Objective To determine the correlation of plasma brain natriuretic peptide(BNP) with severe degree of dilated cardiomyopathy in children.Methods Thirty children with dilated cardiomyopathy and 30 healthy subjects were selected in this degree of study, plasma BNP concentration was measured and compared among groups by using t test.Correlation of BNP levels with left ventricular ejection fraction and heart function was investigated using linear regression analysis.Results Children with dilated cardiomyopathy had significantly higher mean BNP levels compared with healthy children [(429.4?270.2) ng/L vs (67.0?10.2) ng/L].Significantly positive correlations were found between BNP and heart classification(r=0.950 P

Objective To explore the association of chemokines and their receptors with immunologi- cal abnormality in newly diagnosed systemic lupus erythematosus(SLE) patients.Methods The serum con- centration of MIP-1?,MIP-1?,RANTES,IFN-?IL-4 were measured by enzyme-linked immunoabsorbent assay (ELISA) in 37 newly diagnosed.SLE patients and 20 normal controls.The expression rate of CCR1, CCR3,CCR5 on CD4~+T cells were detected by flow cytometry in 18 SLE patients and 10 normal controls.Re- suits Serum MIP-1?,MIP-1?concentrations were significantly higher in SLE patients than in normal control group (P＜0.01),the concentration of MIP-1?positively correlated with MIP-1?(r=0.609,P＜0.01);the per- centage of CD4~+CCR1~+ and CD4~+CCR5~+ cell were significantly lower in newly diagnosed SLE patients than in normal control group (both P＜0.01),the percentage of CD4~+CCRI~+ cells correlated negatively with the level of serum MIP-1?and IFN-?r=-0.525,P=-0.017;r=-0.442,P=0.045);the percentage of CD4~+CCR5~+ cell corre- lated negatively with the level of serum IFN-?(r=-0.645,P=0.001);the ratios of CD4~+CCR3~+/CD4~+CCR5~+ was significantly higher in newly diagnosed SLE patients than in the normal control group (P＜0.01).Conclusion Abnormal change and interaction of chemokines and their receptors with cytokines lead to immunologic dys- function and may participate in the initiation of SLE.

OBJECTIVETo explore the feasibility of the treatment of infected bone defect with one stage open cancellous bone grafting and summarize the key factors improving the curative effects.

METHODSTwelve cases of infected bone defects were reviewed, which involved 8 male and 4 female with an average age of 42 years (range, 22 to 68 years). The study consisted of 7 cases of calcaneal defects, 4 tibial defects and 1 femoral defect. The procedure included dressing change, resection of the devitalized soft tissue and bone tissue. After the debridement, the bone defect at one stage was treated with cancellous bone grafting and the wound was open. The wound was closed with skin transplantation when it was covered by granulation tissue completely.

RESULTSThe wound was covered with granulation tissue in the average 24.1 days after operation and was closed in the average 30.3 days. All the patients were followed up for 8 to 30 months with an average time of 18 months. All the bone defects were healing after bone grafting and there was no infection recurrence.

CONCLUSIONOne stage open cancellous bone graft is an easy and feasible treatment for infected bone defect. Resecting of the devitalized tissue before operation, radical debridement, enough bone graft in operation and careful dressing change after operation are all the key factors to acquire the satisfactory outcome.

Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Bone Diseases ; complications ; drug therapy ; surgery ; Bone Transplantation ; Bone and Bones ; Female ; Follow-Up Studies ; Fractures, Open ; complications ; drug therapy ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Wound Healing ; Wound Infection ; drug therapy ; surgery

Objective: To facilitate the functional analysis of chromosomal genes and their products, the recombineering technique to epitope tagging of chromosomal genes of Y. pestis was adapted. Methods: The epitope tag was generated by primer annealing and then fused with resistance gene by fusion PCR. The epitope-resistance cassette was inserted into pBluecript, resulted in the template plasmid, pBS-MH. The tagging cassette for rpoS was obtained by PCR amplification from pBS-MH with primers containing homology specific to the target gene. PCR products were transformed into recombination competent cells and recombinants were selected. PCR and DNA sequencing were used to confirm the correct tagging event. The expression of the tagged protein was detected with Western blot by using monoclonal antibody to the epitope. Results: The template plasmid containing fusion of epitope and resistance gene was successfully constructed. The sigma factor gene, rpoS, was tagged with a myc-his tag at the COOH terminus. Expression of the tagged rpoS was successfully detected indirectly by the antibody against His tag. Conclusion: The chromosomal gene tagging by recombineering technique represents a powerful tool in the functional study of bacterial genes and their products.

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

Objective To investigate the characteristics of blood routine in 129 patients with COVID-19, and analyze the correlation between blood routine parameter changes and clinical classification. Methods A total of 129 COVID-19 patients were recruited and their blood samples were collected at the beginning and the end of treatment.The neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), lymphocyte-to-monocyte ratio(LMR) and C-reactive protein(CRP) were determined and used to calculate Δ NLR, Δ PLR, Δ LMR.The differences in these parameters were compared between the non-severe group (93 cases) and the severe group (36 cases).In addition, the relationship between the changes in blood routine test result and the prognosis of patients was determined. Results The average age of 129 patients was 46.9±17.4 years old, and the ratio of male to female was 1.2 ∶ 1.Thirty-five (35) cases (27.1%) had leucopenia (< 4×10⁹/L) and 59 cases (45.7%) had lymphopenia (< 1.1×10⁹/L).There were statistically significant differences in age, treatment days, blood routine indexes between these two groups.In all the patients, the differences between before and after treatment were statistically significant in the following: leukocyte number, neutrophil cell percentage, lymphocyte number, lymphocyte percentage, monocyte number, monocyte percentage.The differences in RBC, HGB, CRP, and NLR between the two groups before and after treatment were also statistically significant (P < 0.05). Conclusion The older COVID-19 patients have lower number of lymphocytes, higher NLR and PLR, lower LMR and higher CRP.They have a higher risk of progressing to severe disease.After treatment, there is an increase in the number of granulocytes, especially the number of lymphocytes, while a decrease in CRP and NLR.The change of lymphocyte count, NLR and CRP levels can predict the risk of severe COVID-19 and evaluate the therapeutic effect.

Objective:To prepare the synaptophysin and chromogranin A monoclonal antibodies with clinical evalua -tion.Methods:The fuse gene (Syn and CgA) was designed and it was constructed on the expression vector pET-28a.Then ,the fusion protein was purified.After protein immunization , cell fusion and screening , the target antibodies were selected .Specificity study and correlation coefficient of Syn and CgA was evaluated by clinical sample comparison validation .Results:By screening,two antibodies 3D9 and 4A12,respectively,for Syn and CgA,were obtained.19 kinds of wax block organization were detected by 3D9,4A12 and control antibody(Leica).The statistical results were analyzed ,the results were in good agreement ,and the correlation coefficients were r=0.9892 and r =0.9939, respectively.Conclusion: This method is prepared to obtain the synaptophysin and chromogranin A antibodies successfully and both can be used for immunohistochemistry .This method can also provide some reference for the study of antibody .

Objective To investigate the effect of prophylactic administration of atropine before carotid angioplasty and stenting (CAS) on the happening of intraoperative and postoperative hypotension,bradycardia or cardiovascular complications. Methods Seventy-seven patients with carotid atherosclerosis, admitted to our hospital from November 2008 to May 2010 and performed CAS, were chosen in the study. Prophylactic administration of atropine before CAS was performed on 42 patients and the other 35 without atropine administration were adopted as control group. The clinical data of these patients were analyzed and the high risk factors of cardiovascular events (hypotension or bradycardia) at the perioperative period were observed. The incidence of cardiovascular complications at the perioperative period was also recorded and compared. Results No significant differences on the clinical data, high risk factors of cardiovascular events and morphological characteristics of the vessels were noted between the 2 groups (P＞0.05). The operation procedures were almost the same between the 2 groups. As compared with the control group, the atropine treatment group enjoyed significantly lower incidences of intraoperative or perioperative bradycardia and cardiovascular complications at the perioperative period (P＜0.05). Conclusion The prophylactic administration of atropine before CAS decreases the incidence ofbradycardia and cardiovascular complications during and after CAS.

Objective To evaluate the transfusion rates and identify perioperative factors associated with allogeneic blood transfusion ( AllTx) after primary total knee arthroplasty ( TKA) with routine use of low-molecu-lar-weight heparins .Methods We retrospectively studied the transfusion rate of 1165 consecutive patients who underwent primary TKA between January 2005 and December 2011 .Totally 34 independent variables were ana-lyzed in 617 primary unilateral TKAs without autologous blood predonation for requirement of AllTx .Multiple re-gression analysis model was used to identify risk factors associated with perioperative blood transfusion .Results Overall, 58.2% (678/1165 ) of patients required AllTx .The median number of units transfused was 2.7 U ( range:1 to 13 U).The AllTx rate was 40.0%(278/695) in unilateral TKA procedures and 85.1%(400/470) in one-stage bilateral TKA procedures .Univariate analysis demonstrated the risk of transfusion was independently predicted by the patients'age at surgery ( P<0.0001 ) , preoperative hematocrit ( P<0.0001 ) , preoperative he-moglobin concentration (P<0.0001), American Society of Anesthesiologists (ASA) score ≥3 (P=0.004), surgical time ( P=0.004 ) , and tourniquet time ( P=0.050 ) .Multivariate Logistic regression analysis confirmed significant relationship between allogeneic blood transfusion and age ( P <0.0001 ) , preoperative hemoglobin ( P<0.0001 ) , and surgical time ( P<0.0001 ) .Conclusions AllTx rate is high in TKA procedures , especial-ly in one-stage bilateral TKA procedures .Patient's age, preoperative hemoglobin level , and surgical time are helpful in identifying high-risk patients who require postoperative blood transfusion .