Objective To investigate the genetic mutation of the norA gene and its promotor from the wild-type drug-resistance Staphylococeus aureus(S.aureus)strains. Methods A total of 10 antibiotic-resistant S.aureus strains were isolated and screened from the burn wound for the sequencing and analysis of the nora gene and its promoter. Results There isolated 87 S.aureus strains from the burn wound flora,which were completely sensitive to vacomycin,highly sensitive to Quinupristin and Nitrofurantoin,but highly resistant to the other antibiotics,even up to91.7% of MRSA.There found the same point mutation(G→A) located at 1 349 sites of the norA gene coding region in all the S.aureus strains,saying that the amino acid was changed from Gly(glycin)to Asp(agpartic acid) in 291 sites.The resetpine reverse test showed that the MICs value of three antibiotics was lowered at various degrees in all 10strains.Conclusion NorA gene mutation is one of the mechanisms for antibiotic-resistance of S.aureus.

Objective To summarize the experience of rapid liver and kidney graft harvesting. Methods From Jan 2001 to Sep 2003,a quick procedure for combined liver and kidney procurement were used in 138 cases. The procedure includes in situ perfusion through aorta and superior mesenteric vein(SMV) plus drainage through inferior vena cava. Liver,pancreas,spleen and kidney were harvested en bloc. Results The warm ischemia time averaged at 2 to 6 minutes for kidneys and 3 to 8 minutes for livers. The total procurement time averaged at 20 to 30 minutes. All aberrant arteries were preserved. After transplantation there was no primary non-function in all 131 liver grafts,and the peak sALT level during the first 3 post-operative days was (581?392) U/L. Acute tubular necrosis rate was 3.3%(9/274) in renal grafts. Conclusion[WT5”BZ] This rapid procurement protects the quality of liver and kidney simultaneously. It is a simple,effective,safe and reasonably standardized procedure.

OBJECTIVE: To investigate the therapeutic effect of Yihuo Qingxia method, a traditional Chinese medicine therapeutic method for replenishing qi to activate blood, clearing away heat and dredging intestines, in treating hyperlipoidemia-related severe acute pancreatitis (SAP) in early stage. METHODS: One hundred and four patients with hyperlipoidemia-related SAP were divided into two groups: early group (admitted to hospital within 3 days after onset) and late group (admitted to hospital from 3 days to 7 days after onset). There were 52 cases in each group. All the patients were treated by Yihuo Qingxia method. RESULTS: There were no statistical differences in 48-hour Ranson scores, CT scores, 24-hour acute physiology and chronic heath evaluation II scores (APACHE II scores), and the levels of 24-hour serum triglyceride (TG) and serum glucose in the two groups (P>0.05). At the 10th day after onset, the serum TG level in early group was lower than that in late group (P<0.01). The incidences of acute respiratory distress syndrome, acute renal failure, hepatic inadequacy, congestive heart failure, shock, encephalopathy, infection and alimentary tract hemorrhage in early group were higher than those in late group (P<0.05). The mortality in early group was lower than that in the late group (P<0.05). The length of hospital stay in early group was shorter than that in late group (P<0.05). CONCLUSION: Yihuo Qingxia method has a good efficacy in treating hyperlipoidemia-related SAP in early stage.

Objective To evaluate clinical effect of simultaneous kidney-pancreatic transplantation(SKPT) with portal venous and enteric drainage. Method Between June 2001 and June 2004, six insulin-dependent diabetes mellitus(IDDM) and renal failure patients underwent this procedure. The venous drainage of the graft was established between donor′s portal vein and recipient′s superior mesenteric vein. The exocrine secretion was drained into proximal jejunum via side-to-side anastomosis between donor′s duodenum and recipient′s proximal jejunum. Steroids, mycophenolate mofetil, tacrolimus and Zenapax were used as immunosuppressants. Results Procedures were successful in all 6 cases. Excellent renal function and euglycemia were achieved in 4 cases. Follow-up of 4-34 months on the 4 survivers found excellent kidney-pancreatic function without any rejection episode. Two patients died perioperatively due to sepsis secondary to pancreatic leakage and drug toxicosis of excessive FK506. Conclusion Our preliminary experience suggests that simultaneous pancreas-kidney transplantation with enteric and portal drainage is reliable procedure for the treatment of IDDM with renal failure.

Objective To explore the clinical application value of coronary angiography (CAG) combined with fractional flow re-serve(FFR) in percutaneous coronary intervention treatment of coronary artery disease (CAD) .Methods 82 cases of CAD(147 le-sions) with single hemadostenosis at least 70% -90% were randomized into the observation group and the control group .The ob-servation group(40 cases ,72 lesions) was performed the myocardial FFR detection by the pressure guide wire and the drug-eluting stents(DES) were placed in the lesions only if FFR ≤0 .80 .The patients with postoperative FFR ≤0 .80 were given the in-stent post-balloon dilatation .The control group(42 cases ,75 lesions) underwent the percutaneous coronary intervention(PCI) for conduc-ting the routine DES implantation .The general condition ,risk factors(hypertension ,diabetese ,hyperlipidemia ,smoking ,etc .) ,num-ber of lesions ,implanted stents ,hospitalization cost ,occurrence rate of major adverse cardiac events (MACE) after postoperative 6 months and the angina recurrence rate were compared between the two groups .Results The number of used stents per patient and the hospitalization cost in the observation group were significantly lower than those in the control group [(0 .88 ± 0 .88) vs .(1 .81 ± 0 .83) ,(47 200 ± 2 3000)Yuan vs .(60 000 ± 2 4100)Yuan P< 0 .05] .The two groups had no all-cause death in postoperative 6-months .The recurrent myocardial infarction rate ,revascularization rate and recurrent angina in the two groups were 2 .50% vs .0 , 2 .50% vs .2 .38% and 5 .00% vs .7 .14% respectively ,the differences had no statistical significance(P>0 .05) .Conclusion CAG combined with FFR detection can significantly reduce the number of stents and the hospitalization cost without increasing the occur-rence rates of MACE and angina within postoperative 6 months in CAD patients .

Quantum dots (QDs) are nanometer-sized luminescent semiconductor nanocrystals. Their unique optical properties, such as high brightness, long-term stability, simultaneous detection of multiple signals and tunable emission spectra, make them appealing as potential diagnostic and therapeutic systems in oncology. Preparing the functional QDs by modifying bio-molecules such as antibody will have potential value for cancer diagnosis and treatment. This paper summarized the recent progress of promising application of QDs in cancer diagnosis and therapy, from identifying molecular targets, to drug delivery and therapy; from limitations of toxicity issues related to QDs in living organisms to multifunctional design and development. Finally, the promising applications of QDs are also discussed.
Animals ; Diagnostic Imaging ; trends ; Drug Delivery Systems ; trends ; Humans ; Nanomedicine ; methods ; Nanoparticles ; therapeutic use ; Neoplasms ; diagnosis ; therapy ; Quantum Dots

Objective:To analyze the effect of home quarantine on blood glucose and lipids in healthy adults during the COVID-19 epidemic times.Method:From April 7, 2020 to May 1, 2020, 512 adults wereexamined in Beijing physical examination center, of which 87 adults aged olderthan 18, received community closed management or home quarantine from January 23, 2020 to March 30, 2020, and theadultshad physical examination in Beijing physical examination center in the same month of 2018 and 2019 were selected as controls. The change trend of blood glucose and blood lipid acrossthe three years was analyzed by one-way repeated measurement of variance, and the difference of blood lipid and blood glucose between two years of physical examination was further analyzed by Bonferroni method. Datawereanalyzed by gender.Result:Among the 87 subjects, 36 (41.4%) were male and 51(58.6%) were female. The average age was (46.3±13.2) years and ranged from 24 to 74. The difference of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC) and fasting blood glucose (FBG) among 2018, 2019 and 2020 was statistically significant (all P<0.05), while differences in LDL-C, TC and FBG were statistically significant for males (all P<0.05) and HDL-C, LDL-C, TC and FBG were statistically significant for females (all P<0.05). HDL-C in 2018and 2020were significantly lower than that in 2019 [(1.27±0.29), (1.30±0.31) vs. (1.36±0.34) mmol/L], LDL-C in 2020was significantly higher than that in 2018and 2019 [(3.11±0.88) vs. (2.81±0.77), (2.84±0.71) mmol/L], TG in 2020 was significantly higher than that in 2019[(1.54±1.17) vs. (1.32±0.80) mmol/L], TC in 2019and 2020were significantly higher than that in 2018 [(4.88±0.94), (5.10±0.99) vs. (4.63±0.90) mmol/L], and the FBG in 2019and 2020were significantly lower than that in 2018 [(5.34±1.17), (5.44±1.58) vs. (5.84±1.70) mmol/L] (all P<0.05). The comparative analysis of men and women showed that the means of LDL-C, TG, TC and FBG of men were higher than those of women while the mean of HDL-C was lower than that of women in each year; compared with 2019, the increase of LDL-C and TC of men was obvious while the decrease of HDL-C of women was obvious (all P<0.05) in 2020. Conclusion:During the epidemic period of COVID-19, the home quarantine has adverse effects on blood glucose and lipid.

Objective:To observe the motor capacity of patients early after cardiac surgery using a cardiopulmonary exercise test.Methods:Patients who had performed a cardiopulmonary exercise test within 3 months after cardiac surgery were included in this retrospective study. Patients who took the test within 30 days of the operation formed a discharge group ( n=20), those within 30 to 60 days and 60 to 90 days formed the one month and two month groups ( n=10 for both). The discharge group was further divided into an aortic surgery group ( n=9), a bypass surgery group ( n=6) and a valve surgery group ( n=5) according to their procedure. The exercise capacity of each person was measured in terms of the changes in heart rate and systolic pressure from the resting to the anaerobic threshold stage. Anaerobic threshold, peak oxygen uptake and carbon dioxide ventilation equivalent were also recorded. Results:All of the patients completed the cardiopulmonary exercise test above the anaerobic threshold, and no adverse events such as exercise accidents occurred. At the anaerobic threshold the average heart rate of the discharge group was (8.8±7.1)bpm, significantly lower than the averages of the one month and two months groups: (17.0±5.9) and (18.3±10.5)bpm respectively. The average anaerobic thresholds and peak oxygen uptakes of the 1 month and 2 months groups were not significantly different, but they were all significantly higher than the discharge group′s averages. There were, however, no significant differences among the groups in the average changes in their systolic pressure and carbon dioxide ventilation equivalent. Moreover, the average anaerobic threshold and peak oxygen uptake of the aortic surgery group and the bypass surgery group were significantly lower than the valve surgery group′s averages.Conclusions:Postoperative motor ability after cardiac surgery improves significantly for at least 30 days. Patients who have received aortic or bypass surgery have significantly lower exercise capacity than those after valve surgery.

Objective:To study the risk factors of massive bleeding in patients with acute Stanford type A aortic dissection undergoing moderate hypothermic circulatory arrest repair.Methods:From January 2016 to October 2017, 486 consecutive patients with acute type A aortic dissection were included in the study. All operations were performed with moderate hypothermic circulatory arrest. The basic clinical data of patients were collected retrospectively. Massive bleeding was defined according to definition of Universal Definition of Perioperative Bleeding(UDPB) 4 class and the Blood Conservation Using Antifibrinolytics in a Randomized Trial(BART). Significant variables in univariate analysis were included in multivariate logistic regression analysis. Results:Thirty-four patients(7.00%) died in hospital. A total of one hundred and eighty-seven patients(38.48%) fulfilled criteria of the definition of BART massive bleeding. Forty-five patients(9.26%), 8 patients(1.65%), 114 patients(23.46%), 147 patients(30.25%) and 172 patients(35.39%) were in grade 0, grade 1, grade 2 and grade 4, respectively. With BART as the end point, the result of multivariate logistic regression showed that female gender( OR=3.32, P<0.001), anemia( OR=2.24, P=0.04), clearance creatine≤85 ml/min( OR=1.93, P=0.01), D-dimer level(every 500 ng/ml increase, OR=1.02, P=0.003), cardiopulmonary bypass(CPB) time( OR=1.01, P<0.001), total arch replacement(TAR, OR=2.40, P=0.02) were independent risk factors for massive bleeding, and the time from onset to operation( OR=0.86, P=0.01) was protective factor. With UDPB 4 class as the end point, multivariate logistic regression showed that creatinine clearance≤85 ml/min( OR=2.05, P=0.001), CPB time( OR=1.01, P=0.04) were independent risk factors for massive bleeding. The time from anset to operation( OR=0.85, P=0.002) and Bentall procedure( OR=0.65, P=0.04) were the protective factors. Conclusion:Massive bleeding was more common in acute Stanford type A aortic dissection. Female gender, poor preoperative renal function, high D-dimer level, early time accepting surgical operation and long CPB were independent risk factors. For high-risk patients, simple and effective surgical methods should be taken to reduce the risk of bleeding.

Objective To summarize surgical treatment of Takayasu arteritis,and analysis the drug treatment effect during the perioperative period.Methods Retrospective analysis 46 patients with Takayasu's arteritis disease and received cardiovascular surgery between January 2010 to December 2015,in Anzhen Hospital.By collecting their clinical characteristics,preoperative drug therapy,surgical treatment,pathological examination results to analyze operation conditions,effect of drugs and preoperative conditions.Results The perioperative mortality rate was 2.2％ and the complication rate was 23.9％ in 46 patients.There were 34 patients with symptomatic relief in the perioperative period,11 patients didn't take hormone drugs before operation.There were 11 cases of complications during the perioperative period,of which 7 patients were in active stage and 10 patients had not been used before operation.Conclusion The surgical treatment of patients with Takayasu's arteritis disease can effectively improve symptoms.The patients in Takayasu's arteritis active stage will affect the outcome of the surgery.Rational use of hormone drugs before surgery,can effectively control the patient's condition,improve the rate of remission of symptoms,and effectively reduce the incidence of perioperative complications.