Introduction：Neonatal tetanus is a major cause of neonatal mortality in many developing countries and remains a major public health problem. This study aimed to determine risk factors associated with neonatal tetanus in Wenzhou, China.Methodology：Medical records of neonatal tetanus cases from 17 hospitals over a 13-year period (2000–2012) were reviewed for potential risk factors. Controls were selected from neonates with diseases other than tetanus who were admitted to the same facility during the same period. The potential risk factors of the neonatal tetanus group were compared with the control group using univariate analysis and an unconditional logistic regression model.Results：A total of 246 neonates with tetanus and 257 controls were included in this study. Univariate analysis showed that having untrained birth attendants, home delivery, an unsterile method of delivery and being a migrant to Wenzhou were significantly different between the two groups (P < 0.001). Logistic regression analysis revealed that the odds of having an untrained birth attendant, home delivery and an unsterile method of delivery were significantly higher in the tetanus group than the control group (odds ratio: 1371.0; 95% confidence interval: 206.0, 9123.5).Conclusion：This study identified that the main risks of neonatal tetanus in cases from Wenzhou were having an untrained birth attendant, home delivery and an unsterile method of delivery. Preventive measures directed to these risk factors may reduce the occurrence of neonatal tetanus in the studied area.

OBJECTIVETo evaluate the efficacy and safety of fast track surgery(FTS) in patients undergoing laparoscopic colorectal resection.

METHODRandomized controlled trials(RCT) or clinical controlled trials(CCT) on fast-track surgery in patients undergoing laparoscopic colorectal resection were obtained from databases including CNKI, Wanfang, PubMed, EMBACE, and Cochrane Library between January 2000 and March 2012. Meta-analysis was performed with RevMan 5.1.

RESULTThere were 6 RCTs and 7 CCTs including 1795 patients. There were 955 patients in the FTS group and 840 in the control group. The time to passage of flatus was shorter(WMD=-1.37, 95%CI:-1.55~-1.19, P<0.05), time to resumption of diet/drink was shorter(WMD=-2.62, 95%CI:-2.69~-2.55, P<0.05), length of postoperative hospital stay was decreased(WMD=-1.63, 95%CI:-1.92~-1.34, P<0.05) and the incidence of postoperative complications were less(OR=0.52, 95%CI:0.41~0.67, P<0.05) in the FTS group. However, there were no differences in readmission(P>0.05).

CONCLUSIONFast-track surgery in patients undergoing laparoscopic colorectal resection can promote bowel function recovery, decrease the incidence of postoperative complications and length of hospital stay.

Controlled Clinical Trials as Topic ; Digestive System Surgical Procedures ; Humans ; Incidence ; Laparoscopy ; Length of Stay ; Postoperative Complications

Adolescent ; Adult ; Biomarkers ; Female ; Hepatitis B, Chronic ; metabolism ; Humans ; Liver ; chemistry ; Liver Cirrhosis ; blood ; therapy ; Male ; Middle Aged ; Platelet-Derived Growth Factor ; analysis ; Proto-Oncogene Proteins c-sis

[Objective]To study the relationship between bridging septa thickening in the perinephric space and split renal function in acute unilateral upper urinary tract obstruction.[Methods]50 patients with acute unilateral upper urinary tract obstruction by calculus were analyzed retrospectively. According to the images of multi-slice spiral CT (MSCT)scanning,all cases were divided into thickened bridging septa group(n=25)and normal bridging septa group (n=25),The CT values of renal cortical in the plain(CTp)and renal cortical enhancing(CTe)phase were measured, the difference of increasement value(CTe-CTp)and the CT value ratio of the ipsilateral and opposite in renal cortical phase was analyzed by independent sample T test.[Results]The CT increasement value of bridging septa thickening and normal group were(103±30)HU and(128±24)HU respectively,the difference between the two groups was statistically significant(P<0.01);and CTac/CTuc were 0.81±0.13 and 0.96±0.06 respectively(P<0.01).[Conclusion]Thickening of bridging septa in the perinephric space with acute unilateral upper urinary tract obstruction will weaken the enhancement of renal cortical,and increased the likelihood of split renal function impairing.

Objective: To study the biomechanical property and histocompatibility of acellular porcine fascia so as to supply a new substitute material for tissue repair. Methods: Samples of normal porcine fascia, acellular porcine fascia and normal human fascia were prepared for histological and biomechanical examination. Xenogeneic fresh porcine fascia, acellular porcine fascia and allogeneic rabbit fascia were implanted into the back of rabbit. Tissues were taken for HE staining and histocompatibility test. Results: Histological examination showed that the cellular components which elicit immune rejections had been removed in the acellular porcine fasciam, with the complete extracellular matrix reserved. Arrangement of collagen fiber was loose in the acellular porcine fascia. The biomechanical performance test of the three samples showed that there was no significant difference in the extreme tensile strength (4.47±0.54) MPa, (4.49±0.91) MPa, (4.79±1.35) MPa for acellular porcine fascia, normal porcine fascia and normal human fascia respecively, P>0.05). There was no significant difference between acellular porcine fascia extracellular matrix and porcine fascia with the cell in breaking elongation (501.83%±52.01%, 661.17%±200.28%, P>0.05). However, there was a significant difference in the breaking elongation between human fascia (98.08%±26.02%)and the other 2 kinds of porcine fascia (P<0.01). Histocompatibility test showed the local reactions of the acellular porcine fascia group were weaker than the normal porcine fascia group. Conclusions With sound preparativemethod, the acellular porcine fascia has good biomechanical property and histocompatibility and may serve as a good alternative material for tissue repair.

OBJECTIVETo study the therapeutic effect of Weicao Capsule (WCC) on gout.

METHODSTwo hundred gout patients were assigned to two groups. The treated group was treated with WCC and the control group was treated with Tongfengding Capsule. Both groups were given the respective treatments orally 3 times a day, 2 capsules each time with 2 weeks as one course and all patients received 2 successive courses of treatment. Changes of blood beta(2)-microglobulin (beta(2)-M), hemoglobin (Hb), 24 h urinary protein (24 h UP), pH value of urine and blood uric acid (BUA) as well as kidney function were observed.

RESULTSAfter treatment, level of beta(2)-M got lowered significantly, Hb and 24 h UP, blood urea nitrogen, serum creatinine and the clearance rate of creatinine, as well as blood lipids all improved obviously in the treated group (all P<0.01), while these parameters remained unchanged in the control group (P>0.05). The pH value of urine was improved in both groups showing an insignificant difference between them (P>0.05). BUA was decreased in both groups with a decrease to a larger extent in the treated group (P<0.01). The total effective rate was 87% in the treated group, which was superior to that in the control group (62%, P<0.05).

CONCLUSIONWCC has a favorable therapeutic effect on gout and its mechanism of action for improving renal function and reducing urinary protein could be related with the lowering of blood beta(2)-M, BUA and lipids.

Adult ; Aged ; Capsules ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Gout ; blood ; drug therapy ; physiopathology ; Hemoglobins ; analysis ; Humans ; Hydrogen-Ion Concentration ; Kidney Function Tests ; Lipids ; blood ; Male ; Middle Aged ; Proteins ; analysis ; Treatment Outcome ; Uric Acid ; blood ; beta 2-Microglobulin ; blood

OBJECTIVETo assess the clinical outcomes of brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique for treatment of Stanford type A aortic dissection.

METHODSTwenty-three patients with Stanford type A aortic dissection requiring arch replacement underwent brachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique. The operations were performed within 72 h (20 cases) or 3-14 days (3 cases) after the onset of aortic dissection.

RESULTSThere was no perioperative death in these cases. The mean extracorporeal circulation time was 209∓52 min, the aortic cross clamp time was 85∓21 min, and the mean chest tube output within the first 24 h after the operation was 570∓263 mL; none of the patients required chest reopening for management of bleeding. Postoperative acute renal failure requiring hemodialysis occurred in 3 cases, transient neurologic dysfunction in 2 cases, paraplegia in case and hematosepsis in 1 case. No such complications as permanent neurologic deficit or postoperative visceral malperfusion occurred in these cases. All the patients survived and were discharged from hospital without experiencing severe complications in the follow-up for 6-18 months.

CONCLUSIONBrachiocephalic artery-sparing aortic arch repair combined with stent-graft elephant trunk technique is a safe and simple procedure with controllable bleeding and can serve as an optional procedure for aortic arch replacement.

OBJECTIVETo examine the correlation between the health-related quality of life measured by the St. George's Respiratory Questionnaire (SGRQ) and the commonly used physiological measures in lymphangioleiomyomatosis (LAM).

METHODSThis study retrospectively analyzed the SGRQ scores and other measures (the Borg scale of breathlessness at rest, 6-minute walking distance, blood oxygen levels, and pulmonary function) of patients diagnosed and confirmed with LAM. Altogether 38 patients between June 2007 and November 2009 were included.

RESULTSThe mean values of the SGRQ three components (symptoms, activity, and impacts) and total scores in the LAM patients were 46.95 +/- 28.90, 58.47 +/- 25.41, 47.89 +/- 29.66, and 51.11 +/- 26.35, respectively. The SGRQ total or component scores were correlated well with the Borg scale of breathlessness, 6-minute walking distance, partial pressure of oxygen in arterial blood, spirometry and diffusion capacity of lung. There were poor correlations between SGRQ score and residual volume or total lung capacity. In our preliminary observation, sirolimus improved the SGRQ total and three component scores and the Borg scale of breathlessness significantly after 101-200 days of treatment (n = 6).

CONCLUSIONSThe SGRQ score in LAM is correlated well with physiological measures (Borg scale of breathlessness, 6-minute walking distance, blood oxygen levels, and pulmonary function tests). The SGRQ could therefore be recommended in baseline and follow-up evaluation of patients with LAM. Treatment with sirolimus, an inhibitor of mammalian target of rapamycin, may improve the quality of life and patient's perception of breathlessness in LAM.

Adult ; Forced Expiratory Volume ; Humans ; Lymphangioleiomyomatosis ; physiopathology ; psychology ; Middle Aged ; Quality of Life ; Residual Volume ; Surveys and Questionnaires ; Vital Capacity

Objective To investigate the effect of allogeneic adipose derived mesenchymal stem cells (hADSCs) on regulatory T cells (Tregs) in peripheral blood of patients with premature ovarian failure (POF).Methods hADSCs were isolated from adipose tissue using 0.1％ type Ⅰ collagenase digestion.Adipogenic,osteogenic differentiation and surface molecular characterization were also performed.Peripheral blood mononuclear cells (PBMCs) of POF patients were isolated by density gradient centrifugation.PBMCs were co-cultured with 1 × 104,2 × 104 and 1 × 105 hADSCs for 72 hours under the stimulation of phytohemagglutinin (PHA).The proliferation rate of lymphocytes was measured by CCK-8 method,the proportion of CD4+ CD25+ Foxp3+ Treg cells was measured by flow cytometry.Real-time fluorescent quantitative PCR was used to detect the mRNA level of Foxp3+.Results hADSCs were positive for CD90,CD105 and negative for CD34,CD45,and has adipogenic and osteogenic differentiation ability.The results of CCK-8 showed that hADSCs could significantly inhibit the proliferation of lymphocytes compared with that in control group (P＜0.001).Flow cytometry showed that hADSCs could promote the proliferation of CD4+ CD25+ Foxp3+ Treg cells (P＜0.05).The results of qPCR showed that Foxp3+ mRNA expression was obviously up-regulated in all experimental groups compared with that in control group (P＜0.001).Conclusion hADSCs can play an immune regulatory role and promote the proliferation of Tregs in peripheral blood of patients with premature ovarian failure.

Objective To investigate the awareness and attitude towards menopause and menopausal hormone therapy (MHT) among the medical staff of Zhujiang Hospital of Southern Medical University.Methods A self-designed questionnaire related to menopause and MHT was conducted among 1143 medical staffs in Zhujiang Hospital of Southern Medical University.Results The best-known symptoms,in sequences,were dysphoria and depression (90.6％),sleep disorders (81.5％),hot flashes and night sweating (69.4％),dizziness and palpitation (59.3％),and paresthesia (50.3％).Of 1143 respondents,42.1％(481) knew about MHT,and 62％(709) considered that MHT is necessary for symptomatic menopausal women.Significant differences existed in attitudes towards MHT between different titles and departments (P=0.027,P=0.000).Fifty-seven percent (651) of medical staff expressed concern about the side effects of MHT and had scruples about its use,73.1％(836) believed that MHT can improve menopausal symptoms,while 54.5％(623) believed MHT can prevent and treat osteoporosis.Conclusions The awareness rate on menopause and MHT is relatively low among the medical personnel of Zhujiang Hospital of Southern Medical University.There exist differences in attitudes towards menopause and MHT among different departments,doctors and nurses,and different titles.