Adult ; Aged ; Axilla ; innervation ; surgery ; Brachial Plexus ; surgery ; Breast Neoplasms ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; methods ; Mastectomy, Radical ; adverse effects ; methods ; Middle Aged ; Pain, Postoperative ; etiology ; Somatosensory Disorders ; etiology

We reviewed medical data of 22 patients receiving intravenous thrombolysis therapy for acute isehemic stroke and evaluated our efforts of promoting intravenous thrombolysis for acute ischemic stroke.The mean in-hospital delay was 107 minutes.The most common reason was waiting for the results of laboratory tests.Only 6 cases received a standard dose of recombinant tissue plasminogen activator (rtPA) at 0.9 mg/kg.Only one patient had asymptomatic intracranial hemorrhage.No symptomatic hemorrhage occurred.Intravenous thrombolysis for ischemic stroke had excellent safety profile.Intravenous thrombolysis for ischemic stroke should be promoted under the guidance of standardized protocol according to the national guideline.

Objective To investigate the risk factors of severe intrahepatic cholestasis during early period after liver transplantation.Methods The clinical data of 225 patients who received orthotopic liver transplantation at the Nanfang Hospital of Southern Medical University from August 2004 to February 2011 were retrospectively analyzed.All patients were divided into positive group (60 patients with intrahepatic cholestasis) and negative group (165 patients without intrahepatic cholestasis).Preoperative,intraoperative and postoperative factors of the 2 groups were compared via t test,chi-square test,Wilcoxon test or Logistic regression analysis.Results The proportion of patients with hepatic cirrhosis,hepatic encephalopathy integral,ascites integral,international normalized ratio,and the levels of prothrombin time (PT),total bilirubin (TBil),aspartate aminotransferase of the positive group before operation were significantly higher than those in the negative group (x2 =6.09,Z =2.22,2.60,2.46,2.84,4.81,3.42,P ＜ 0.05),while the levels of albumin,Na +,K +,hemoglobin,platelet (PLT) of the positive group in the operation were significantly higher than those in the negative group (t =2.10,4.97,Z =2.49,t =3.51,Z =3.66,P ＜ 0.05).The ratio of compatible blood type of the donors and recipients,ratio of fatty liver graft,cold ischemia time,relative warm ischemia time,intraoperative blood loss,intraoperative transfusion of red blood cells,PLT,and cryoprecipitate of the positive group after the operation were significantly higher than those in the negative group (x2 =4.29,13.11,Z =2.45,2.61,3.75,3.20,2.89,3.95,P ＜0.05).The incidences of acute rejection,hepatic artery embolism,pulmonary infection,bacteraemia,fungal infection and cytomegalovirus (CMV) infection were significantly higher than those in the negative group (x2 =9.87,4.91,8.21,6.29,3.92,9.26,P ＜0.05).The results of multivariate analysis revealed that preoperative level of TBil ＞ 51.3 μmol/L,fatty of the liver graft,intraoperative transfusion of cryoprecipitate,postoperative acute rejection,hepatic artery embolism,postoperative pulmonary infection,bacteraemia,CMV infection were independent risk factors of severe inrahepatic cholestasis (OR =15.82,7.99,2.88,3.03,53.20,3.34,4.11,3.22,P ＜ 0.05).The incidence of severe intrahepatic cholestasis was significantly lower in patients with higher level of PLT and longer PT (OR =0.33,0.25,P ＜ 0.05).The mortality rates of the positive group and negative group at 6 months after the operation were 41.7％ (25/60) and 19.4％ (32/165),and the mortality rate of the positive group was significantly higher (x2 =11.54,P ＜ 0.05).Conclusion Correction of poor clinical status before liver transplantation,reinforcement of infection control and anti-rejection may reduce the incidences of complications and decrease the associated early mortality.

OBJECTIVETo investigate the short-term clinical outcome of unicompartmental knee arthroplasty for the treatment of spontaneous osteonecrosis of the knee.

METHODSFrom September 2013 to April 2014,5 patients with spontaneous osteonecrosis of the knee underwent unicompartmental knee arthroplasty, included 3 males and 2 females, aged from 65 to 80 years old with an average of 74 years. The courses of disease was from 1 to 6 years with the mean of 3 years. According to the radiographic staging criteria of Koshino, 1 case was stage II, 2 cases were stage III, 2 cases were stage IV. Clinical effects were assessed by VAS score, HSS score, and knee range of motion, tibiofemoral angle before and after operation.

RESULTSAll the patients were followed up from 6 to 7 months with an average of 6.4 months. All incisions obtained primary healing, and there were no complications such as infection, thrombosis, fracture of lower limbs. All 5 patients' pain relieved and their knee function improved significantly after operation, but knee range of motion had no obviously improved. Postoperative HSS scores, VAS scores, tibiofemoral angle were significantly improved than that of preoperative.

CONCLUSIONThe short-term effect of unicompartmental knee arthroplasty in treating spontaneous osteonecrosis of the knee is satisfactory.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Joint Diseases ; physiopathology ; surgery ; Knee Joint ; Male ; Osteonecrosis ; physiopathology ; surgery ; Range of Motion, Articular

Objective To investigate the antimicrobial resistance of clinical isolates in Tongling People′s Hospital during 2013. Methods A total of 2 281 nonduplicate clinical isolates were collected.Kirby-Bauer disc diffusion method was employed to study the antimicrobial susceptibility.The data were analyzed with WHONET 5.6 software according to CLSI 2012 breakpoints. Results The top 5 most frequently isolated microorganisms were E.coli (479,21.0%),K.pneumoniae (360,15.8%),A. baumannii (271,11.9%),P .aeruginosa (240,10.5%),S.aureus (171,7.5%).Gram negative and gram positive microorganisms accounted for 76.5% and 23.5%,respectively.The prevalence of methicillin-resistant strains in S.aureus (MRSA)and coagulase negative Staphylococcus (MRCNS)was 38.6% and 73.1%,respectively.The resistance rates of MR strains to beta-lactams and other antimicrobial agents were much higher than those of MS strains.No staphylococcal strain was found resistant to vancomycin or teicoplanin.E.faecalis showed relatively lower resistance to penicillin,ampicillin and nitrofurantoin.E.faecium strains were more resistant than E.faecalis to most of the antibiotics tested.Approximately 50.5% of E.coli and 44.5% of Klebsiella isolates produced extended-spectrum beta-lactamases (ESBLs).The ESBLs-respectively.And 29.8% and 23.4% of the P .aeruginosa strains were resistant to imipenem and meropenem.Nearly all (94.0%)P .aeruginosa isolates were susceptible to amikacin.Conclusions There appears a trend of increasing resistance in the clinical bacterial isolates in this hospital,especially the carbapenem-resistant Enterobacteriaceae,which is of great concern.It is mandatory to take effective antibiotic policy and infection control measures.

Objective To investigate the effect of carotid artery stenting (CAS) on cognitive function in patients with asymptomatic severe carotid artery stenosis.Methods The patients with asymptomatic severe carotid stenosis (stenosis ≥ 70％) were enrolled in the study.The cognitive function evaluation was performed before CAS,1 and 3 months after procedure respectively with mini-mental status scale (MMSE),digital span (DS),Chinese auditory learning test (CALT),judgment of line orientation test (JLOT),and verbal fluency test (VFT),including attention,memory,visual spatial function,and frontal fluency function.Results A total of 26 patients with asymptomatic severe carotid artery stenosis who performed CAS were enrolled,18 were males and 8 were females (aged 52 to 79 years,mean 64.19 ±6.76 years),and the years of education was 9.84 ± 3.29 years.Eighteen patients had left carotid artery stenosis and 8 had contralateral carotid artery stenosis.CAS was performed successfully in all patients,and no complications occurred.Compared with the CAS before procedure,all the cognitive functions were improved significantly at 1 and 3 months after procedure (all P ＜0.01),however,there was no significant difference between 1 and 3 months after procedure (all P＞ 0.05).Conclusions CAS may improve cognitive function in patients with asymptomatic severe carotid artery stenosis,and it was more obvious in the early postoperative period.

Objective To judge the prognosis of adult recipients after first liver transplantation by stepwise discriminant analysis,and screen out the main influencing factors.Methods The clinical data of 221 patients who received liver transplantation at the Nanfang Hospital of Southern Medical University were retrospectively analyzed.A total of 218 patients who met the criteria were divided into the training samples (188 patients admitted from August 2004 to June 2010) and checking samples (30 patients admitted from July 2010 to February 2011),and then all patients were re-divided into dead group (survival time ≤ 90 days,34 patients) and surviving group (survival time ＞ 90 days,184 patients).Factors which had significant difference after the univariate analysis was further analyzed by the stepwise discriminant analysis method.All data were analyzed by the t test,rank sum test,chi-square test or Fisher exact probability test.Results The ages of the recipients in the dead group and the living group were (54 ± 11)years and (51 ± 11)years,respectively,with no significant difference between the 2 groups (t =-1.681,P ＞ 0.05).The preoperative levels of hemoglobin in the dead group and the living group were 106.7 g/L and 119.2 g/L,respectively,with a significant difference between the 2 groups (t =2.809,P ＜ 0.05).There were significant differences in the levels of serum creatinine,urea nitrogen,albumin,total bilirubin,indirect bilirubin,Na+,prothrombin time,activated partial thromboplastin time,international normalized ratio,fibrinogen,prothrombin activity,platelet,nutrition risk index,model for end-stage liver disease score,number of patients with preoperative hepatic encephalopathy (HE),preoperative hepatorenal syndrome (HRS),preoperative digestive tract bleeding,preoperative infection,preoperative diabetes,Child-Turcotte-Pugh score,cardiac function classification and anesthesia risk rating operation time,anhepatic time,volume of intraoperative blood transfusion,volume of peritoneal effusion ; intraoperative urine output,between the 2 groups (Z =-2.277,-2.595,-3.290,-3.486,-2.562,-2.577,-3.670,-3.882,-3.625,-3.557,-3.837,-1.974,-3.693,-3.815,x2 =19.632,9.756,28.143,Z =-4.175,-3.905,-4.865,-3.564,-5.822,P ＜ 0.05).Preoperative HE,preoperative HRS,duration of operation,intraoperative blood transfusion and intraoperative volume of urine were the independent influencing factors of early prognosis after liver transplantation.The standardized partial regression coefficients were 0.146,0.188,0.257,0.181,-0.340,89.9％ (169/188) of the training samples and 90.0％ (27/30) of the checking samples were correctly classified.Conclusion Based on factors including HRS,HE,intraoperative blood transfusion,intraoperative volume of urine and duration of operation,the early prognosis can be judged in adult recipients after first liver transplantation.

Proteomics, which has been widely used in life science, is an emerging discipline following genomics. It can help to explore the pathogenic mechanism and early onset marker of Bacillus anthracis, playing an important part in the prevention, diagnosis and treatment of B.anthracis. In this paper,the application of proteomics in the research of B.anthracis is reviewed.

Toll-like receptors (TLRs) family may play important roles in inflammatory bowel disease. This study examined the expression of TLR2, TLR4 and TLR9 in the colonic tissues of patients with ulcerative colitis (UC) and explored their roles in the pathogenesis of UC. Colonic biopsies were taken from the colon of 30 patients with mild or moderate UC (at active phase) and 10 healthy controls during colonoscopy. TLR2, TLR4 and TLR9 protein expression levels were immunohistochemically detected. The mRNA expression levels of TLR2, TLR4 and TLR9 were assessed by reverse transcription polymerase chain reaction (RT-PCR). The disease activity index (DAI), colonoscopic and histologic grades and fecal microbial flora were determined. Histological examination showed that the intestinal mucous membrane of UC patients underwent acute inflammation changes. Immunohistochemistry exhibited that the expression levels of TLR2, TLR4 and TLR9 in colon epithelia and inflammatory cells were higher in UC patients than in control group (P<0.01). The mRNA expression levels of TLR2, TLR4 and TLR9 were increased in UC patients but were not detected in the normal controls. Expression levels of TLR2, TLR4 and TLR9 were positively correlated, and bore close correlation with DAI, colonoscopic and histologic grades and fecal microbial flora. An important mechanism of UC might be that abnormal activation of mucosal immunity by intestinal dysbacteriosis caused dysregulation of TLRS that mediates innate immunity.

AIMTo study the effects of sodium salicylate on the expression of GABAalpha NR1 and hearing response properties of inferior colliculus neurons in mice.

METHODSThirty-six kunming mice were divided into three groups (A, B, C,). The expression of GABAalpha NR1 were measured by using RT-PCR. The intensity-rates functions, intensity-latency functions and frequency-turning curves were recorded by extracellular electrophysiological recording techniques.

RESULTS(1) The expression of GABAalpha mRNA of B group was decreased remarkably than the control group (A group, P < 0.05), there weren't noticeable differences between A group and C group (P > 0.05). The expression of NR1 mRNA of B group was increased remarkably than the control group (A group, P < 0.01), there were noticeable differences between A group and C group P < 0.05). (2) The intensity-rates functions, intensity-latency functions were monotonic while the frequency-turning curves were more broad when sodium salicylate was given. (3) The intensity-rates functions, intensity-latency functions were non-monotonic while the frequency-turning curves were sharpened after lidocaine was given.

CONCLUSIONS(1) The results suggested that administration of sodium salicylate decreased the expression of GABAalpha while increased the expression of NR1mRNA. (2) The intensity-rates functions, intensity-latency functions were monotonic, the frequency-turning curves were more broad when salicylate was given and the changes above could be reversed by given lidocaine.

Acoustic Stimulation ; Animals ; Inferior Colliculi ; drug effects ; metabolism ; physiology ; Mice ; Mice, Inbred Strains ; Neurons ; drug effects ; metabolism ; physiology ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Sodium Salicylate ; pharmacology ; gamma-Aminobutyric Acid ; metabolism