Objective To detect the phenotype and genotype of 11 vancomycin-resistant enterococci(VRE).Methods Disk diffusion test,microdilution broth method,VITEK-2 and Etest were used to determin the susceptibility of 11 VRE to vancomycin and teicoplanin. MIC to 10 antimicrobial agents were determined with microdiluton broth method. vanA, vanB ,vanC_1, vanC_2 were detected with multiplex PCR and were further confirmed by DNA sequencing. TEM, tetM,ermB,aac(6′)/aph(2′′),ant(6)- I,aph(3′)-Ⅲ were detected with PCR.Results Susceptibilities of 11 VRE to vancomycin and teicoplanin were different in four vitro susceptibility testing methods. VRE showed resistance to erythromycin(9/11),ciprfloxacin(7/11),levofloxacin(7/11),rifampin(8/11) and chloramphenicol(7/11). HLGR and HLSR is 10/11 and 9/11 respectively. 1 VanA,4 VanB,5 VanC_1 and 1 VanC_2 were detected and their phenotypes confirmed to the genotypes. High rate of TEM(8/11), tetM(6/11), ermB(7/11), aac(6′)/aph(2′′)(7/11), ant(6)- I(5/11) and aph(3′)-III(9/11) were detected in 11 VRE.Conclusions VRE screening test and the determination of MIC are reliable in finding VRE. PCR is precise and specific in the testing and confirmation of VRE. The high rates of drug resistance genes showed the complicated mechanisms of drug resistance in VRE.

BACKGROUND:An amyloid-beta (Aβ) aggregation in the brain can induce nerve cel apoptosis, loss of synapses and functional damage. However, there is stil no effective intervention. Improving the synaptic plasticity provides an important direction for the treatment of early Alzheimer’s disease. OBJECTIVE: To screen the best model of Alzheimer’s disease and to explore the expression of synapse-associated proteins in Aβ25-35-injured PC12 neurons. METHODS:PC12 cels were induced by 50 μg/L nerve growth factor to differentiate into neuronal-like cels. Then, these cels were treated with Aβ25-35 at different concentrations. Consequently, cel survival rate was detected using cel counting kit-8; neurogranin and neuregulin immunofluorescence stainings were used to observe morphological changes of model cels; western blot used to detect the expression level of neurogranin, calmodulin kinase II, postsynaptic density-95 proteins. RESULTS AND CONCLUSION:Over time, the survival rate of PC12 neurons induced by Aβ25-35 was decreased in a dose-dependent manner. Shortened synaptic length, neuronal atrophy and sparsely interconnected neurons were visible. Expression levels of neurogranin, calmodulin kinase II and postsynaptic density-95 proteins were al down-regulated. These findings indicate that to screen the cel model of Alzheimer’s disease, the optimal concentration and interventional time of Aβ25-35are 10 μmol/L and 48 hours, respectively.

Intertrochanteric fracture,a common kind of injury in orthopaedic surgery,often requires surgical intervention,especially the unstable ones.Since far back in 1995,Baumgaertner et al.recommended using the distance between the screw tip and femoral head apex (tip-apex distance,TAD) as a predictor of the risk of lag screw cutout,the importance of TAD has been recognized by orthopaedic surgeons.This concept has been widely accepted in practice,and even used as a standard in determining the helical blade position.It is not clear,however,whether the helical blade system is equal to lag screws in terms of TAD.After the limitations of TAD had been reported,Kuzyk et al.proposed a tip-apex distance referenced from the calcar (Cal-TAD) as a predictor of lag screw cutout to improve the concept further.In this article,these concepts and the latest clinical applications of TAD and Cal-TAD are reviewed based on the publications available.

Health Promotion ; Humans ; Pilot Projects ; Workplace

Objective To find the reasonable treatment strategy by analyzing the failure pattern and survival rates of radical resection of gastric cancer.Methods Data were collected from 110 patients with radical resection and adjuvant treatment of gastric cancer,counted up the number of cases that failure in different ways.The survival rate after operation was calculated by Kaplan-Meier.The chi-square test was used to find the differences in survival rates between different differentiation,location and gender.Results 1,3,5-year survival rates of 110 cases were 83.64％ (92/110),46.36％ (51/110),35.45％ (39/110),respectively.Malignant ascites was the main failure type for postoperative of gastric cancer,approximately accounting for 41.51％ (22/53),abdominal lymph node metastasis accounting for 30.19％ (16/53),anastomotic recurrence accounting for 13.21％ (7/53),abdominal implantation and mesenteric metastasis accounting for 9.43％ (5/53),organ metastasis accounting for 5.66％ (3/53).The 5-year local failure rate of concurrent chemoradiotherapy group was a little lower than that in adjuvant chemotherapy alone group (15.00％ ∶22.22％).The 1-year survival rates of adjuvant chemotherapy alone and concurrent chemoradiotherapy group were 84.44％ and 80.00％ respectively,with no significant difference (x2 =0.236,P =0.627).However,the 3,5-year survival rates of the two groups were 66.67％ vs 40.00％ and 53.33％ vs 20.00％ respectively,with statistically significant differences (x2 =4.930,P =0.026 ; x2 =7.294,P =0.007).Conclusion Peritoneal metastasis is the most common failure pattern for the patients with gastric cancer who received radical operation and adjuvant treatment.The relapse rate of concurrent chemoradiotherapy group is lower than that in adjuvant chemotherapy alone group,but the overall survival rate is similar.

BACKGROUND: With the development of thrombolysis therapy in recent years, there has been an increasing focus on the protective effect of ischemic reperfusion injury (IRI) and its mechanism at home and abroad,and aspirin is of great importance in the treatment of thrombus diseases owing to its powerful antiplatelet aggregative activity.OBJECTIVE: To explore the protective effect of aspirin on the gerbil brains with IRI and its influence on the intercellular adhesion molecule (ICAM) and calcitonin gene-related peptide (CGRP) expressions.DESIGN: A randomized controlled animal experiments.SETTING: Department of Neurology, Jinan Municipal Central Hospital,College of Clinical Medicine, Shandong University.MATERIALS: The experiment was performed at the Physiological Laboratory of Taishan Medical University from December 2001 to June 2002.Sixty-three healthy male gerbils of Mongolian specimen were randomly assigned into sham group, IRI group and aspirin group with 21 in each group. And each group was further divided into three subgroups according to the time after IRI: 24 hours, 3 days and 7 days, with 7 gerbils for each.METHODS: The models of global brain IRI were established by bilateral carotid artery occlusion. Sham group: The unfolded bilateral carotid artery was not occluded; IRI group: The unfolded bilateral carotid artery was occluded by bulldog clamp for 7 minutes, and then the blood circulation was recovered by removing the clamp. Aspirin group: Before the operation,50 mg/kg enteric-coated aspirin was infused via gastric canal. And the same procedures as IRI group were performed. The gastric infusion of aspirin was given daily until the gerbils were executed at 24 hours, 3 days and 7 days after IRI for brain tissue examinations. The immunohistochemistry SABC method was applied to detect the changes of ICAM 1 and CGRP expressions as well as the influence of aspirin on the two.MAIN OUTCOME MEASURES: The expressions of ICAM and CGRP in brain tissues.RESULTS: A total of 63 gerbils were involved in the result analysis.①Changes of ICAM expression: In IRI group, the expression of ICAM began to increase at 24 hours after IRI,enhanced remarkably at 3 days and maintained at high levels at 7 days,with the significant difference compared with sham group [IRI group: (3.36±2.26)%, (5.68±3.13)%, (4.98±2.10)%; Sham group: (1.53±1.07)%, (1.56±1.23)%, (1.62±1.33)%, P ＜ 0.05];However,the ICAM expression was significantly lower in aspirin group than in IRI group at different time points [(0.96±0.83)%, (2.76±2.10)%,(1.96±1.09)%, P ＜ 0.05].②Changes of CGRP expression: At the different time points after IRI,the CGRP expression was weakly positive in IRI group [(3.12±2.26)%, (2.68±2.04)%, (2.57±1.97)%], but strongly positive in aspirin group [(4.98±2.47)%, (5.97±2.35)%, (6.04±2.40)%].CONCLUSION: IRI can increase the ICAM 1 expression while inhibit the CGRP expression; Aspirin can make great impacts on brain protection by inhibiting ICAM 1 expression and reinforcing the CGRP expression.

Aim To observe the protection effect of Tribulus terrestris saponin monomer B (TTSMB) on cadiocytes impaired by hypoxia-reoxygenation (H/R).Methods Cadiocytes of neonate rat were cultivated for 72 hours and divided into normal control group, H/R group,GSTT 100 mg·L~(-1) group and TTSMB 10,1,0.1 nmol·L~(-1) group.Morphocytology change of cadiocytes was observed after the treatment.Cadiocyte survival rate was detected with MTT colorimetric method.Levels of creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), malondialdehyde (MDA), and activity of superoxide dismutase (SOD) were determined. Apoptosis rate was detected with flow cytometry.Expression of caspase-3 was examined with western blot.Results Compared with the control group, the survival cell number in H/R group decreased obviously, content of CK,LDH, AST, MAD increased, and activity of SOD decreased (P<0.01).Compared with the model group, the survival cell population increased in TTSMB 10,1,0.1 nmol·L~(-1) group (P<0.05 and P<0.01).Contents of CK, LDH, AST, MAD decreased, whereas the activity of SOD increased (P<0.05 and P<0.01).Apoptosis rate and expression of caspase-3 also reduced in TTSMB 10,1,0.1 nmol·L~(-1) group.Conclusion TTSMB has significant cadiocytes protective effect against H/R and inhibits cadiocyte apoptosis,and the mechanism depends on the effect against oxygen free radical.

Objective To report the clinical outcome of dual plating in treating humeral intercondylar fractures. Methods From February 2002 to June 2003, 22 cases of humeral intercondylar fractures were treated with dual plating. It involved 15 males and 7 females, whose average age was 42.2 years with a range from 19 to 67 years. According to the AO classification, 5 cases were of type C1, 11 of C2 and 6 of C3. The posterior midline approach was selected, and the intercondylar fracture ends were exposed through the trans-olecranon osteotomy. The intercondylar fragments were fixed first, in 6 cases with C3 type fractures, the auto-grafting from the iliac bone was performed because of comminution, then the supracondylar fracture was fixed with dual plating. The semi-tubular plates was applied on the medial epicondylar crest of the humerus; and the reconstruction plate was implanted on the postero-lateral side, the two plates were kept in 90? with each other. The osteotomized ends were fixed with tension band. Results All the 22 patients were followed up for 13-29 months ( mean, 20.2 months ). By the end of the first postoperative month, the elbow flexion averaged 86.2?( range, 80?-105?), and the loss of extension averaged 40.7?(range, 30?-45?). But at the 12th month, the flexion improved to 117?(range, 95?-135?), and the extension loss decreased to 23.2?( range, 10?-35?). The averaged union time was 15.7 weeks with a range of 12 to 20 weeks. Assessed by the Jupiter scoring system, 3 cases were rated as excellent, 15 as good and 4 as fair. Complications included 4 cases of incision exudation, 3 K-wires withdrawal, 1 ulnar neuropathy and 3 heterotopic ossification. But no incision necrosis, deep infection, loosening or breakage of the internal fixators occurred. Conclusion The dual plating is able to provide stable and durable fixation for the humeral intercondylar fractures. In addition, it can prevent malunion or nonunion effectively, and decrease the related complications significantly. This method is helpful to improve the functional recovery of the elbow joint satisfactorily.

BACKGROUND:Femoral neck fracture combined with femoral shaft fracture as a high-energy injury exhibits some difficulties in its clinical treatment because of bone chips and bone defects. Bone and cel transplantations have been used recently in order to effectively fil the bone defect area. OBJECTIVE:To explore the therapeutic effect of bone transplantation versus cel transplantation for treatment of femoral neck fracture combined with femoral shaft fracture. METHODS: A retrospective analysis was performed in patients with femoral neck fracture combined with femoral shaft fracture, who respectively underwent internal fixation with bone transplantation, tissue transplantation and cel transplantation. Perioperative indexes, incidence of complications and Harris scores were observed and compared. RESULTS AND CONCLUSION: (1) Femoral neck fractures are most commonly classified into Garden type, AO type and Pauwel type. Fracture classification aims to unify standards, which is easy to guide treatment and scientific research. (2) Internal fixation with bone transplantation and tissue transplantation is easy, safe and effective to promote fracture healing and improve hip function, which is an effective way to repair femoral neck fractures with femoral shaft fractures. (3) Compared with autogenous bone graft, alograft transplantation materials as finished products have a variety of sources, and have indications and efficacy similar to non-vascularized bone graft, which are suitable for clinical practice, but long-term effects need to be furtherexplored. (4) Internal fixation with cel transplantation is simple, reliable and effective for femoral neck fractures with femoral shaft fractures, which provides a new idea to reduce the early incidence of femoral head necrosis.

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