Objective To investigate the clinical benefits and the impacts on distribution and antibiotic resistance of pathogenic bacterium associated with fluoroquinolone prophylaxis during neutropenia in patients with acute leukemia.MethodsA total of 62 infection episodes occurred in patients with acute leukemia were retrospectively analyzed from October 2013 to October 2015.The patients admitted in ward A (group A,n=31) received Cephalosporin drugs as contrast, and received quinolones in ward B (group B,n=31).ResultsTo observe the implementation of quinolones in treatment of patients, the bacteria decreased significantly, the Klebsiella pneumoniae was the most common, but compared with the control group, there are still differences (P<0.05, and the observation group of patients with oral ulcer infection rate was 9.68%, upper respiratory tract infection rate was 6.45%, the infection rate of lung 6.45%, the digestive tract infection rate was 6.45%, the infection rate was 3.23%, perianal skin infection rate was 3.23%, the infection rate was 3.23%, which is significantly lower than the control group (P<0.05, and the observation group of patients with severe neutropenia, duration of neutropenia lack degree is significantly better than the control group (P<0.05).ConclusionThe fluoroquinolone prophylaxis induces diminishing proportion of normal flora and increasing frequency of Escherichia coli in severely neutropenic patients with acute leukemia,may not influence the distribution of other bacteria.The susceptility of main pathogens may not be affected by antibiotic prophylaxis.The fluoroquinolone don't decrease the incidence of septicemia and infection in gastrointestinal tract.Our data suggest that more prudent use of antibiotic prophylaxis may be reasonable even in patients at high-risk for developing infection.

BACKGROUND: Previous studies has explored the effects of nerve growth factor (NGF) on cultured rabbit Schwann cells as well as preparation of acellular nerve allografts, in addition, the neural complex was prepared in vitro.OBJECTIVE: To investigate the effect of acellular nerve allografts on the functional recovery and reconstruction of the nerve-muscle structure of the sciatic nerve defect in rabbits.DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed at the Center Laboratory of Third Hospital of Hebei Medical University from March 2006 to June 2007.MATERIALS: Totally 37 healthy, adult, New Zealand, white rabbits were selected. One rabbit was prepared for extracted nerve bridge, and the others were randomly divided into the experimental and control groups, with 18 animals in each group.METHODS: The double sides of sciatic nerve were removed, divested surrounding tissues, and cut into 3 cm segments, then placed in TdtonX-100 solution for 12 hours, washing with distilled water. The procedure was repeated, and TritonX-100 totally used for 96 hours. Then the extracted nerve bridge was conserved in Hank's solution at temperature of 4 ℃. The concentration of 2~(nd) passage Schwann cell was regulated to 1 ×10~(11)/L, and injected to extracted nerve bridge, followed by DMEM culture, to obtain neural complex. Rabbits in the experimental group were prepared a 20 m defects above knee joints, and the recellularized neural complex were transplanted into the defective sciatic nerve. Rabbits in the control group were prepared by transplanting extracted nerve bridge without Schwann cells.MAIN OUTCOME MEASURES: The elcosis and healing of feet were observed at weeks 4, 8, and 16 after operation, meantime,the recovery of axon of distal end peroneal nerves, myelin sheath, tibialis anterior, as well as motor end plate were detected by electromyogram, light microscope and transmission electron microscope.RESULTS: At weeks 4, 8 and 16 after operation, the rejection was not found in the operating field. The experimental group was better than the control group in healing of ulcers, the number of nerve fibres, the ultramicrostructure of medullary sheaths, the regeneration nerve, the structure of the motor end plate and muscle. At 4 weeks after operation, no nerve conduction was found in 2 groups, but at weeks 8 and 16 after operation, the experimental group was better than the control group in wet weight of tibialis anterior muscle and nerve conduction velocity (P < 0.05).CONCLUSION: The recellularized neural complex can significantly promote the reconstruction of the nerve-muscle structure and functional recovery of injured sciatic nerve.

Objective To study the initial application of 3.0T high field intensity intraoperative magnetic resonance(iMR)for cranial tumors.Methods Forty-three patients with cranial tumors including 23 glioma cases,12 pituitary tumor cases,3 brain stem cavernous hemangioma cases,2 meningioma cases,2metastatic tumor cases,1 neurilemmoma case,received operation examined with GE Signa HDX 3.0T iMR system.The operation process and influence of iMR were reviewed.Results In 43 patients,average iMR examination was 1.3(1-3)times.In 16 patients the first iMR examination revealed tumor remnants,and in 13 of them continued surgical interventions and complete resection.The rate of complete resection was increased from 63％(27/43)to 93％(40/43).No complications related to iMR occurred.Conclusion 3.0T high field intensity iMR can provide accurate positioning and real-time navigation for the surgery,increase the rate of complete resection,improve the accuracy and safety of cranial tumor resection,and decrease complications.

Objective To investigate the prognosis of children with acute kidney injury(AKI)treated with peritoneal dialysis(PD)following cardiopulmonary bypass.Methods A retrospective study of 46 children aged under 14 years old with AKI treated by using PD following cardiopulmonary bypass from Jan.2006 through Dec.2010.All of them were divided into three groups,namely group A(AKI Ⅰ),group B(AKI Ⅱ)and group C(AKI Ⅲ)according to the stratification of RIFLE criteria.The timing of PD was depended on the phase of AKI.The ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD were compared among three groups.Their APACHE Ⅱ score,sequential organ failure assessment(SOFA)score,serum interleukin-6(IL-6),oxygenate index,serum creatinine,and mean arterial pressure were also compared between before PD and after PD for 48 hours.One-way ANOVA was used for statistical analysis between different phases of AKI.Data got before PD and after PD for 48 hours were analyzed with paired Student' s t-test.Results The APACHE Ⅱ score,SOFA score and serum IL-6 before PD were higher in patients with phase Ⅲ of AKI than those in patients with phases Ⅰ and Ⅱ of AKI(P ＜ 0.01).There were no significant differences in APACHE Ⅱ score and SOFA score between patients with phases Ⅰ of AKI and patients with phase Ⅱ of AKI before PD(P ＞0.05),but serum IL-6 before PD,ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD in patients with phase Ⅱ of AKI were higher or longer than those in patients with phase Ⅰ of AKI(P ＜ 0.01).After PD for 48 hours,APACHE Ⅱ score,SOFA score,serum IL-6,oxygenate index,serum creatinine and mean arterial pressure improved insignificantly in patients with phase Ⅲ of AKI(P ＞0.05),but those were improved significantly in patients with phases Ⅰand Ⅱ of AKI(P ＜ 0.05),while serum IL-6 in patients with phase Ⅱ of AKI was still higher than that in patients with phase Ⅰ of AKI(P ＜ 0.01).Conclusions Therapeutic effect of PD on children with AKI following CPB is better if PD is started in the phases Ⅰ and Ⅱ of AKI,especially in the phase Ⅰ of AKI.The RIFLE criteria and IL-6 are useful guidance to the assessment of patients' illness.

Background and purpose:Pathological lymph node metastasis (LNM) is not rare in clinical lymph node negative (cN0) papillary thyroid carcinoma (PTC). The aim of this study was to investigate the risk factors of LNM, especially of high volume LNM (more than 5 metastatic lymph nodes) and contralateral central compartment LNM, in cN0 PTC.Methods:Medical records of 350 PTC patients (265 female, 85 male, 212 patients with solitary lesion in unilateral lobe) were reviewed. All operations of these patients were performed by one surgical team. The clinical pathological data were collected, and univariate and multivariate analysis was performed.Results:LNM was conifrmed in 138 patients (39.4%) and 20 patients had high volume LNM. In 169 patients with solitary lesion in unilateral lobe with total thyroidectomy and bilateral central neck dissection, 24 patients had contralateral metastasis (14.2%). In univariate analysis, tumor size (58.5% in >1 cmvs 33.6% in≤1 cm) and tumor with calcification in preoperational ultrasonography (43.7% withvs 31.7% without) showed signiifcant difference in prevelance of LNM. In multivariate analysis, tumor size >1 cm (OR=2.792) was the independent risk factor of LNM. Gender (3.8% in male vs 11.8% in female), age (10.7% <40 yearsvs 3.4%≥40 years ), tumor size(13.4% in >1 cmvs 3.4% in≤1 cm) and tumor with low echo in preoperational ultrasonography (13.9% withvs 4.8% without) showed signiifcant difference in univariate analysis of high volume LNM. Male (OR=5.152), tumor size >1 cm (OR=5.712) and age <40 years (OR=3.959) were conifrmed as independent risk factors of high volume LNM. Male (OR=3.105) and tumor size >1 cm (OR=3.863) were also demonstrated as independent risk factors of contralateral LNM in patients with solitary lesion in unilateral lobe, the prevalence of LNM were 26.5% in male and 26.1% in tumor size >1 cm, respectively.Conclusion:LNM was not “rare” in cN0 PTC patients. Prophylactic central neck dissection should be performed in cN0 patients with tumor size >1 cm. For cN0 microcarcinoma, more active surgical treatment may be considered in male and young patients.

Objective:With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques,it is necessary to re-examine the therapeutic strategy for the treat-ment of petroclival meningiomas.To sum up the operative experience and methods in microsurgical resec-tion of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach.To explore the minimally invasive operation approach of petroclival meningiomas,to raise the removal degree and to improve the postoperative result using this approach.Methods:The clinical data of the consecutive 21 patients with the petroclival meningiomas were reviewed retrospectively.The meth-od,degree of tumor resection,techniques of the combining keyhole approach,Karnofsky performance score (KPS)before and after operation were also analyzed.The neuronavigation guided operation was performed in 9 cases,and 12 cases were operated in the neuroelectrophysiological monitoring.Results:Total excision of the tumor resection (Simpson,Ⅰ -Ⅱlevels)was conducted in 18 cases (85.7%,18 /21),and 3 patients underwent close resection (Simpson Ⅲ level,14.3%,3 /21).Postoperative three-dimensional CT showed good lock bone flap restoration;Postoperative pathology confirmed meningioma. Postoperative cranial nerve dysfunction or new original nerve dysfunction were aggravated in 5 cases (23.8%),including transient trochlear nerve (3 cases),abducent nerve (1 case),and the motor branch of trigeminal nerve paralysis (1 case).Abducent nerve paralysis (1 case)appeared,with hearing impairment.After the 3-month follow-up,11 cases had the same KPS aspreoperation,7 cases improved,and 3 cases not improved.The KPS score was 77.14 ±23.12 on average,and there was no statistically significant difference compared with that before operation (P >0.05 ).The postoperative follow-up for half a year showed fluent speaking and writing in 19 cases (KPS 70 or higher),and general recovery in 2 cases (KPS <70).The postoperative follow-up for 3 -29 months showed no tumor recur-rence or progress.Conclusion:The combining trans-subtemporal and suboccipital retrosigmoid keyhole approach is simple,safe,and minimally invasive,and an ideal operation approach of petroclival menin-gioma.To master the operation skills and the intraoperative matters needing attention in the operation,is favorable to improve the resection rate and curative effect.

OBJECTIVETo intervene the health behavior of lead exposed workers by setting down and implementing a series of measures and evaluating the effects of these measures so that the occupational lead poisoning would be decreased.

METHODS105 lead exposed workers in a factory were chosen as subjects. Blood lead concentration and rate of cognition on relevant health knowledge were examined before and after intervened measures.

RESULTSThe cognition rate raised from 56.6% to 97.3% after training. Lead concentration in blood decreased by 17.7% (t = 4.10, P = 0.000) and delta-ALA in urine decreased by 23.9% (t = 4.248, P = 0.000) 12 months after intervention. The prevalence of occupational lead absorption and poisoning also decreased. The number of workers with blood lead content > 2.41 mumol/L was decreased from 6 to 3, and > 1.93 mumol/L from 14 to 10.

CONCLUSIONTo develope occupational health promotion, enhance health education and improve health behavior are the effective way to prevent from occupational lead poisoning.

Health Behavior ; Health Education ; Health Promotion ; Humans ; Lead ; blood ; Lead Poisoning ; prevention & control ; Occupational Diseases ; prevention & control ; Occupational Exposure

Objective: To explore the efficacy of valvuloplasty on mitral valve regurgitation (MR) in infants and small children, in order to provide evidence for clinical treatment. Methods: Retrospective analysis was conducted in patients aged less than 3 years old who have undergone mitral repair surgeries at Department of Cardiovascular Surgery, General Hospital of Western Theater Command from January 2015 to December 2017.Cardiopulmonary bypass (CPB) surgery was performed under general anesthesia.The corresponding repair operations were selected for various MR types.All the children were examined by cardiac ultrasound before discharge.Patients were followed up after surgery and mitral regurgitation was recorded. Results: A total of 69 patients were enrolled, including 30 boys and 39 girls, with an average age of (19.3±11.6) months and an average weight of (9.6±2.1) kg.There were 32 cases of Carpentier type Ⅰ, 30 cases of type Ⅱ and 7 cases of type Ⅲ.Twenty-nine patients were diagnosed as simple MR, while the other 40 patients were combined with other cardiac malformations.One patient died at postoperative day 7.One patient still had severe MR after surgery, and then second operation was performed on the 10^th day after first surgery.Sixty-five patients were followed up from 1 month to 3 years[(15.9±10.9) months]. During the follow-up period, no patient died or had reoperation.Aggravated MR was observed in 4 patients. Conclusions Mitral valvuloplasty is a safe and effective surgical method for treating infants and younger children with MR.The key to the success of surgery is to choose the appropriate individualized repair operation.At the same time, the growth potential of mitral valve should be fully considered to avoid restrained development.

This research was carried out to investigate the effect of basic fibrous growth factor (bFGF) controlled release hydrogel nanoparticles on the proliferation and differentiation of mesenchymal stem cells. The dex-GMA-bFGF-NPs were prepared by an improved emulsion polymerization method; their morphology, size and encapsulated ratio were assessed by routine procedure. Dynamic dialysis method was used to determine the release characteristics of dex-GMA-bFGF-NPs in vitro. The secondary culture MSCs were divided into four groups according the different ingredients being added into the DMEM culture medium: free bFGF group (A), blank dex-GMA nanoparticles group (B), dex-GMA-bFGF nanoparticles group (C), nothing group (D). The proliferation of cultured MSCs was measured by using cell counting method, MTT method and flow cytometry. ALP kit was used to evaluate the ALP activity of the MSCs to show the differentiation of the cells by adding the dex-GMA-bFGF-NPs to the DMEM culture medium (C group) or bFGF only (A group). B group and D group were taken as the controls. The results were analyzed by statistical analysis software (SPSS11.0). All results showed that the shape of dex-GMA-bFGF-NPs was spherical. The encapsulated ratio was 88% and more than 85% of the encapsulated bFGF could be released during 14 days. The in vitro cellular study showed the control release of bFGF from nanoparticles could promote the proliferation of MSCs. After 12 days, the cell number in groups A, B and C was (21.97 +/- 0.25) x 10(4) cells/ml, (12.43 +/- 0.13) x 10(4) cells/ml, (27.45 +/- 0.78) x 10(4) cells/ml and (12.03 +/- 0.43) x 10(4) cells/ml, with the difference being statistically significant among them (P < 0.05). The flow cytometry revealed that the G2/M+S percentage in group C was the highest at 4-8 days after plate culture(P < 0.05). During the first 3 days, the proliferation and differentiation of BMSCs between group A and group B were of no significance (P > 0.05), but were much faster than those of group C and D. After 7 days, dex-GMA-bFGF-NPs could enhance BMSCs proliferation and differentiation continually, but bFGF had no enhancement any more, the difference between group A and group B became more significant (P < 0.05). So we made the conclusions the bFGF loading dex-GMA hydrogel nanoparticles can release bFGF more than 21 days and can promote the proliferation and differentiation of the BMSCs through a long period of controlled release of bFGF. Dex-GMA-bFGF-NPs may be an ideal controlled release carrier for bioactive growth factors.
Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Culture Media ; Female ; Fibroblast Growth Factor 2 ; pharmacology ; Male ; Mesenchymal Stromal Cells ; cytology ; Nanoparticles ; Rats ; Rats, Sprague-Dawley

Objective To summary the microsurgical strategies and techniques of petroclival meningiomas by trans-subtemporal combined with suboccipital retrosigrnoid keyhole approaches to raise the removal rate and improve the prognosis.Methods The clinical data of consecutive 26 patients with petroclival meningiomas,admitted to our hospital from January 2011 to December 2015 and accepted microsurgical treatment,were reviewed retrospectively;7 of them were guided by neuronavigation,8 were performed under neuroelectrophysiological monitoring,and 11 were guided by neuronavigation combined intraoperative MRI or neuroelectrophysiological monitoring.The operative methods and techniques,tumor resection rate and Kamofsky performance scale (KPS) scores before and after operation were analyzed.Results Of all patients who underwent surgical treatment by trans-subtemporal combined with suboccipital retrosigmoid keyhole approaches,gross total tumor resection (Simpson Ⅰ-Ⅱ) was achieved in 23 patients (88.5％),subtotal (Simpson Ⅲ-Ⅳ) in 3 patients (1 1.5％).Six patients (23.1％) had cranial nerve deficit postoperatively.No mortality which related with operation was noted.Patients were followed up for 3-35 months,23 patients had KPS scores ≥70,and 3 patients had KPS ＜70;no tumor recurrence or progression was noted.Conclusion The trans-subtemporal combined with suboccipital retrosigmoid keyhole approaches are safe,effective and minimally invasive for resection of petroclival meningiomas;mastering the operation strategies and intraoperative skills is conducive to improve the efficacy of surgery.