Objective To analyze the relationship between collateral status and clinical manifestations or prognosis in patients with acute cerebral infarction in the territory of internal carotid artery.Methods 181 patients with acute cerebral infarction in internal carotid arterial were selected.According to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) standard,the degree of carotid stenosis was divided into 5 grades.All patients were divided into 3 subgroups according to the status of collateral circulation formation evaluated with the Regional Lepomeningeal Score(rLMC).The correlations were observed between the degree of carotid stenosis and the compensation level of collateral circulation,and the compensation level of collateral circulation and cerebral infarct volume,and the National Institute of Health Stroke Scale(NIHSS) on admission and the Activity of Daily Living(ADL) score at 3 months after stroke onset.Results The degree of carotid stenosis positively correlated with the compensation level of collateral circulation (r=0.724,P<0.01).The compensation level of collateral circulation negatively correlated with infarct volume (r=-0.313,P<0.01) and NIHSS score on admission (r=-0.504,P<0.01),but positively correlated with ADL score at 3 months after stroke onset (r=0.370,P<0.01).Diabetes was risk factor for the formation of moderate (OR=1.361,95%CI=1.145-1.902,P=0.029) collateral circulation,and hyperlipemia was risk factor for the establishment of moderate (OR=1.050,95%CI=1.011-1.219,P<0.01) or poor (OR=1.048,95%CI=1.010-1.225,P<0.01) collateral circulation.Conclusion The compensation level of collateral circulation positively correlates with the severity of carotid stenosis.Diabetes and Hyperlipemia are risk factors for the formation of collateral circulation.The improvement in the status of collateral circulation can significantly reduce infarct volume and improve prognosis in patients with acute cerebral infarction in the territory of internal carotid artery.

Objective: To investigate the prevalence and risk factors of occupational musculoskeletal disorders among workers in heavy-duty automobile parts factories in Beijing Municipality, so as to provide insights into development of effective interventions for occupational musculoskeletal disorders. Methods: The workers in three heavy-duty automobile truck parts factories in Beijing Municipality were recruited using the convenient sampling method during the period from May 2019 to October 2020. Subjects' demographic characteristics, type of job and prevalence of occupational musculoskeletal disorders at various sites were collected using self-designed electronic questionnaires, and the factors affecting the development of occupational musculoskeletal disorders were identified using a multivariable logistic regression model. Results: A total of 264 workers were enrolled, including 260 males (98.48%) and 4 females (1.52%). The participants had a mean age of (31.71±6.13) years, and mean duration of (7.51±5.25) years at current position, and mechanical technician was the major type of work (129 workers, 48.86%). The prevalence of occupational musculoskeletal disorders was 70.08% among the participants, and high prevalence of occupational musculoskeletal disorders was found in the lower back/waist (41.28%), shoulder (40.15%), neck (39.02%) and upper back (33.33%). Multivariable logistic regression analysis identified females (OR=1.280, 95%CI: 1.021-1.602) and head-down posture at work (OR=2.644, 95%CI: 1.034-6.763) as risk factors for occupational musculoskeletal disorders at neck; females (OR=1.633, 95%CI: 1.624-2.117), sheet metal workers, mechanical technicians and painters (OR: 5.811-10.452, 95%CI: 1.205-54.027), working in an uncomfortable posture (OR：1.376-7.749, 95%CI: 1.034-27.270) and frequent working overtime (OR=2.081, 95%CI: 1.192-4.137) as risk factors for occupational musculoskeletal disorders at shoulder; and sheet metal workers, mechanical technicians and painters (OR: 8.760-11.948, 95%CI: 1.630-66.927), working in an uncomfortable posture (OR：4.067-12.185, 95%CI: 1.332-47.523) and frequent working overtime (OR=2.201, 95%CI: 1.142-4.244) as risk factors for occupational musculoskeletal disorders at waist/back. Conclusions The prevalence of occupational musculoskeletal disorders is high among workers in heavy-duty automobile parts factories, which mainly occur at shoulder, neck, waist and back. Type of work, working posture and working duration are main factors affecting the development of occupational musculoskeletal disorders.

The aim of fluid resuscitation is to restore tissue perfusion, ameliorate cellular injury, increase tissue perfusion and oxygenation, and improve end-organ functions. Many researches in the field of fluid resuscitation strategy have been made in the last decade, but vigorous debate on optimal method of resuscitation still exists. The hypotensive resuscitation strategy is particularly applicable in patients with uncontrollable hemorrhage, whereas, it is uncertain whether the theory could be used in burn shock management. Resuscitation using both colloid and crystalloid has a better outcome in treating extensive burns and septic shock. Caution should be exercised when using higher concentrations of artificial colloid and lactated Ringer's solution, of which some adverse effects have been observed. Along with the increasing use of novel hemodynamics monitoring in intensive care, parameters including stroke volume variation (SVV), intrathoracic blood volume index (ITBVI), and cardiac index (CI) have been examined as indexes of resuscitation endpoint. However, further studies should be made when applying SVV, ITBVI, and CI in guiding fluid resuscitation in burns.
Burns ; complications ; Fluid Therapy ; methods ; Humans ; Shock ; etiology ; therapy

Fungal infection is one of the serious complications of severely burned patients with high mortality. Application of antifungal agents timely and rationally is very important to control the infection. Antifungal agents including polyenes,triazoles, and echinocandins have been used widely in burned patients and are proved to be effective. Since diagnosis of fungal infection remains difficult, prophylactic and empirical therapies appear to be particularly necessary. In order to improve the efficacy and safety of antifungal agents, the factors of fungal strains, infection sites, hepatic and renal functions, and age, etc. should be considered in selecting antifungal agents.
Antifungal Agents ; therapeutic use ; Burns ; complications ; Humans ; Mycoses ; complications ; drug therapy

OBJECTIVETo explore the effects of rat maternal exposure to fenvalerate during lactation on behaviors development in rat pubertal female offspring.

METHODSTwelve ICR maternal mice were randomly divided into 7.5 and 30.0 mg/kg fenvalerate exposure groups and control group (four dams each group, ten pups each dam, half male half female, twenty female pups each group). The exposure groups were orally exposed to fenvalerate at the doses of 7.5 and 30 mg/kg a day from postnatal day 1 (PND1) to PND21. The control group was exposed to corn oil. The effects of maternal fenvalerate exposure during lactation on motor and species-typical behaviors in female offspring were observed on the PND 35.

RESULTSThe peripheral time and standing frequency of 30.0 mg/kg exposure group were (263.4 ± 54.8) s and (47.3 ± 16.2) times, which were significantly higher than those [(203.4 ± 53.0) s and (30.9 ± 17.3) times] of control group (P < 0.05). The scores in 7.5 mg/kg and 30.0 mg/kg exposure groups were 56.50 ± 50.79 and 54.73 ± 53.91, respectively, which were significantly lower than that (114.53 ± 53.87) in control group (P < 0.05). However, no significant differences in beam walking scores, food hoarding quantity, food digging quantity, and nest construction scores between two exposure groups were found (P > 0.05).

CONCLUSIONThe rat maternal exposure to fenvalerate during lactation could decrease the ability of exploration and motor condition and increase the anxiety but not affect life habit in rat pubertal female offspring.

Animals ; Behavior, Animal ; Female ; Male ; Maternal Exposure ; Mice ; Mice, Inbred ICR ; Nitriles ; toxicity ; Pregnancy ; Prenatal Exposure Delayed Effects ; Pyrethrins ; toxicity

Acute Kidney Injury ; etiology ; Adult ; Burns, Chemical ; complications ; surgery ; Chromates ; toxicity ; Humans ; Male ; Young Adult

The contents of adenosine, gastrodin, 4-hydroxybenzyl alcohol, 4-hydroxybenzaldehyde, parishin and sulfur dioxide residue were compared in differently-processed Gastrodiae Rhizoma to provide the basis for a reasonable processing method of Gastrodiae Rhizoma. The analysis was performed on a Merck Purospher STAR column (4.6 mm x 250 mm, 5 μm) with a mobile phase consisting of methanol and water (containing 0.1% formic acid) under gradient elution at a flow rate of 1.0 mL x min(-1). The eluates were detected at 270 nm, and the column temperature was 35°C. The content of adenosin, gastrodin, 4-hydroxybenzyl alcohol, 4-hydroxy-benzaldehyde and parishin in processing of boiling or sulfur-fumigated were lower than that of in processing of steaming. Furthermore, the sulfur dioxide residue of sulphur-fumigated groups exceed 400 mg x kg(-1). This stable and reliable method will contribute to the quality control of different processed Gastrodiae Rhizoma.
Drug Contamination ; Drugs, Chinese Herbal ; chemistry ; Gastrodia ; chemistry ; Sulfur Dioxide ; analysis ; Technology, Pharmaceutical ; methods

Objective: To explore the effect of herb-partitioned moxibustion (HPM) on tight junctions (TJs) of intestinal epithelial cells in Crohn disease (CD) mediated by tumor necrosis factor-α (TNF-α)-nuclear factor kappa B (NF-κB)-myosin-light- chain kinase (MLCK) pathway. Methods: Forty-eight male Sprague-Dawley rats were randomly divided into a normal control (NC) group, a model control (MC) group, an HPM group and a mesalazine (MESA) group, with 12 rats in each group. Trinitrobenzene sulfonic acid (TNBS) was administered to establish CD models. When the model was confirmed a success, the HPM group rats were treated with HPM at Tianshu (ST 25) and Qihai (CV 6), while the MESA group rats were given MESA solution by lavage. When the intervention finished, the colonic epithelial tissues were separated, purified and cultured in each group to establish the intestinal epithelial barrier model in vitro, and TNF-α was added (100 ng/mL) in the culture medium and maintained for 24 h to establish an increased epithelial permeability model. Transepithelial electrical resistance (TEER) was used to examine the permeability of the barrier; Western blot was used to observe the expressions of the proteins related to TJs of intestinal epithelial cells mediated by TNF-α-NF-κB-MLCK pathway; immunofluorescence staining was used to observe the expressions and distributions of tight junction proteins in the intestinal epithelium. Results: After TNF-α induction, compared with the MC+TNF-α group, the TEER value increased significantly in the HPM+TNF-α and MESA+TNF-α groups (both P<0.001); the expressions of nuclear factor kappa B (NF-κB) p65, MLCK, myosin light chain (MLC), tumor necrosis factor receptor-associated factor 6 (TRAF6) and receptor interaction protein-1 (RIP1) decreased significantly (P<0.01 or P<0.05), and the expression of zinc finger protein A20 (A20) increased significantly (P<0.01); the expressions of occludin, claudin-1, zonula occludens protein 1 (ZO-1) and F-actin also increased significantly (all P<0.01). Compared with the MESA+TNF-α group, the expressions of MLC, occludin, claudin-1, ZO-1 and F-actin increased significantly in the HPM+TNF-α group (P<0.01 or P<0.05). Conclusion: HPM can protect or repair the damage of intestinal epithelial barrier in CD rats, which may be achieved through modulating the abnormal TJs in intestinal epithelium mediated by TNF-α-NF-κB-MLCK pathway.

OBJECTIVETo observe the antimicrobial activity of topical agents commonly used for burns on Acinetobacter baumannii (AB) in both free and biofilm states, and their synergistic effect with ambroxol on AB within biofilm.

METHODSEleven AB strains were isolated from wound excretion, respiratory tract, and blood of patients hospitalized in our hospital from August 2005 to April 2007. (1) The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of mafenide acetate and chlorhexidine acetate to free AB (including drug-resistant, drug-sensitive, and standard strains) were determined by dilution method. (2) AB was cultured with LB or TSB medium for 12, 24, and 48 h to form biofilm, and it was treated with above-mentioned two topical agents in MBC (mafenide group and chlorhexidine group) for 30 min. Biofilm not treated by topical agent was used as control group. The biofilm thickness was determined with confocal laser scanning microscope. The proportion of living bacteria in biofilm was calculated. AB biofilm in each topical agent group was mixed and inoculated into LB culture dish to observe the growth of bacteria. (3) AB was cultured with LB medium for 48 h to form biofilm, which was respectively treated by above-mentioned two topical agents in MBC (mafenide group and chlorhexidine group) and combination of each topical agent with 3.75 mg/mL ambroxol solution (ambroxol + mafenide group and ambroxol + chlorhexidine group) for 30 min. Biofilm not treated by topical agents was used as control group. Growth of bacteria in biofilm was detected with MTT method (denoted as absorbance value). Data were processed with one-way analysis of variance and LSD-t test.

RESULTS(1) MIC of mafenide acetate and chlorhexidine acetate for free AB was respectively 25.00 mg/mL and 0.03 mg/mL. MBC of both agents for free AB was the same as their MIC. (2) Among three groups, the thickness of biofilm of sensitive AB was thicker than that of drug-resistant bacteria at most of the time points. Compared with those in control group, biofilm thickness and proportion of living bacteria in biofilm were slightly decreased in mafenide and chlorhexidine groups. The growth of bacteria was abundant in each group. (3) Absorbance value of drug-resistant bacteria in control, mafenide, and chlorhexidine groups was respectively 0.776 ± 0.071, 0.625 ± 0.063, and 0.420 ± 0.068. Absorbance value of drug-resistant bacteria in ambroxol + mafenide group (0.174 ± 0.089) was significantly lower than that of control group (t = 11.823, P = 0.000) and mafenide group (t = 9.248, P < 0.01). Absorbance value of ambroxol + chlorhexidine group (0.178 ± 0.044) was significantly lower than that of control group (t = 16.009, P = 0.000) and chlorhexidine group (t = 6.681, P < 0.01).

CONCLUSIONSDrug-resistant AB forms biofilm readily, which prevents topical agents from killing the bacteria inside. Combined use of ambroxol with topical agents gives synergistic effect on killing AB in biofilm in the wound.

Acinetobacter baumannii ; drug effects ; isolation & purification ; Anti-Bacterial Agents ; pharmacology ; Biofilms ; drug effects ; Burns ; microbiology ; Chlorhexidine ; pharmacology ; Drug Resistance, Bacterial ; Humans ; Mafenide ; pharmacology ; Microbial Sensitivity Tests

OBJECTIVETo study the changes in expression of quorum sensing gene aba I in Acinetobacter baumannii (AB) strains isolated from burn patients during biofilm formation process, and its influences on the extracellular matrix of biofilm and drug resistance of AB.

METHODSSix drug-resistant and five drug-sensitive AB strains isolated from wound excretion, blood and venous catheter were collected from burn patients hospitalized in Ruijin hospital of Shanghai Jiao Tong University School of Medicine from January to October 2011. The AB standard strain ATCC 19606 was used as control. (1) Clinical strains and standard strain were normally cultured 10, 24, and 48 h respectively in vitro. The bacteria samples were stained with propidium iodide to measure biofilm thickness with confocal laser scanning microscope. (2) Clinical strains and standard strain were cultured in tubes 10, 24, and 48 h respectively in vitro under shaking condition. The bacteria floating in the medium were regarded as free bacteria, while those adhered to the tube wall as the bacteria within biofilm (biofilm bacteria). Relative expression value of genes aba I and pgaB was detected by real-time fluorescent quantitative PCR with the expression value of the standard strain set at 1. Data were processed with analysis of variance.

RESULTS(1) At post culture hour (PCH) 10, 24, 48, biofilm thickness of clinical strains was thicker than that of standard strain; biofilm thickness of drug-resistant strains [(28.8 ± 0.6), (31.7 ± 1.1), and (38.1 ± 3.1) µm] was respectively thicker than that of drug-sensitive strains [(17.1 ± 0.4), (20.1 ± 1.6), and (25.8 ± 1.7) µm, with F value respectively 1274.38, 206.60, and 61.73, P values all below 0.05]. (2) Biofilm bacteria: at PCH 10, 24, 48, expression values of aba I in drug-resistant strains (6.6 ± 1.7, 25.7 ± 3.5, 9.8 ± 3.6) were much higher than those of drug-sensitive strains (2.7 ± 1.0, 15.0 ± 3.5, 4.7 ± 3.2, with F value respectively 21.82, 25.24, and 6.22, P values all below 0.05); expression values of pgaB in drug-resistant strains (37.4 ± 1.1, 44.5 ± 3.6, 33.1 ± 11.5) were obviously higher than those of drug-sensitive strains (14.6 ± 0.8, 20.0 ± 6.9, 18.7 ± 6.8, with F value respectively 1488.44, 57.26, and 6.01, P values all below 0.05). (3) Free bacteria: at PCH 10, 24, 48, there was no significant statistical difference between drug-resistant strains and drug-sensitive strains in expression value of aba I (with F value respectively 0.24, 2.33, and 0.11, P values all above 0.05); expression values of pgaB in drug-resistant strains (13.8 ± 3.8, 12.5 ± 2.9, 23.7 ± 2.1) were obviously higher than those of drug-sensitive strains (7.0 ± 5.9, 5.0 ± 1.3, 15.6 ± 6.7, with F value respectively 5.44, 28.42, and 7.76, P values all below 0.05). (4) Comparison between biofilm bacteria and free bacteria in resistant strains: expression value of aba I in biofilm bacteria at each time point was respectively higher than that of free bacteria (with F value respectively 43.69, 286.61, and 9.98, P values all below 0.05); expression values of pgaB in biofilm bacteria at PCH 10, 24 were higher than those in free bacteria (with F value respectively 214.26 and 283.20, P values below 0.05). (5) Comparison between biofilm bacteria and free bacteria in sensitive strains: expression value of aba I in BF bacteria at PCH 24 was higher than that of free bacteria (F = 70.28, P < 0.05); expression values of pgaB in biofilm bacteria at PCH 10, 24 were higher than those of free bacteria (with F value respectively 8.03 and 22.62, P values below 0.05).

CONCLUSIONSDuring biofilm formation process, the increasing expression of quorum sensing gene aba I in drug-resistant AB strains isolated from burn patients may up-regulate the expression of gene pgaB, which leads to high production of extracellular matrix and biofilm formation, and enhances drug resistance of AB.

Acinetobacter Infections ; Acinetobacter baumannii ; genetics ; isolation & purification ; Biofilms ; Burns ; microbiology ; Drug Resistance, Bacterial ; Genes, Bacterial ; Humans