Objective To detection analysis of blood infectious disease markers in patients before blood transfusion or before surgery .Methods HBsAg ,anti-HBs ,HBeAg ,anti-HBe ,anti-HBc ,anti-HCV ,anti-HIV ,TP-Ab were detected for 3 542 cases of se-rum using chemiluminescence immunoassay(CLIA) and ELISA .Results For HBsAg ,there were 704 cases of positive among 3 542 cases ,the proportion was 19 .8% ;For anti-HCV ,there were 52 cases of positive among 3 032 cases ,the proportion was 1 .72% ;For anti-HIV ,there were 3 cases of positive among 3 049 cases ,the proportion was 0 .09% ;For TP-Ab ,there were 200 cases of positive among 3 153 cases ,the proportion was 6 .34% .The infection rate was different in different gender of HBV ,anti HCV ,anti HIV and TP-Ab .But for HBV ,anti-HCV and TP-Ab ,the detection rate of male was higher than female(P<0 .05);The infection rate was different in different age of HBV ,anti HCV ,anti HIV and TP-Ab different age .The detection rate of HBV and Anti-HCV in 21-40 years old was the highest ,They were 31 .9% and 2 .33% ;The detection rate of TP-Ab increases with age increased ,more than 60 years old was the highest ,up to 7 .55% .Detection of the above two methods ,for HBsAg ,there were 51 cases did not match ,the proportion was 1 .44% ;for anti-HCV ,there were 1 case did not match ,the proportion was 0 .03% ;for Tp-Ab ,there were 3 cases did not match ,the proportion was 0 .1% ;for anti-HIV ,CLIA agrees well with ELISA ,there were 3 cases of positive .The samples that did not match were detected by the third party verification of the reagent .The result displayed that CLIA was more accurate . Conclusion CLIA is a high-sensitivity detection method which could effectively avoid positive specimens missed ,detection of infec-tious disease markers in patients before transfusion or before surgery by CLIA had important significance .

OBJECTIVETo compare therapeutic effects between surgical and conservative treatment for postoperative lumbar discitis.

METHODSFrom January 2004 to January 2009, 41 patients (17 males and 24 females ranging the age from 37 to 68 years with an average of 53.6 years) with postoperative lumbar discitis were retrospectively studied and divided into two groups. There were 19 patients in operation group, 22 patients in conservative group. Clinical data and features,image data, laboratory examinations, antibiotics utilization, hospital stays and sequelae were recorded and analyzed. Visual analogue scales system (VAS) and Oswestry disability index (ODI) were applied to evaluate therapeutic effects.

RESULTSAll patients were followed up over 2 years. Imaging revealed good bone fusion and no occurrence of discitis. VAS score and ODI at 1 month, 1 year and 2 years were significantly improved after treatment (P < 0.01). While VAS and ODI in operation group at 1 month were improved more than that of conservative group (P < 0.01), and there was no significant difference between two groups at 1 year and 2 years (P > 0.01).

CONCLUSIONSurgical and conservative treatment for postoperative lumbar discitis is effective. Surgical treatment is superior to conservative treatment in a short time, while conservative treatment can achieve long-term satisfactory curative effects.

Adult ; Aged ; Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Discitis ; drug therapy ; surgery ; Female ; Humans ; Lumbar Vertebrae ; drug effects ; surgery ; Male ; Middle Aged ; Postoperative Complications ; drug therapy ; surgery ; Retrospective Studies ; Treatment Outcome

Objective To evaluate the changes in the expression of CXCR3 in regulatory T cells (Tregs) in the renal tissues of mice with renal ischemia-reperfusion (I/R) injury .Methods Forty-eight SPF male C57BL/6J mice ,aged 8-12 yr ,weighing 20-25 g ,were randomly divided into 3 groups ( n=16 each ) using a random number table:sham operation group (group S) ,group I/R and CD25 monoclonal antibody PC61 group (group P) . Bilateral kidneys were exposed and their pedicles were occluded for 45 min with atraumatic mini-clamp followed by 72 h reperfusion .PC61 250 μg was injected intraperitoneally at 24 h before the model was established .Blood samples were collected from the inferior vena cava at 24 and 72 h of reperfusion (T1 ,2 ) for determination of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations .Bilateral kidneys were obtained for determination of CD4+ CD25+ Foxp3+ Treg count and CXCR3+ CD4+ CD25+ Foxp3+ Treg count in renal tissues and the pathological changes of the kidney were scored .Results Compared with group S , the serum BUN and Cr concentrations and pathological scores were significantly increased at T1 ,2 in I/R and P groups ,and the number of CD4+ CD25+ Foxp3+ Treg and CXCR3+ CD4+ CD25+ Foxp3+ Treg was increased at T2 in I/R group ( P<0.05) .Compared with group I/R ,the serum BUN and Cr concentrations and pathological scores were significantly increased at T2 ,and the number of CD4+ CD25+ Foxp3+ Treg and CXCR3+ CD4+ CD25+ Foxp3+ Treg was decreased at T2 in P group ( P<0.05 ) .Conclusion Up-regulation of CXCR3 is helpful in migration of Tregs into the renal tissues of mice with renal I/R injury .

Objective To investigate the teaching effect of applying idea of ‘ integrating world with specialty' in teaching ward - round.Methods Totally 112 undergraduates from department of anesthesiology in Chongqing medical university were randomly divided into 2 groups:group C and group T.The students in group C and group T were received traditional method and teaching ward-round applying idea of ‘integrating world with specialty' respectively.The teching effects were compared.Results Constituent ratio of performance of written test and defence of case analysis in group C and group T were respectively as follow,excellent ( 12％,19％) vs.(31％,37％),good (25％,19％ ) vs.(50％,44％ ),middle (54％,50％ ) vs.( 19％,13％ ),bad (9％,12％ ) vs.(0,6％ ),and there were statistically differences between the two groups.Conclusion Teaching ward-round applying idea of ‘ integrating world with specialty' integrates medical knowledge with social skills and common sense of life,making it easier for medical students to understand and master professional knowledge,as a result of improving the students' ability of problem analysing and solving.

Objective To explore the value of 64-slice spiral CT angiography in diagnosis of pulmonary arteriovenous fistulas(PAVF).Methods 12 patients with suspect PAVF were performed by enhanced scan with 64-SliceCT.Two-dimensional and three-dimensional reformation were performed in all cases including coronal multiplanar reconstruction(MPR),maximum intensity projection(MIP),volume rendering(VR).Resnlts 12 cases were diagnosed as PAVF by 64-SliceCT angiography.Single PAVF in 7 cases,Multi-PAVF in 5cases.We found 20 lesions in 12 patients,Except direct multi-pulmonary arteriovenous fistulas in the area of near the heart in one case.Conclusion 64-slice spiral CT angiography is a useful and noninvasive means to identify PAVF and is also useful for therapeutic planning and postoperative follow-up.

Polymerase chain reaction was employed to amplify the whole HBV CP region from the serum of patients with chronic hepatitis B virus(HBV) infection, and then the PCR products were subcloned into pGEM Teasy vectors. Clones were randomly selected to be sequenced and the selected clones were compared to look for the difference.The sequencing results suggested that each sequence of selected clones was different and there were HBV quasispecies groups in patients. There were hot deletion region and point mutation near the TATA like box of CP gene. To address whether the mutations were responsible for the transcriptional activity, the wild type(wt) and the mutants of HBV CP genes were subcloned into pcDNA3 1( ) vectors, respectively. The reverse oriented clones were digested with KpnI and XhoI, and cloned into the KpnI and XhoI sites of the chloramphenicol acetyltransferase (CAT) expressing vector (pCAT3 basic).The recombinant CAT plasmids were transfected into HepG2 cells using lipofectamine PLUS reagent, and the CAT expression which indirectly represented the transcriptional activity of HBV CP lying upstream of CAT gene was detected with a CAT ELISA kit. The restriction enzyme digesting results indicated that the recombinant CAT plasmids were successfully constructed, and the transfection tests indicated that the transcriptional activity of the mutants with deletion or substitute point mutation of TATA like box were reduced in comparison with that of CPwt. The HBV CP gene heterogeneity downregulated the transcriptional activity to some extent.

Objective To explore the more effective measures for the prevention of deep vein thrombosis (DVT ) by comparing the different efficacy between the multimodal strategy and liberal measures .Methods From July 2011 to June 2013 ,medical records of 289 patients who had accepted total knee replacement (TKR) were collected .Patients were divided into two groups according to whether exploring to the multimodal strategy or liberal measures after TKR .The multimodal strategy consisted of sequentially used perioperative intermittent pneumatic compression ,intermittent pneumatic compression ,and postoperative continues femoral nerve block analgesia .Patients in group A were treated during July 2011 to June 2012 ,and accepted liberal measures for the prevention of DVT .Patients in group B were treated after June 2012 ,and accepted multimodal strategy .The data of each group were collected for statistical analysis on the following aspects :DVT occurrence rate ,DVT distribution ,age ,gender ,body mass index ,disease ,operation duration ,volume of blood loss and transfusion during operation phase ,drainage volume after TKR .Results The DVT occurrence rate of patients in group B were significantly lower than that of patients in group A (P<0 .05) .No significant difference were foun-ded in the DVT distribution between the two groups(P>0 .05) .Conclusion The multimodal strategy consisted of sequentially used perioperative intermittent pneumatic compression ,postoperative low molecular weight heparin ,and postoperative continues femoral nerve block analgesia is more effective than liberal measures for the prevention of DVT .

OBJECTIVETo compare the ability of osthole (OST) and genistein (GEN) in enhancing bone peak bone mass of rats to prevent osteoporosis.

METHODSThirty-six female one-month-old SD rats of (125 +/- 3) g body weight were randomly divided into three groups, 12 rats in each group, one group was orally administered osthole at 9 mg x kg(-1) d(-1), one group was given genistein at 10 mg x kg(-1) d(-1) and another was given equal quantity of distilled water as the control. The body weight was monitored weekly and the bone mineral density (BMD) of total body was measured every month. All rats were sacrificed after three months, the femoral bone mineral density, the serum levels of osteocalcin (OC) and anti-tartaric acid phosphatase 5b (TRACP 5b) were measured by Elisa. The bone microarchitectures were analyzed with micro-CT and the bone biomechanics properties were tested with universal material machine.

RESULTSNo significant differences were observed between O-treated or GEN group and the control for the food-intake and body weight during three months. However, the rats treated with OST had significant higher BMD for both total body and femur than the control and GEN group. The O-treated rats also had higher level of serum OC and lower level of TRACP 5b. Besides, they owned bigger bone volume/tissue volume, trabecular thickness, trabecular number but smaller trabecular spacing. In the three point bending tests of femurs,they were found to have larger maximum load, the young's modulus and structural model index (SMI).

CONCLUSIONOrally administered osthole could efficiently increase the peak bone mass of rats,which provide new ideas for preventing osteoporosis.

Acid Phosphatase ; blood ; Animals ; Body Weight ; drug effects ; Bone Density ; drug effects ; Coumarins ; pharmacology ; Female ; Femur ; diagnostic imaging ; drug effects ; pathology ; Genistein ; pharmacology ; Isoenzymes ; blood ; Osteocalcin ; blood ; Radiography ; Rats ; Rats, Sprague-Dawley ; Tartrate-Resistant Acid Phosphatase

BACKGROUND: Ischemia-reperfusion injury in the myocardium after cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) is an important pathologic basis of post-cardiac arrest of syndrome (PCAS), and apoptosis is one of the major mechanisms in myocardial ischemia-reperfusion injury. To lessen myocardial ischemia-reperfusion injury after cardiac arrest and CPR, it is important to reduce energy consumption and to increase energy supply in the myocardium. This study aimed to observe changes of cell apoptosis and expression of Bcl-2 and Bax protein on the myocardium after CPR in rats, and the protective effects of different doses of exogenous phosphocreatine (creatine phosphate, CP) on them. METHODS: A total of 32 male adult Sprague-Dawley rats were randomly divided into 4 groups: control group (group A), CPR group (group B), low-dose CP group (group C, CP 0.5 g/kg at beginning of CPR and 1.0 g/kg at 2 hours after CPR) and high-dose CP group (group D, CP 1.0 g/kg at beginning of CPR and 2.0 g/kg at 2 hours after CPR). Cardiac arrest was induced by asphyxiation and CPR started at 7 minutes after asphyxiation in groups B, C and D. Myocardium samples were taken at 24 hours after CPR. Cardiomycytic apoptosis was detected by the TdT-mediated dUTP-biotin nick end labeling (TUNEL) method. The expression of Bcl-2 and Bax protein was measured by immunohistochemistry. RESULTS: Cardiomyocytic apoptosis index (AI) and expression of Bcl-2 and Bax protein increased more significantly in groups B, C and D than in group A (P<0.01), but Bcl-2/Baxratio significantly decreased (P<0.01). Cardiomyocytic AI and expression of Bcl-2 and Bax protein decreased more significantly in groups C and D than in group B (P<0.01), but Bcl-2/Bax ratio increased more significantly (P<0.01). Cardiomyocytic AI and expression of Bcl-2 and Bax protein decreased more significantly in group D than in group C (P<0.05), but Bcl-2/Bax ratio increased more significantly (P<0.05). CONCLUSION: Exogenous phosphocreatine, especially at a large dose, could inhibit cardiomyocytic apoptosis and alleviate myocardial injury after CPR in rats.

OBJECTIVETo investigate the incidence of needlestick and sharps injuries among the medical staff in an upper first-class hospital and its risk factors and to provide a basis for the infection control department of hospital and health administration department to establish the policies for safe injection.

METHODSA questionnaire survey was conducted in 800 healthcare professionals in an upper first-class hospital in Nanjing, China to investigate the incidence of needlestick and sharps injuries in the past year. A total of 641 persons completed the questionnaire, including 239 doctors, 348 nurses, and 54 other healthcare workers. The obtained data were subjected to chi-square test and logistic analysis.

RESULTSNeedlestick and sharps injuries occurred in 373 of 641 healthcare professionals, with an incidence rate of 58.19%. There were significant differences in the incidence of needlestick and sharps injuries among the medical staff of different types or in different departments (P < 0.01). The syringe needles, glass, scalp infusion needles, and suture needles were the major medical apparatus that caused needlestick and sharps injuries; the incidence rate of injury caused by suture needles in doctors (48.21%) was significantly higher than that in nurses (6.72%) (P < 0.01), and the incidence rates of injuries caused by syringe needles, scalp infusion needles, and glass in nurses (71.15%, 59.68%, and 49.04%) were significantly higher than those in doctors (46.43%, 6.25%, and 16.96%) (P < 0.01); compared with nurses, the doctors had higher incidence rates of injuries due to body fluid or tissue sample collection, wound flushing, suture, and cutting (P < 0.05); compared with doctors, the nurses had higher incidence rates of injuries due to injection, intravenous infusion, heparin cap sealing, intravenous infusion line connection, and venous or arterial blood collection (P < 0.05).

CONCLUSIONNeedlestick and sharps injuries are common in medical staff. The results of the study on risk factors provide a basis for the infection control department of hospital and health administration department to establish the policies for safe injection.

Accidents, Occupational ; statistics & numerical data ; China ; Female ; Health Personnel ; Humans ; Incidence ; Male ; Needlestick Injuries ; epidemiology ; Risk Factors ; Surveys and Questionnaires