Objective To investigate the incidence of brain injury and analyze the risk factors in very low birth weight infants (VLBWI),in order to explore methods to improve neurodevelopmental outcome.Methods This was a retrospective study in which we reviewed the incidence of brain injury in 326 VLBWI who admitted to our NICU from October 2007 to September 2014.The differences of general characteristics,high-risk perinatal factors,complications of prematurity and respiratory support in brain injury group (n =132) and no brain injury group(n =194) were analyzed,and Logistic regression was used to analyze the related risk factors.Results In 326 VLBWI,premature brain injury was observed in 132 cases(incidence of 40.49％).Hemorrhagic brain injury was observed in 80 cases(incidence of 24.54％,80/326),in whom total 66 cases (20.25％,66/326) with periventricular-intraventricular hemorrhage (PVH-IVH),41 cases with PVH-IVH grade Ⅰ-Ⅱ,25 cases with PVH-IVH grade Ⅲ-ⅣV.Non-hemorrhagic brain injury was observed in 52 cases (incidence of 15.95 ％,52/326),in whom 46 cases with periventdcular leukomalacia (14.11％,46/326).There were no statistically significant differences in general characteristics except gender differences between the two groups.Further analysis of the 28 factors including high-risk perinatal factors,premature complications and respiratory support between the two groups,showed that there were significant differences in 16 factors including asphyxia,chorioamnionitis,antenatal steroid use,neonatal respiratory distress syndrome,hypoxemia,apnea,pulmonary hemorrhage,patent ductus artedosus,hypotension,acidosis,hypocapnia,anemia,hyperglycemia,thrombocytopenia,high frequency ventilation and extrautedne growth retardation.Further binary Logistic regression analysis showed that antenatal steroids use was negatively correlated with brain injury,chorioamnionitis,acidosis,and patent ductus arteriosus were positively correlated with brain damage,the relative risks of premature brain injury was 0.108,7.222,3.045 and 4.565 respectively.Conclusion The mortality rate and the incidence of brain injury in VLBWI are still high.Chorioamnionitis,acidosis and patent ductus arteriosus are closely associated with premature brain damage.Antenatal steroids can prevent premature brain injury.We should pay much attention to these risk factors in the perinatal management of VLBWI,in order to decrease the incidence of premature brain injury.

The pathogenesis of multiple sclerosis ( MS) involves alterations to multiple pathways and processes, which represent a significant challenge for developing more-effective therapies.In MS, abnormalities have been identified in several cytokine-signaling pathways, as well as those of other immune receptors.Among the downstream molecules implicated are Jak/Stat, NF-κb, ERK1/2, p38 or Jun/Fos, current MS drugs target some of these pathways.This article will with the aid of the latest research results of systems biology approaches that study pathway dysregulation in the process of MS development, targeting these relevant MS-signaling pathways, offers the opportunity to accelerate the development of novel individual or combination therapies for the future of new drug research.

Objective An investigation on social function cognition for bedside care service at patient's home was conducted in the residents aged over SS years in Jingshan Community,Dongcheng District,Beijing,to lay a scientific basis for provision of it.Methods Ninety-seven residents aged over 55 years were selected from 58 families with systematic sampling in Jingshan Community by a questionnaire interview,including history of illness,income,medical expense,awareness of bedside service at patient's home,etc.Results Totally,98.9 % of the residents suffered from at least one kind of chronic disease,98.9 % of them never received bedside care service at their homes,94.9% of them only knew a little of such kind of health care service,91.85% of them knew some social function of it,and 84.5 % of them did not know the criteria of payment for the service.Conclusions Publicity of bedside care service at patient' s home should be strengthened,focusing on its social function,inexpensiveness,convenience,etc.Function of bedside service should be perfected further,with quality care,to make it an important part of community health care.

Objective To study the outcome of surgical therapy of perforation of gastric cancer. Methods The clinical data of 37 cases with perforation of gastric carcinoma which underwent different surgical procedures were analyzed retrospectively. Among them,24 cases underwent partial gastrectomy,8 cases underwent radical mastectomy,4 cases had repair of perforation. 1 case received non-operative therapy. Results The preoperative diagnotic rate was 24.3%,and misdiagonsis rate was 75.7%. The perioperative mortality rate was 5.4%,including 1 case that underwent repair of perforation. The post-operative complication rate of patients undergoing palliative gastrectomy,radical gastric cancer operation and repair of perforation was 41.7%,25.0% and 75.0%,respectively,and the mean survival time was 25 months,29 months and 3.0 months,respectively.The partial gastrectomy and radical mastectomy patients had significantly better outcomes than those who underwent repair of perforation or received non-operative therapy.Conclusions For patients with perforation of gastric cancer with resectable lesions and who are in good general coaditon,a one-stage radical gastric resection or palliative subtotal gastrectomy can be performed.

We developed a three-dimensional finite element model of the shoulder glenohumeral joint after shoulder arthroplasty including humerus shaft, scapular, scapular cartilage and eight muscles, while each of the muscles was simulated with 50 spring elements. To reduce the element number and improve the analytical precision, we used mixed tetrahedral and hexahedral elements in the model. We then used the model to calculate the biomechanics of the shoulder glenohumeral joint after hemiarthroplasty during humeral external rotation. Results showed that the maximum joint reaction force was 374.72 N and the maximum contact stress was 6. 573 MPa together with the contact areas at 40 degrees external rotation. These might be one of the reasons for prosthetic disarticulation, and would provide theoretical bases to prosthetic design.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Humeral Head ; anatomy & histology ; Models, Anatomic ; Prosthesis Design ; Range of Motion, Articular ; Rotation ; Shoulder Joint ; anatomy & histology

BACKGROUND: The cerebral edema after brain injury is associated with the generation of oxygen-derived free radicals after ischemia reperfusion.Hyperbaric oxygen can relieve the cerebral edema and ameliorate the tissue hypoxia.OBJECTIVE: To observe the influence of hyperbaric oxygen on cerebral edema and the lipid peroxide after brain injury in rats.DESIGN: A random controlled trial.SETTING: Institute of Field Surgery, Daping Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Department of Hyperbaric Oxygen and the Fourth Room of the Institute of Field Surgery,Daping Hospital of the Third Military Medical University of Chinese PLA between March and June 2004. Fifty-eight 3-month-old Wistar rats of clean degree with the body mass of (256±23) g were used.METHODS: The 58 rats were randomly divided into control group (n=17),brain injury group (n=22) and hyperbaric oxygen group (n=19). The struck test was not conducted in the control group. The rats in the brain injury group and hyperbaric oxygen group were anesthetized, then the right calveria was struck with the BIM-Ⅲ striker, and closed brain injury was duplicated. After brain injury, rats in the hyperbaric oxygen group were placed into a hyperbaric oxygen chamber of 2 absolute atmospheric pressures for 2 hours, and the rats were killed at 24 hours after injury by taking blood from heart.MAIN OUTCOME MEASURES: The water content of brain tissue, content of Evans blue, and the contents of the lipid peroxide malondialdehyde (MDA) in brain and plasma after brain injury were observed.RESULTS: Totally 41 rats were injured, and 7 died after 24 hours, including 2 in the hyperbaric oxygen group and 5 in the brain injury group, and brain tissue: The water content of right brain in the brain injury group was obviously higher than that in the hyperbaric oxygen group and control group [(79.06±0.52)%, (78.38±0.37), (78.21±0.25)%, t=3.022-3.285, P ＜ 0.01]. In the brain injury group, the water content of right brain was obviously higher than that of left brain [(79.06±0.52), (78.57±0.14)%, t=2.651, P ＜ 0.05].injury group was obviously higher than that in the hyperbaric oxygen group and control group [(197.28±31.49), (167.65±25.88), (145.07±30.45) nmol/g,t=2.231-3.347, P ＜ 0.01-0.05]. In the brain injury group, the MDA content of right brain was obviously higher than that of left brain [(197.28of MDA: It was markedly higher in the brain injury group than in the control group [(2.69±0.54), (1.94±0.40) μmol/L, t=2.473, P ＜ 0.05].CONCLUSION: The hyperbaric oxygen therapy after brain injury can obviously decrease the water content and MDA content in brain tissue of the injured side, and such is the case with the MDA content in plasma,which is indicated that hyperbaric oxygen has a therapeutic effect on brain injury.

Objective To determine the electrical conductivity of cerebrum, liver, lung and muscle of rats at different postmortem intervals for investigating the relationship between EC and PMI. Methods Healthy Sprague-Dawley rats were sacrificed and kept at constant temperature of 25°C. Cerebrum, lung, liver and muscle were extracted at different PMIs of immediate (0d), 1d, 2d, 3d, 4d, 5d, 6d and 7d, and their extraction liquids were prepared with ultrapure water at the ratio of 1g:10mL. EC were separately determined for different tissues and organs. The relationships between EC of different tissues and organs and PMI were analyzed and their regression functions were established. The characteristics of EC values for four tissues and organs were compared and their decomposition processes were discussed. Results EC of brain and muscle showed no significant changes within 1d, and increased rapidly during 2~7d; but EC of liver and lung started to increase within 1d and increased rapidly during 2~7d.The relationship between EC of different tissues and organs and PMI were well fitted with cubic equations and liver gained the highest coefficient (R2=0.96). Additional, the EC of four organs presented various increasing laws in different periods of PMI. Conclusion The EC of cerebrum, lung, liver and muscle of rats were well fitted with PMI and the determination of EC of cadaver tissues can be expected to become an effective method for PMI estimation in forensic practice.

In the era of outbreaking of antibiotic resistance, the discovery of new antibacterial drugs is emergent.Antimicrobial peptides are important components of the natural defenses of most living organisms against invading pathogens.The unique antibacterial mechanism, direct bactericidal effect, relatively slow of resistance acquirement, and can used alone or combined with antibiotics, make antimicrobial peptides be attractive potential antibacterial drugs.In this paper, we review the physicochemical property of antibacterial peptides, action mechanism and design of antimicrobial peptides, and give a brief introduction of several promising antimicrobial peptides.

Objective To investigate the anti-inflammatory/immune modulatory effects of high-expressing membrane bound M-CSF-hematopoietic malignant cells on macrophages. Methods After coculturing RAW264.7 and murine macrophage cell line with Namalwa-M, a cell line stably expressing mM-CSF, and companing with Nainalwa-V, a cell line stably transfected with the empty vector as the control, flow cytometry was used to detect the expression of the marker of alternatively activated macrophages, CD206, and intracellular expression of IL-10, IL-12, IL-6 and TNF-α to study the immunophenotype of RAW264.7; phagocytic assays to investigate their functional activity in vitro. Results RAW264.7 cocultured with Namalwa-M consistently showed high-level expression of CD206, which indicated activities of these macrophage cells were increased. Furthermore, these RAW264.7 expressing high levels of IL-10, TNF-a and low levels of IL-12, IL-6, as determined by intracellular staining were suggested that the phagocytic activity was increased. Functionally, RAW264.7 cocultured with Namalwa-M showed a higher level of phagocytic activity. Conclusion Macrophage generated in vitro after cocultured with mM-CSF-expressing hematopoietic malignant cell line could be transformed into abnormal macrophage with an immunophenotype defined as IL-10-high, IL-12-low, IL-6-low and TNF-α-high.

Heilongjiang Provincial Hospital has scored an initial success in dealing with medical disputes since the medical liability insurance and third-party mediation mechanism were introduced into the hospital in 2013.The paper identified problems found in the practice,and recommended the following:rationalizing the cost of insurance coverage,expanding scope of third-party mediation properly,enhancing professional authority in assessment of medical dispute cases,simplifying insurance compensation procedure,and consolidating the legal status of the medical dispute mediation institutions,for better resolution of such disputes.