Health Knowledge, Attitudes, Practice ; Humans ; Occupational Diseases ; prevention & control ; Rural Population ; Sampling Studies ; Surveys and Questionnaires ; Transients and Migrants

Objective To analyze the risk factors of subclavian venous catheter-related infections in patients with traumatic hemorrhagic shock (THS) and provide a basis for prevention and control of the infection. Methods A retrospective study was conducted. 357 patients with THS and indwelling of subclavian vein catheter admitted in the Department of Emergency of Affiliated Hospital of Sichuan Provincial Luzhou Medical College were enrolled, and according to the infection state, they were divided into infection group (56 cases) and non-infection group (301 cases). The patients' data of gender, age, history of underlying disease, catheter position, catheter indwelling time, time staying in hospital, situation of antimicrobial drug used, application of tracheotomy or not, white blood cell count (WBC) levels, etc were collected for univariate analysis. The resulting indexes with statistical significance were applied for carrying out the multivariate logistic regression analysis, and then the independent risk factors involved in the development of subclavian venous catheter-related infections in the shock patients could be screened out.Results In 357 patients with THS, 56 were infected (15.7%). Univariate analysis showed: age ≥ 60 years (χ2 = 19.839,P < 0.001), with diabetes mellitus in past history (χ2 = 6.252,P = 0.012), catheter indwelling time ≥ 7 days (χ2 = 19.261,P < 0.001), time staying in hospital ≥ 7 days (χ2 = 4.315,P = 0.038), time for use of antimicrobial drug≥ 7 days (χ2 = 16.161,P < 0.001), tracheotomy (χ2 = 40.969,P < 0.001), WBC < 4×109/L (χ2 = 39.451,P < 0.001) and the disease severity grade 4 - 5 (χ2 = 8.345,P = 0.004) were the risk factors of subclavian venous catheter-related infections in patients with THS. Multivariate analysis showed: catheter indwelling time ≥ 7 day [odds ratio (OR) = 16.713, 95% confidence interval (95%CI) 3.651 - 76.624), tracheotomy (OR = 6.861, 95%CI 2.377 - 18.246), WBC < 4×109/L (OR = 4.903, 95%CI 1.887 - 12.643) were the independent risk factors of subclavian venous catheter-related infections in THS patients.Conclusion The strict implementation of aseptic catheterization, shortening the time of catheter indwelling as much as possible and the rational use of antibiotics can effectively reduce and prevent the incidence of venous catheter-related infection in THS patients.

Objective To observe the clinical efficacy of acupuncture in treating severe pneumonia complicated with gastrointestinal dysfunction (GIDF).Method Sixty patients with severe pneumonia complicated with GIDF were randomized into a treatment group and a control group, 30 cases in each group. The two groups were both given conventional Western medications. In addition, the treatment group was intervened by acupuncture, and the control group by oral administration of Mosapride citrate capsules and enteral nutrition via nasogastric tube. After 7-day treatment, the changes of GIDF score, intraabdominal pressure, bowel sound and gastric retention were observed in the two groups, and the clinical efficacies were compared.Result The total effective rate was 93.1% in the treatment group versus 78.6% in the control group, and the between-group difference was statistically significant (P<0.05). The scores of GIDF and the indexes (intraabdominal pressure, bowel sound, and gastric retention) were significantly changed after the treatment in both groups (P<0.05). The scores of GIDF and the indexes in the treatment group were significantly different from those in the control group after the intervention (P<0.05).Conclusion Acupuncture can promote the recovery of gastrointestinal function in severe pneumonia patients, since it can significantly improve the intraabdominal pressure, bowel sound and gastric retention.

Objective To detect the influence of fluoride on the expression TM9SF1 mRNA and Ras mRNA of osteoblasts. Methods The third generation of primary cultured osteoblasts were exposed to a series concentrations of 0,2.5,5.0, 10.0,20.0 mg/L fluoride for 10 days. The influence of different doses of fluorine on the expression of TM9SF1 mRNA and Ras mRNA of osteoblasts cultured in vitro was investigated by SYBR Green I methods. Results The osteoblasts of the control group and the 2.5 mg/L group were in the shape of long spindle, triangle or irregular polygon and had processes, and the cytoplasm was translucent, adjacent cells affixed to each other under light microscope. Those of the 20.0 mg/L group shaped as long spindle or irregular polygon, and some vacuolization and granular materials appeared in cytoplasm. The number of the cells decreased and the volume increased significantly. After exposed to fluoride for 10 days, osteoblasts of 2.5 mg/L group morphologically proliferated. There were statistical siguificances between each groups of TM9SF1 mRNA in human osteoblasts(F = 322.82, P < 0.01). The highest in the 2.5 mg/L group(9326.0 ± 115.97), the expression of TM9SF1 mRNA decreased along with the increasing dose of fluorine. There were statistical significances between 5.0, 10.0,20.0 mg/L groups(6495.0 ± 323.9, 4387.5 ± 545.2, 5962.5 ± 536.7) and control group(9221.0 ± 107.5, all P< 0.01). There was a statistical significance between each groups of Ras mRNA in human osteoblasts(F = 703.28, P < 0.01). The highest in the control group, the expression of Ras mRNA decreased along with the increasing of dose of fluorine. There were statistical significance between 2.5, 5.0, 10.0, 20.0 mg/L groups(6144.5 ± 270.82,5603.5 ± 88.39,3181.0 ± 159.81,4067.5 ± 37.4) and control group(6571.0 ± 196.58). Conclusion The influence on TM9SFI mRNA and Ras mRNA expression in osteoblasts correlates with the dose of fluorine.

Objective To study the effects of fluoride on minichromosone maintenance(MCM)3 mRNA and the bone formation-related gene:bone sialoprotein(BSP),osteocalcin(OC),osteopontin(OP)mRNA expression on human osteoblast cells.The expression of MCM3 was tested for diagnosis and surveillance value on osteoblast treated with excess fluoride.Methods Human osteoblast cell(Saos-2)was cultured in McCoy5A medium and treated with fluoride(sodium fluoride,NaF).There were eight groups including:0(control),0.625,1.250,2.500,5.000,10.000,20.000,40.000 mg/L groups.Expression of MCM3,BSP,OC,OP mRNA were detected by real-time PCR.Dual-standard curve method was used for analysis.ALPase was determined by measuring the absorbance using a micro titer plate reader. Results Expression of MCM3 mRNA was lower in the 0.625,1.250,2.500,5.000,20.000, 40.000 mg/L groups(0.059 ± 0.003,0.027 ± 0.001,0.272 ± 0.004,0.115 ± 0.002,0.137 ± 0.004,0.754 ±0.002, all P > 0.05) and was higher in10.000 mg/L group(21.300 ± 1.200, P < 0.01 ) than control group( 1.000 ±0.020), especially 10.000 mg/L group was higher than groups treated with fluoride(all P < 0.01 ), the differences among groups were significant(F = 305.842, P < 0.01 ). Expression of BSP mRNA was significantly higher in 0.625,1.250,2.500,5.000,10.000 mg/L groups(71.80 ± 3.60,133.00 ± 7.20,85.50 ± 0.60,80.90 ± 1.20,304.00 ± 21.00)than the control group( 1.00 ± 0.04), especially 10.000 mg/L group was higher than others groups treated with fluoride(all P < 0.01 ), the differences among groups were signifieant(F = 159.531, P < 0.01 ). Expressions of OC mRNA were higher in 0.625,1.250,2.500,5.000 mg/L groups(110.00 ± 12.00,143.00 ± 2.10,90.60 ± 4.10,23.70±1.20) than control group(1.00 ± 0.01, all P < 0.01), and the differences among groups were significant (F = 158.734, P < 0.01 ). Expression of OP mRNA were higher in 0.625,1.250,2.500,5.000,10.000,20.000 mg/L groups(167.00 ± 11.20, 111.00 ± 12.10,72.50 ± 3.50,134.00 ± 14.00,42.30 ± 2.40,45.20 ± 3.30) than the control group(1.00 ± 0.04, all P < 0.05 or < 0.01 ), the differences among groups were significant(F = 60.226, P < 0.01 ).Compared with control group(4.2 ± 1.2), the ALPase activity was increased in all groups treated with fluoride (6.0 ± 0.4,5.8 ± 0.1,5.7 ± 0.4,7.7 ± 1.1,19.2 ± 2.4,8.5 ± 3.0,18.1 ± 4.2), but only 10.000 mg/L and 40.000 mg/L groups were higher than control group and other groups treated with fluoride(all P < 0.01 ), the differences among groups were signifieant(F = 7.806, P < 0.01 ). Conclusions Irregular expression of MCM3 mRNA is not suitable as a diagnostic and monitoring biomarker of osteoblasts exposed to excessive fluoride. Fluoride may affect the osteoblast-related gene expression and to promote osteogenic differentiation.

Objective To study the effect of fluoride on expression of osteoblast Runx2, Osterix and their downstream COL I A2 in vitro. Methods Human osteoblast Saos-2 was cultured in vitro. The cells were grouped according to fluoride(NaF) dose used: 0(control ), 0.625,1.250,2.500,5.000,10.000,20.000,40.000,80.000,160.000 mg/L. Cells were collected after 24 h culture, RNA extracted, and the mRNA expression of Runx2 and Osterix and downstream genes COL I A2 was detected using fluorescent quantitative reverse transcription polymerase chain reaction [Real-time (RT)-PCR]). Results After 24 h in vitro cell cultivation with NaF, the expression of Runx2 in 0.625,1.250,2.500,5.000,10.000,20.000 mg/L groups(388.00 ± 41.80,209.00 ± 25.80,42.80 ±4.52,63.00 ± 16.10,24.30 ± 4.23,16.20 ± 4.32) was higher than that of the control group( 1.00 ± 0.12, all P ＜0.05). The expression of Runx2 in 40.000,80.000,160.000 mg/L groups(0.40 ± 0.05,1.91 ± 0.28,4.87±1.36)compared with that of control group, the difference was statistically insignificant(all P ＞ 0.05).The expression of Osterix mRNA in 1.250,2.500,5.000 mg/L groups(4.04 ± 1.67,229.00 ± 51.00,46.40 ± 10.60) was higher than that of the control group( 1.00 ± 0.42,all P ＜ 0.05). The expression of Osterix mRNA in 10.000,20.000,40.000,80.000,160.000 mg/L groups(0. 16 ± 0.07,0.13 ± 0.01,1.73 ± 0.54,0.01 ± 0.01, 0.09 ± 0.01) compared with that of control group, the difference was statistically insignificant (all P ＞ 0.05). The expression of COL I A2 mRNA in 0.625,1.250,2.500,5.000,10.000,20.000 mg/L groups (2.27 ± 0.89,8.03 ± 2.31,14.20 ± 2.75,7.66 ± 1.34,8.96 ±2.30) was higher than that of the control group (1.00 ± 0.04, all P ＜ 0.05). The expression of COL I A2 mRNA in 160.000 mg/L(0.54 ± 0.01 ) was lower than that of the control group(P ＜ 0.05). Conclusions Fluoride may affect mRNA expression of Osterix and Runx2 in osteoblast and their expression level is related to fluoride concentration.Runx2 and Osterix can also regulate the expression of COL I A2 mRNA.

Objective To investigate the effect of bifidobacterial adhesin (BA) on nuclear factor of κB (NF-κB) and cytokines of intestinal mucosa of stressed rats.Methods Forty-eight rats were divided into stress group (n =24) and BA group (n =24) using the stochastic indicator method.After the stressed rat models were established withfettering as the stress condition,the experiment lasted 8 days.Both groups were given enteral nutrition (EN) with heat 125.4 kJ/(kg · d) and nitrogen 0.2 g/(kg · d).The BA group was fed with EN plus 5 mg/ (kg · d) bifidobacterial adhesin,and the stress group was fed with EN plus equivalent volume of normal saline [5 mg/ (kg · d)].The levels of NF-κB,interleukin-10 (IL-10),tumor necrosis factor (TNF-α),and interferon-γ (IFN-γ) were measured in both groups before modeling,after modeling,on the 3rd intervention day,and on the 8th intervention day.The changes in the morphology of intestinal mucosal were observed by transmission electron microscopy.Results (1) Expression of NF-κB:The positive expression rate of NF-κB in the intestinal mucosa was 0,79.2％,63.5％,and 66.7％ in the control group and 0,68.4％,55.7％,and 45.8％ in the BA group before modeling,after modeling,on the 3rd intervention day,and on the 8th intervention day.The expressions of NF-κB in both groups significantly increased after the modeling (both P =0.000).Even on the 3rd and 8th intervention days,the positive expression rates of NF-κB in the intestinal mucosa were still significantly higher than the pre-modeling level (both P =0.000).Compared with the levels after modeling and in the control group,the expression of NF-κB in the intestinal mucosa in the BA group on the 8th intervention day was significantly down-regulated (P =0.015,P =0.021).(2) Quantitative expressions of TNF-α and IFN-γ:Compared with the pre-modeling levels,the intestinal mncosa levels of TNF-α [stressed group:(154.63 ± 17.52) pg/g,(198.72 ±26.59) pg/g; BA group:(154.63 ±17.52) pg/g,(201.45 ±28.16) pg/g],IFN-γ [stressed group:(39.47 ±5.76) pg/g,(55.32 ±5.93) pg/g; BA group:(39.47 ± 5.76),(60.75 ± 7.68) pg/g] and the plasma levels of TNF-α [stressed group:(17.35±2.62) pg/g,(30.56±4.85) ng/L; BA group:(83.31 ±9.78) pg/g,(114.82±13.78) ng/L] and IFN-γ [stressed group:(17.35 ±2.62) pg/g,(28.73 ±4.17) ng/L; BA group:(17.35 ± 2.62) pg/g,(30.56 ± 4.85) ng/L] significantl increased (all P ＜ 0.05).On the 3rd and 8th intervention day,the intestinal mucosa levels of IFN-γ [(58.16 ± 7.38) pg/g,(56.37 ± 7.29) pg/g] and TNF-α [(215.76 ±31.54) pg/g and (211.83 ±33.61) pg/g] and plasma levels of IFN-γ [(29.35 ±4.76) ng/L,(30.25±3.67) ng/L] andTNF-α [(125.71 ±17.38) ng/L,(141.26±19.65) ng/L] in the stressed group were significantly higher than the pre-modeling levels (all P ＜ 0.05).On the 3rd and 8th intervention day,the intestinal mucosa levels of IFN-γ [(165.43 ± 24.58) pg/g,(171.57 ± 26.87) pg/g]and IFN-γ [(42.35 ±4.92) pg/g,(40.58 ±4.65) pg/g] and the plasma levels of TNF-α [(103.96 ±13.68) ng/L,(94.53±12.66) ng/L] and IFN-γ [(20.78±2.84) ng/L,(19.65±2.45) ng/L] in the BA group were significantly lower than the post-modeling levels (all P ＜ 0.05),whereas those of IL (intestinal mucosa:(62.82 ±8.34) pg/g,(75.16 ±9.65) pg/g; plasma:(43.32 ±5.28) ng/L,(55.64 ±6.87) ng/L] were significantly higher than the post-modeling levels (all P ＜ 0.05).Compared with the stressed group,the intestinal mucosa levels of TNF-α and IFN-γand plasma levels of IFN-γ and TNF-α significantly decreased while the IL-10 level significantly increased (all P ＜0.05) in the BA group.(3) Histomorphology showed that,compared that the ileal mucosal villi and crypt structure were recovered in the BA group on the 8th intervention day.Compared with the post-modeling conditions,the ileal mucosal villi and crypt structure were damaged in the stressed group,showing edema of the lamina propria,in which inflammatory cell infiltration was observed.Conclusions BA is helpful for the repair of the intestinal mucosa injury after stress by regulating the release of inflammatory mediators and cytokines of intestinal mucosa.

Acinetobacter has been the major pathogen of nosocomial infection. With the wide use of carbapenems, the emergence of multi-resistant isolates especially those resistant to carbapenem, brings a great problem to clinical treatment. The production of inactive enzymes is the main mechanism for antibiotic resistance, particularly the production of carbapenemases mediated by chromosome or plasmid. Combinations of β-lactam antibiotics and sulbactam may show synergism or partial synergism for acinetobacter isolates.
Acinetobacter ; drug effects ; enzymology ; Acinetobacter Infections ; drug therapy ; Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Bacterial Proteins ; metabolism ; Carbapenems ; pharmacology ; therapeutic use ; Drug Resistance, Bacterial ; Microbial Sensitivity Tests ; beta-Lactamases ; metabolism

Objective The aim of the study was to investigate the expression of P-glycoprotein (P-gp)and nuclear factor κB (NF-κB) in the cerebral cortex of rat with chronic fluorosis,and to reveal the mechanisms of damaged nervous system resulted from the toxicity of fluoride.Methods Sixty SD rats were randomly divided into three groups.The rats in each group were given drinking water containing different levels of fluoride:control group less than 0.5 mg/L,small amount of fluoride exposure group 10.0 mg/L and large amount of fluoride exposure group 50.0 mg/L.The animals were examined at the sixth month after initiating the experiment.Protein levels of P-gp and NF-κB in brain tissues were detected by immunocytochemistry and Western blotting,and the P-gp protein and mRNA level by quantitative real time PCR method.Results As compared to the control group(28.21 ±6.13),the numbers of positive staining cells by P-gp antibody in the cortex of rat brains were significantly increased in both the small and the large amount of fluoride exposure groups[(48.46 ± 8.00),(53.72 ± 9.15),respectively,all P ＜ 0.05] ; the protein levels in the control group(100.00 ± 3.86)％ detected by Western blotting were significantly increased in the cortex of rat brains treated with fluoride in both the small and the large amount of fluoride exposure groups[(189.47 ± 3.14)％,(191.36 ± 11.09)％,respectively,all P ＜ 0.05].The significantly increased expression of NF-κB at the protein level was observed in the cortex of rat brains of the small and the large amount of fluoride exposure groups[(365.97 ± 6.04)％ and (417.15 ± 10.89)％,respectively] as compared with the control group[(100.00 ± 10.07)％,all P ＜ 0.05].The mRMA level of P-gp in the cortex of rat brains of the small and the large amount of fluoride exposure groups(2396 ± 427,3479 ± 371,respectively) were higher than that of the control group(260 ± 106,all P ＜ 0.05).Conclusion The increased expressions of P-gp and NF-κB in the cortex of rat brains are induced by chronic fluorosis,which might be connected with the mechanism of brain damages.

Objective To investigate the changes of reactive oxygen species(ROS) level and mitochondria fission-fusion-balance in cortical neurons of rats with chronic fluorosis and reveal the correlation between these two factors. Methods One hundred and twenty rats were randomly divided into 3 groups(control group, low-dose fluorosis group, high-dose fluorosis group) and 40 rats were in each group according to body weight and the experiments were carried out for 3 months or 6 months. The rats were fed with different concentrations of fluoride (NaF) to establish fluorosis models. Controls were fed with tap water( < 0.5 mg/L), experimental animals in low- or high-dose group were fed with water containing NaF 10.0,50.0 mg/L, respectively. The level of ROS and the morphology in mitochondria fission-fusion balance in neurons of the cortex of rat brains prepared with cortical frozen sections were detected with ROS fluorescent probe and MitoTracker RED probe, respectively. Results Significant differences of the level of ROS and the numbers of abnormal mitochondria in morphology in the cortical neurons were found between 3 groups at the experiment period of 3 month and 6 month(F= 3.07,3.06,3.05,3.07, all P < 0.05). As compared with control group(10.43 ± 5.98,4.12 ± 3.86) at the experiment period of 3 month, the level of ROS and the numbers of abnormal mitochondria in morphology in the cortical neurons were obviously increased in high-dose fluorosis group(25.48 ± 6.09,20.47 ± 6.09, all P < 0.05), whereas no significant changes were found in low-dose fluorosis group(11.67 ± 3.49,6.68 ± 3.48, all P> 0.05). Furthermore, the increases in both ROS level and abnormal numbers of mitochondria were significant observed in the cortical neurons of low-dose fluorosis group (63.02 ± 8.15, 49.33 ± 8.61) and high-dose fluorosis group(65.60 ± 7.40,53.10 ± 6.95) as compared with the control group (25.26 ± 6.41,20.26 ± 6.41) at the experimental period of 6 month (all P < 0.05). The abnormal numbers of mitochondria correlated with ROS level(r = 0.93,0.81, all P < 0.05). Conclusions Taking excessive amount of fluoride results in high level of oxidative stress and impaired the balance of mitochondrial fission-fusion,which is dependent on the feeding times and doses of fluoride. The mechanism of the mitochondrial abnormalities might be associated with the high level of oxidative stress induced by chronic fluorosis.