The degQ gene, amplified from Bacillus subtilis by PCR, was cloned to pUBS (sucrose induced secretion vector). After transformed into DB403, recombination named DB403(pUBSD) was formed. The results of the fermentation showed that degQ gene enhanced the expression of B. subtilis fibrin enzyme. The activity of the enzyme was increased to 2.2 times as the original one. In this article, the effects of different conditions, such as different kinds of sugar, different concentration of sucrose and different induced time were also be investigated and compared.

Objective To study the effect of Zhimaikang Granules (Granules for lipid abnormality) on atherosclerosis of hyperlipidemia patients of phlegm turbidity retention type.Methods Totally 120 hyperlipidemia patients were randomized into treatment group and control group, 60 cases in each. The treatment group was administered Zhimaikang Granules, each time 1 bag, twice a day. The control group was given Simvastatin Tablets, oral taking before sleeping. Both groups were treated for 45 days. Changes of superoxide dismutase (SOD), malondialdehyde (MDA), and nitric oxide (NO) were observed.Results After treatment, activity of NO and SOD were significantly higher than before in both groups (P0.05).Conclusion Zhimaikang Granules was proved to enhance the activity of antioxidase, promote anti-free radical reactions, inhibit lipid peroxidation and protect endothelial cells in atherosclerosis patients.

OBJECTIVETo evaluate the therapeutic effect and security of CT guided unilateral percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fracture (OVCF) in senile patients.

METHODSFrom April 2009 to June 2010, 26 patients undergoing CT guided unilateral percutaneous vertebroplasty were analyzed retrospectively. There were 9 males and 17 females,ranging in age from 60 to 85 years with an average of (67.50+/-6.76) years, ranging in course of disease from 2 to 30 days with an average of (8.92+/-4.36) d. The affected segments involved 35 vertebras. The major clinical manifestations of OVCF were lumbar-back pain (especially when turning over or stooping down) and unable to bear. The needle was punctured into vertebral of lesions through unilateral puncture under the CT guidance; and then 3-5 ml bone cement was injected into vertebral. Antibiotic was used 3 days to prevent postoperative infections. Postoperative complications were observed after operation, such as local leakage of bone cement, penetrating spinal cord and/or segmental spinal nerve injuries and pulmonary embolism. X-ray was used to measure the height of anterior, middle and exterior of vertebral before and after treatment. A visual analog scale (VAS) scoring was applied to evaluate pain score preoperative, 48 hours postoperative and the terminal follow-up.

RESULTSTwenty-six patients achieved success in punctuation without serious complications. Local leakage of bone cement occurred in 6 cases, but without clinical symptoms or signs. One patient suffered from acute intraoperative reactions to bone cement and relieved by 5 mg dexamethasone and oxygen. All patients were followed up for 6 to 12 months [averaged (8.4+/-1.6) months]. The postoperative vertebrae height was higher than preoperative,but there was no statistical difference between postoperative and preoperative (P>0.05). Preoperative VAS scores was 7.63+/-0.92, postoperative score was 3.00+/-1.09, the final follow-up score was 2.38+/-1.17; there was significant difference between preoperative and postoperative at 48 hours (P<0.05), but there was no statistical difference between final follow-up and postoperative at 48 hours (P>0.05).

CONCLUSIONUnilateral PVP under CT guided can increase the vertebral strength and stabilize vertebral body,and the procedure is a safe and effective method for OVCF in elderly patients.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Retrospective Studies ; Spinal Fractures ; surgery ; Tomography, X-Ray Computed ; methods ; Vertebroplasty ; methods

Objective: To explore a single center large cohort of patients with Takayasu’s arteritis for their clinical manifestation and long-term outcome in China. Methods: We retrospectively analyzed 566 patients with Takayasu’s arteritis admitted in our hospital from 2002-01 to 2013-11 for their clinical characteristics, laboratory ifndings, angiographic features, treatment and long-term outcomes. Results: The patient’s ratio for female to male gender was 1 to 3.8 and the average onset age was (28.9 ± 12.0) years. The most common non-speciifc symptom, initial symptom and complication were fever (52/566 patients, 9.2%), dizziness (214 patients, 37.8%) and hypertension (392 patients, 69.3%) respectively. The patients with pulmonary artery and coronary artery involvement were 83 (14.7%) and 66 (11.7%) respectively, and 131 (23.1%) patients had faster erythrocyte sedimentation rate. The major vascular damage was steno-occlusive lesion and the most common involvement was left sub-clavian artery, which was observed in 278 (49.1%) patients. The treatments were mainly included in medication, interventional therapy, autologous blood vessel transplantation, artiifcial blood vessel transplantation and aortic valve replacement. There were 32 patients died during the mean follow-up period of (5.0 ± 0.2) years. Hypertension, complication and the progressive stage of disease were the major factors affecting prognosis in relevant patients (regression coefifcients: 4.664, 1.959 and 1.870 respectively, allP<0.05). Conclusion: Hypertension was the leading reason for patients’ hospital visit. Takayasu’s arteritis was closely related to cardiovascular disease, the early diagnosis and treatment were really important in clinical practice.

OBJECTIVETo study the efficacy of acetabular antiprotrusio cage for the reconstruction of acetabular bone defect in revision hip arthroplasty.

METHODSTwelve cases of severe acetabular bone defect after total hip arthroplasty were revised with antiprotrusio cage and bone grafting from February 2003 to October 2008. Clinical and radiological data before and after revision surgery were collected and compared for assessment.

RESULTSThe classification of acetabular bone defect of this group of patients according to Paprosky classification was: 2 cases of type IIB, 6 cases of type IIIA and 4 cases of type IIIB. The average postoperative follow-up period was 37 months (9 - 71 months). Mean Harris score of all cases was 35.2 before revision surgery, 80.9 at the first time follow-up and 84.6 at latest follow-up. There were no prosthesis loosening and breakage. There was mild radiolucent line in Delee & Charnley III zone of the acetabulum in one patient 6 month after revision, but no deterioration was found during further follow-up. No further revision was needed in this group of patients during the follow-up.

CONCLUSIONSReconstruction of acetabular bone defect using antiprotrusio cage and bone grafting is a useful method to restore the bone defect and stability of the acetabulum. The outcome via short to middle term follow-up is encouraging.

Acetabulum ; surgery ; Aged ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prosthesis Failure ; Reoperation ; Treatment Outcome

OBJECTIVESTo describe the microbiology, antimicrobial susceptibility of patients proven prosthetic joint infection (PJI) after primary total knee arthroplasty (TKA)and to provide reference for the diagnosis and treatment of this complication.

METHODSThe medical data of the patients with infected knee arthroplasty, who were managed with revision surgery between January 1995 to December 2011 were reviewed. Twenty-nine cases were identified and majority of the patients were female (23/29). Diagnosis of PJI after primary TKA was between 1 week and 10 years (average 24.3 months). The microbiology and antimicrobial susceptibility were analyzed.

RESULTThe overall positive rate of cultures was 65.5% (19/29). The most common organisms identified were Coagulase-negative Staphylococcus (CNS) (7/19) and Staphylococcus Aureus (SA) (5/19). Rare pathogens of Mycobacterium (2/19) and fungi (1/19) were also identified. Vancomycin was the most effective antibiotics with overall sensitivity rates of 100%.Resistant and rare pathogens were all in type IV infection.

CONCLUSIONSGram-positive bacterias are the main pathogen, resistant and rare pathogens should be payed attention to. Antibiotic treatment for infected TKA should be based on the results of drug susceptibility. Vancomycin allows infected knee arthroplasties before the result.

Aged ; Anti-Bacterial Agents ; pharmacology ; Arthroplasty, Replacement, Knee ; Drug Resistance, Bacterial ; Female ; Gram-Positive Bacteria ; drug effects ; isolation & purification ; Humans ; Knee Prosthesis ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Prosthesis-Related Infections ; microbiology ; Vancomycin ; pharmacology

The objective of this study was to explore the incidence and therapeutic efficacy of cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The clinical data of 140 patients undergoing allo-HSCT in our department of hematology from 2010-01 to 2012-01 were retrospectively analyzed. The results showed that the incidence of CMV infection was 4.3% (48/140), the time for the first detection of positive CMV-DNA was at day 45 (33 to 68) after allo-HSCT, and the CMV quantitative range was 1.25×10(3) - 5.5×10(6). There were 2 cases of CMV-related interstitial pneumonia and 5 cases of hemorrhagic bladder inflammation. A total of 65 patients suffered from graft versus host disease (GVHD), in which 32 cases (49.2%) were accompanied with CMV infection, CMV-DNA negative in patients treated with ganciclovir, foscarnet sodium anti-CMV was at day 45 (33 to 68) with the effective rate of 100%. 12 patients with CMV infection were accompanied with transient neutropenia and thrombocytopenia. It is concluded that after allo-HSCT the CMV infection occurs frequently. The patients with GVHD have a higher incidence of CMV infection. Ganciclovir and foscarnet sodium are reliable to be used for treatment of CMV infection with fewer adverse reactions.
Adolescent ; Adult ; Child ; Child, Preschool ; Cytomegalovirus Infections ; drug therapy ; etiology ; Female ; Foscarnet ; therapeutic use ; Ganciclovir ; therapeutic use ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Transplantation, Homologous ; Young Adult

Adolescent ; Adult ; Aged ; Cardiomyopathy, Hypertrophic ; genetics ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Mutation ; Troponin T ; genetics

OBJECTIVE: The relationship between vitamin D and allergic rhinitis (AR) remains unclear. The present study investigated their association by examining serum 25-hydroxyvitamin D (25(OH)D) levels, blood eosinophils, and the expression of vitamin D receptors (VDR) on nasal mucosa in patients with AR. METHODS: A total of 32 patients with persistent AR and 25 controls were enrolled in this study. Serum 25(OH)D levels were detected by enzyme-linked immunosorbent assay, and eosinophils in the peripheral blood were examined by an automated hematology system, while VDR expression on inferior turbinate mucosa was assessed by immunohistochemistry. Furthermore, the correlation of serum 25(OH)D levels with blood eosinophils in persistent AR was analyzed. RESULTS: No significant difference in serum 25(OH)D levels was detected between the AR and control groups (p = 0.371). Interestingly, the serum 25(OH)D levels of the AR group were negatively correlated with blood eosinophil count and its proportion (p = 0.019 and p = 0.010, respectively) even when adjusting confounding factors including age, sex, body mass index, and the season of blood sampling. On the other hand, no significant difference in the expression levels of VDR on nasal mucosa was found between the AR group and the control group (p = 0.231). CONCLUSION: These results suggest that the serum 25(OH)D might be inversely associated with blood eosinophils in patients with persistent AR. However, the relationship between vitamin D and AR still requires further clarification
Body Mass Index ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Hand ; Hematology ; Humans ; Immunohistochemistry ; Mucous Membrane ; Nasal Mucosa ; Receptors, Calcitriol ; Rhinitis, Allergic ; Seasons ; Turbinates ; Vitamin D

Objective: To compare the clinical therapeutic effects of arterial first approach pancreaticoduodenectomy(AFA-PD) with standard approach pancreaticoduodenectomy(SPD) in the treatment of borderline resectable pancreatic cancer (BRPC). Methods: A retrospective analysis of the clinical data of 113 cases of pancreatic cancer patients from January 2014 to August 2015 at Department of Hepato-Biliary-Pancreatic Surgery, Changhai Hospital, the Second Military Medical University, including 43 cases in AFA-PD group and 70 cases in SPD group.Every patient had gone high-resolusion computed tomography before the surgery, when BRPC was definitely diagnosed by both experienced radiologist and pancreatic surgeon.There were 24 males and 19 females in the AFA-PD group, with average age of (61.6±10.2)years.And in the SPD group, there were 47 males and 23 females, with average age of (62.7±9.4)years. Results: The operation time was (210.7±31.5)minutes in AFA-PD group, (187.9±27.4)minutes in SPD group, and peroperative bleeding volume was (1 007.1±566.3)ml in AFA-PD group, (700.0±390.0)ml in the other group.Those two indicators of AFA-PD group, compared with SPD group, were relatively higher, the difference was statistically significant(all P<0.01). And with regard to postoperative diarrhea(9.3% vs.5.7%), postoperative 1, 3 days of white blood cells(postoperative 1 day: (13.3±1.1)×10⁹/L vs.(12.4±2.4)×10⁹/L; postoperative 3 days: (12.7±1.6)×10⁹/L vs.(11.7±2.5)×10⁹/L), postoperative 1, 3, 5 days of peritoneal drainage fluid volume(postoperative 1 day: (184±42)ml vs.(156±54)ml; postoperative 3 days: (155±48)ml vs.(133±35)ml; postoperative 5 days: (66±20)ml vs.(47±31)ml), the differences between the two groups were statistically significant (all P<0.05). One patient in the SPD group was treated with unplanned secondary surgery for postoperative intraperitoneal hemorrhage, and the patient was cured and discharged.There was no death in the two groups within 30 days after surgical operation and no patient with positive gastric margin, duodenal margin, or anterior margin.The resection rate of superiormesenteric artery(SMA) margin R0 in AFA-PD group was higher than that in SPD group (P=0.019). The two groups were followed up for 14 to 30 months.As for AFA-PD group, the average survival time, progression free survival time and median survival time was respectively (20.4±1.2)months, (21.5±1.4)months and 20 months.There were 3 cases(7.0%) with local recurrence and 8 cases(18.6%) with liver metastasis or distant metastasis.In the SPD group, the average survival time, progression free survival time and median survival time was (17.1±1.1)months, (16.4±1.3)months and 16 months, respectively.There were 13 cases(18.6%) with local recurrence and 25 cases(35.7%) with liver metastasis or distant metastasis.As a result, the AFA-PD group had longer survival time(P=0.001)and progression free survival time(P=0.002). However, the lower local recurrence and distant metastasis rate in AFA-PD group did not reach statistical standard (P>0.05). Conclusion The arterial first approach pancreaticoduodenectomy is safe and effective in the treatment of borderline resectable pancreatic cancer, which can improve the resection rate of SMA margin R0, and prolong patient survival time.