be used to predict the recurrence mode.

Adult ; Aged ; Atrial Fibrillation ; physiopathology ; therapy ; Catheter Ablation ; methods ; Electrophysiologic Techniques, Cardiac ; Female ; Humans ; Male ; Middle Aged

Background The optimal endpoint for catheter ablation of persistent atrial fibrillation (AF) remains ambiguous.This study investigated the impact of AF termination as a procedural endpoint and the termination mode on long-term clinical outcome.Methods Two hundred and ninety-three patients who underwent stepwise ablation for persistent AF were categorized into the AF termination by ablation group and into the electrical cardioversion (CV) group.Subgroups were also analyzed based on different termination modes.Follow-up assessment included early recurrence and sinus rhythm (SR) maintenance.Results During initial ablation,33 patients (11.3％) were directly converted to SR,166 patients (56.7％) were converted to atrial tachycardia (AT) that subsequently restored SR with further ablation in 98 patients (33.4％),and a total of 162 patients (55.3％) underwent cardioversion due to persistent atrial arrhythmias.Comparison between termination by ablation and termination by cardioversion in patients exhibiting AF or AT revealed that no significant difference was observed in early recurrence (38.2％ vs.43.8％,P=0.328) and SR maintenance (67.2％ vs.59.8％,P=0.198) during the (23±7) months follow-up.Even after repeat ablation,the SR maintenance continued to exhibit no statistical difference in above two groups (72.5％ vs.70.4％,P=0.686).Further analysis of subgroups,however,demonstrated that patients with AF terminated directly to SR experienced better clinical outcomes than other subgroups (P ＜0.05).Furthermore,atrial arrhythmias present during ablation have been implicated in prediction of recurrence mode:AF or AT (P ＜0.05).Conclusions Termination as a procedural endpoint is not associated with favorable long-term SR maintenance in persistent AF.AF methods that convert arrhythmia directly to SR have,however,been linked with improved clinical outcomes,although conversions to AT may not be correlated.Atrial arrhythmias observed during the ablation may be used to predict the recurrence mode.

Objective:To investigate the recurrence factors of small intestine gastrointestinal stromal tumor (GIST ) after resection .Methods :The clinicopathological data of 67 patients with recurrent small intestine GIST admitted to Zhongshan Hospital affiliated to Fudan University from January 2004 to December 2013 were retrospectively analyzed .Kaplan‐Meier method was used to analyze the effects of different factors on the recurrence time of small intestine GIST .Cox multi‐factor regression analysis was used to analyze the independent factors of recurrence of small intestine GIST .Results :Univariate analysis revealed that the median recurrence time significantly shortened in patients with tumor diameter more than 10 cm , mitotic rate greater than or equal to 30/50 HPF ,tumor rupture ,and R0 resection ,and the difference was significant (P<0 .05) .Multivariate analysis demonstrated that tumor rupture and surgical methods were independent prognostic factors for the recurrence of small intestine GIST (P< 0 .05) .Conclusions :R0 resection and intraoperative tumor rupture avoidance can prolong the recurrence time of small intestine GIST .

Atrial Fibrillation ; surgery ; Cardiac Tamponade ; etiology ; surgery ; Catheter Ablation ; adverse effects ; Female ; Humans ; Male ; Middle Aged

Background::Accurate prediction of ischemic stroke is required for deciding anticoagulation use in patients with atrial fibrillation (AF). Even though only 6% to 8% of AF patients die from stroke, about 90% are indicated for anticoagulants according to the current AF management guidelines. Therefore, we aimed to develop an accurate and easy-to-use new risk model for 1-year thromboembolic events (TEs) in Chinese AF patients.Methods::From the prospective China Atrial Fibrillation Registry cohort study, we identified 6601 AF patients who were not treated with anticoagulation or ablation at baseline. We selected the most important variables by the extreme gradient boosting (XGBoost) algorithm and developed a simplified risk model for predicting 1-year TEs. The novel risk score was internally validated using bootstrapping with 1000 replicates and compared with the CHA 2DS 2-VA score (excluding female sex from the CHA 2DS 2-VASc score). Results::Up to the follow-up of 1 year, 163 TEs (ischemic stroke or systemic embolism) occurred. Using the XGBoost algorithm, we selected the three most important variables (congestive heart failure or left ventricular dysfunction, age, and prior stroke, abbreviated as CAS model) to predict 1-year TE risk. We trained a multivariate Cox regression model and assigned point scores proportional to model coefficients. The CAS scheme classified 30.8% (2033/6601) of the patients as low risk for TE (CAS score = 0), with a corresponding 1-year TE risk of 0.81% (95% confidence interval [CI]: 0.41%-1.19%). In our cohort, the C-statistic of CAS model was 0.69 (95% CI: 0.65-0.73), higher than that of CHA 2DS 2-VA score (0.66, 95% CI: 0.62-0.70, Z = 2.01, P = 0.045). The overall net reclassification improvement from CHA 2DS 2-VA categories (low = 0/high ≥1) to CAS categories (low = 0/high ≥1) was 12.2% (95% CI: 8.7%-15.7%). Conclusion::In Chinese AF patients, a novel and simple CAS risk model better predicted 1-year TEs than the widely-used CHA 2DS 2- VA risk score and identified a large proportion of patients with low risk of TEs, which could potentially improve anticoagulation decision-making. Trial Registration::www.chictr.org.cn (Unique identifier No. ChiCTR-OCH-13003729).

OBJECTIVETo explore the sensitivity and specificity of Golgi protein 73 (GP73) monoclonal antibody in the diagnosis of hepatocellular carcinoma (HCC).

METHODSSelf-prepared GP73 monoclonal antibody was used as the primary antibody for detecting the serum GP73 levels in healthy controls(n=31)and HCC patients (n=59). The baseline level of the healthy controls was determined by semiquantitative analysis. The results were compared with those from GP73 polyclonal antibody and alpha-fetoprotein (AFP).

RESULTSThe GP73 level of healthy controls was 1.2 (0.9-1.7) relative unit (RU), which was significantly lower than that of HCC patients [5.7 (2.5-7.8) RU] (P<0.001) with monoclonal antibody. Using polyclonal antibody, the GP73 level of HCC patients was also significantly higher than healthy controls [7.8 (3.0-12.4) RU vs. 1.1 (1.0-2.0) RU, P<0.001]. The sensitivity and specificity of GP73 monoclonal antibody in diagnosis of HCC were 84.7% and 93.5%; on the contrary, those of GP73 polyclonal antibody were 78.0% and 93.5%, respectively. The sensitivity and specificity of AFP (67.8% and 74.2%, respectively) in the HCC patients were markedly lower than those of GP73. Logistic regression analysis showed that the odds ratio (OR) of GP73 monoclonal antibody was 7.18 and that of GP73 polyclonal antibody was 1.51.

CONCLUSIONSOur self-prepared monoclonal antibody can effectively detect GP73 serum level in HCC patients, and has higher sensitivity and specificity than AFP. It may be superior to the currently used GP73 polyclonal antibody. The results lay the foundation for the further development of ELISA methods by using this monoclonal antibody.

Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal ; Carcinoma, Hepatocellular ; blood ; diagnosis ; Case-Control Studies ; Female ; Humans ; Liver Neoplasms ; blood ; diagnosis ; Male ; Membrane Proteins ; blood ; immunology ; Middle Aged ; Sensitivity and Specificity ; Young Adult