Diabetic Ketoacidosis ; Humans ; Infant, Newborn ; Male

Objective:The abstraction of characteristics in CT perfusion image is crucial in the clinical diagnosis of brain infarction and cerebral tumor.Methods:After describing the relevant parameters of CT cerebral perfusion imaging,such as cerebral blood flow (CBF),cerebral blood volume (CBV),the mean transition time (MTT) and the permeability surface (PS).With using Visual C ++ programming and CT scan images sequence obtained,the time-density curves of the brain tumor region were visualized.The more accurate hemodynamic parameters were calculated through an improved algorithm basing on the deconvolution and measuring method of the length,angle,area and other parameters.Conclusion:The quantitative analysis of feature parameter is of great benefit to clinical doctor in making timely diagnosis and treatment of brain tumor.

Objective To investigate the expression changes of nuclear factor-kappa B(NF-kB) and intercellular adhesion molecule-1(ICAM-1)in rats with severe acute pancreatitis(SAP)and the effect of pretreatment of pioglitazone,a specific peroxisome proliferator-activated receptor?(PPAR?),)ligand, on the development of SAP.Methods Fifty-four SD rats were divided into sham operation group(C), SAP group(A)and pioglitazone pretreatment group(Ⅰ).The SAP was induced by retrograde infusion of 5% sodium taurocholate(0.1 ml/100 g)into the biliopancreatic duct.The rats inⅠgroup were intraperi- toneally injected with pioglitazone(2 mg/100 g)two hours before operation.The rats were sacrificed at 3,6 and 12 hrs,the blood,ascites and pancreatic tissues were collected(6 rats once for each group). The expressions of NF-kB and ICAM-1 in pancreatic tissues were measured by immunochemistry,mean- while the serum amylase,the amount of ascitic,pancreatic wet/dry ratio were measured.The pathologi- cal changes of pancreatic tissues were observed by immunochemistry staining with hematoxylin and eosin and the score of the tissues were evaluated.Results Pretreatment with pioglitazone could significantly attenuated the severity of SAP,including reduction of amylase and ascites,and the mass and pathological scores of the pancreatic tissue were decreased after 6 hrs of medication.The expression of ICAM-1 and NF-kB activity were inhibited.Conclusions Above findings demonstrate that pioglitazone can attenuate the severity of SAP by inhibition of ICAM-1 expression and NF-kB activation.The beneficial effects of pioglitazone might be due to its anti-inflammatory activities.The pioglitazone can be used as a new drug in treatment of SAP.

Objective: To investigate the effects of dexmedetomidine (DEX) on oxidative stress and systemic inflammatory response syndrome(SIRS) during cardiopulmonary bypass (CPB).Methods: Totally 62 patients scheduled for mitral valve replacement surgery were enrolled in this study and randomly assigned to DEX group with constant infusion of DEX (0.5 μg·kg-1 ·h-1 , n =31) and the control group with the same amount of 0.9% sodium chloride injection(n =31).A volume of 4 ml of jugular vein blood was respectively withdrawn before the induction of anesthesia (T0), at 10 min after aortic-off clamping(T1), the end of bypass(T2), 4h after bypass(T3),12h after bypass(T4) and 24h after bypass(T5).The serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6(IL-6), interleukin-8(IL-8) and interleukin-10(IL-10) were determined.Results: The serum CRP in both groups increased remarkably at T1-T5 , while the serum CRP in DEX group was significantly lower than those in the control group at T3-T5.The serum TNF-α increased remarkably in control group at T2-T4, while the serum TNF-α increased remarkably in DEX group at T2-T3;the serum TNF-α in DEX group was significantly lower than those in the control group at T3-T4.The serum IL-6, IL-8, IL-10 in both groups were increased remarkably at T2-T5, T1-T5,T1-T3, respectively.The serum IL-6 and IL-8 in the DEX group were significantly lower than those in the control group at T2-T4 while the serum IL-10 in the DEX group was significantly higher than that in the control group at T1-T3.The serum WBC in both groups at T3-T5 were higher than those at T0, while the serum WBC in the control group was significantly higher than that in the DEX group at T3-T5.However, the differences between the two groups at mechanical ventilation time, ICU observation time, the incidence of postoperative SIRS after 24h, hospitalization days, and the adverse reactions were not statistically significant.Conclusion: DEX has notable protective effects on systemic inflammatory response syndrome during extracorporeal circulation.

Objective To explore the three criteria of Ranson,CT severity index (CTSI) and the bedside index of severity in acute pancreatitis (BISAP) in assessment of severity and prognosis of acute pancreatitis.Methods A total of 503 diagnosed acute pancreatitis patients from January 2008 to April 2011 were studied retrospectively,including 356 mild acute pancreatitis (MAP) cases and 147 severe acute pancreatitis (SAP) cases.The differences of the three criteria of Rason,CTSI and BISAP in assessment of severity and prognosis of acute pancreatitis were compared with receiver operating characteristic (ROC) curve.The SAP group was divided into no organ failure group and organ failure group,and the predictive value of the three criteria in acute pancreatitis with organ failure was compared.Results There was significant differences between MAP group and SAP group with Rason,CTSI and BISAP score (x2 =236.88、126.24 and 101.27,P＜0.01).The sensitivity (97.3％) and AUC value (0.93) of Ranson criterion was highest.In no organ failure group and organ failure group of 147 SAP patients,there was significant difference between Ranson criterion and BISAP criterion (x2 =17.67 and 26.12,P＜0.01),both sensitivity were 100％,the specificity were 96％ and 85％ respectively,and the area under ROC curve (AUC) value of BISAP criterion (0.8) was the highest.In illness improved group and deteriorated group,the difference of score between Ranson criterion and BISAP criterion was significant (x2 ＝ 9.53 and 10.19,P＜0.05),and the AUC value of BISAP criterion (0.74) was the highest.Conclusions All three criteria can be used to determine the severity of acute pancreatitis.In predicting the risk of SAP with organ failure and prognosis,BISAP criterion is better than Ranson criterion.BISAP criterion is simple and easy to practice,which provides an important rule for evaluating the clinical condition of acute pancreatitis.

Abstract: To report the diagnosis, treatment and outcome of 4 patients with hematological diseases complicated with Aeromonas hydrophila bloodstream infection in the Second Affiliated Hospital of Kunming Medical University, further clarify the importance of blood culture and deepen the clinical understanding of the disease. Four patients with hematological diseases complicated with Aeromonas hydrophila bloodstream infection treated in the Second Affiliated Hospital of Kunming Medical University from 2017 to 2021 were recruited as the study objects. The clinical manifestations, blood culture collection, detection time of Aeromonas hydrophila, laboratory examination, treatment and prognosis of the patients were retrospectively analyzed. In this study, 4 cases were male patients with hematological diseases, who were in myelosuppression after chemotherapy. After fever, blood culture was collected and Aeromonas hydrophila was detected. The positive time of blood culture in 4 cases ranged from 4 to 11 hours. The results of antibiotic sensitivity showed that it was highly sensitive to the second, third and fourth generation cephalosporins, quinolones and carbapenems. Four patients were treated with imipenem cilastatin sodium in the early stage, and one patient recovered after active anti infection and leukocyte raising treatment. One patient did not complete chemotherapy due to a request for discharged, and the follow-up was unknown. Two patients developed rapidly into necrotizing fasciitis and died later. Hematological diseases complicated with Aeromonas hydrophila bloodstream infection are rare, but the mortality rate is high. For patients with repeated fever and considering infection, blood culture should be carried out as soon as possible to confirm the pathogen and drug sensitivity test. During clinical treatment, the treatment should be adjusted in time in combination with the patient's situation. In addition to anti-infection treatment, the patient's immunity should be improved and the development of necrotizing fasciitis should be vigilant. Keywords: Aeromonas hydrophila; hematologic diseases; leukemia; bloodstream infection; blood culture; necrotizing fasciitis

OBJECTIVETo observe analgesic effect and safety of acupuncture compound anesthesia in transvaginal ultrasound-guided oocyte retrieval.

METHODSThree hundred and sixteen cases undergoing in vitro fertilization and embryo transfer (IVF-ET) were randomly allocated to an acupuncture compound anesthesia group (n = 146) and a simple Pethidine group (n = 170). They received respectively electroacupuncture combined with intramuscular injection of Pethidine and simple intramuscular injection of Pethidine 30 min before oocyte retrieval.

RESULTSThe acupuncture compound anesthesia group was significantly better than the simple Pethidine group in the pain rating and pain score (P < 0.01); the incidence rate of abdominal pain at 1 h and 2-5 h after oocyte retrieval in the acupuncture compound anesthesia group was lower than that in the simple Pethidine group (P < 0.01).

CONCLUSIONIn transvaginal ultrasound-guided oocyte retrieval, acupuncture compound anesthesia has the advances of safety, high effectiveness, rapid recovery after oocyte retrieval, and few side effects.

Acupuncture Analgesia ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Oocyte Retrieval ; methods ; Ultrasonography ; Vagina ; diagnostic imaging

Objective To explore the influence of Danhong injection on neurological function and concentration level of high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor alpha(TNF-α),interleukin 6 (IL-6) in patients with acute cerebral infarction.Methods According to random number table method,eighty patients with acute cerebral infarction were randomly divided into a control group and a treatment gruop.Both groups were treated by aspirin,vitamine E,C and symptomatic treatment.At the same time,the treatment group was added Danhong injection,the control group was added low molecular dextran and citicoline,once a day,for 14 days.Results After the treatment,the concentration levels of hs-CRP [treatment group (2.11 ± 0.31) mg/L,control group (2.72 ± 0.23) mg/L],TNF-α [treatment group (0.35 ± 0.07) μg/L,control group (0.51 ± 0.06) μg/L],IL-6[treatment group (18.17 ± 3.15) pg/ml,control group (28.13 ± 4.97) pg/ml]was significantly lower than those before the treatment in both groups (P＜0.05).However,the concentration level of hs-CRP,TNF-α,IL-6 in treatment group was significantly lower than that in control group (P＜0.05).ADL scores [treatment group (20.26±2.17) scores,control group (28.83 ± 2.93) scores] and NIHSS scores [treatment group (18.34± 1.25) scores,control group s (22.52 ± 1.09) cores] were significantly lower after treatment than those before the treatment in both groups (P＜0.05),but all scores in treatment group were significantly lower than those in control group (P＜0.05).Conclusion Danhong injection decreased the concentration level of hs-CRP,TNF-α,IL-6 and NIHSS scores,ADL scores significantly.It also alleviated neurological function defect,enhanced the patient's activities of daily living,and reduced the disability rate of ischemic brain damage.

Objective To explore the methods of the nutritional support of children with severe sepsis.Methods The biochemical index,nutrition index,blood gas,blood routine and 24 hours urinary urea nitrogen of 198 children with severe sepsis were detected after hospitalization.Enteral nutrition,parenteral nutrition,or enteral and parenteral nutrition at the same time were selected for every children according to patients status.Children with parenteral nutrition were divided into glutamine (Gln) group and non-Gln group.Nutrition and metabolism indexes of survival and dead children were detected,including blood glucose,C-reactive protein,hemoglobin (Hb),pH,blood sodium,blood potassium,alanine transaminase,blood urea nitrogen,creatinine,blood lacticacid,lactate clearance rate,blood triglycerides,blood total cholesterol,serum pre-albumin (PA),retinal-binding protein (RBP),serum albumin (ALB) and 24 hours urinary urea nitrogen.The intake of calories were compared between survival and dead children before nutrition support (0 d),3 d and 7 d after nutrition support.Immunoglobulins of Gln group and non-Gln group were compared.Results The nutrition indexes of the survival group were higher than those of dead group [PA (130.0 ± 30.0) mg/L vs (50.8 ±20.5) mg/L,RBP(22.3 ±10.3) mg/L vs (15.7 ±6.7) mg/L,ALB(35.3 ±8.1) g/L vs (28.7 ±6.2) g/L,Hb(113.2 ±27.7) g/L vs (95.3 ±10.6) g/L,IgA(0.40 ±0.03) g/L vs (0.40 ±0.03) g/L,IgM(0.52 ±0.18) g/L vs (0.49 ±0.03) g/L] (P ＜0.05).The intake calories of survival group in 3 d and 7 d after nutrition support were (50.32 ±2.76) kcal/(kg·d) and (65.70 ±3.25) kcal/(kg·d),which were significantly higher than those of dead group [(32.54 ± 1.72) kcal/(kg·d) and (46.12 ± 1.08) kcal/(kg·d)).Among the survival children with parenteral nutrition,the levels of immunoglobulin in Gln group were higher than non-Gln group [IgG(4.93 ± 2.1) g/L vs (4.01 ± 1.03) g/L,IgA (0.31 ± 0.07) g/L vs (0.19 ±0.03) g/L,IgM(0.52 ±0.08) g/L vs (0.32 ±0.10) g/L] (P ＜0.05).Negative nitrogen balance was better in Gln group as(-2.5 ± 1.4) g/d than non-Gln group as (-5.3 ± 1.3) g/d(P ＜0.05).Conclusion Children with severe sepsis manifeste significantly increased metabolic rate and energy consumption,the protein decomposition utilization is greater than the synthetic with negative nitrogen balance.Children with more severe sepsis have lower metabolic indexes,nutrition indexes,and immunoglobulin.It is necessary for children with severe sepsis to use glutamine while having parenteral nutrition.

Objective To obtain better insights into transmission dynamics of macrolide resistance genes between human and animal Enterococcus strains.Methods The antimicrobial susceptibility to 8 anti-bioties of 52 Enterococci isolated from animal and 55 Enterococci isolated from human was determined.PCR was used to detect the macrolide resistance genes ermB and mefA,tetracycline resistance genes tetM,and the integrase gene int of Tnl545 of the total 107 strains.Forty-nine ermB positive strains were chosen to be se-quenced.Filter mating experiments were taken.Results The resistance rate to erythromycin were 89.09% and 80.77%for isolates from human and animal:and resistance rate to tetracycline were 80.00%and 67.3l%for isolates from human and animal.respectively.All isolated Enterococci strains were found sensi-tive to vancomycin ermB was detected in 61.82% human Enterococci and 53.85% porcine ones.Identical er-mB gene sequences were found in animal and human Enterococci.Transfer of the ermB gene from porcine E.faecalis to human E.feacalis was successful.and the transfer frequency is 1.2×10-5.Conclusion En-terococci have a high resistance rate to erythromycin and some other antibio tics,especially in pediatric iso-lates:but still very sensitive to glycopeptide.ermB was the predominant genes for macrolide and tetracy-cline.Identical ermB gene sequences were present in animal and human Enterococci and that transfer of the ermB gene from porcine E.faecalis to human E.faecalis and vice versa is possible.but probably occurs at a low frequency.