Adult ; Amyloidosis ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Muscular Diseases ; pathology ; surgery ; Neck Muscles ; pathology ; surgery

Objective To investigate the cause and related factors of hospitalization in patients with diabetic nephropathy with maintenance hemodialysis.Methods Fifty-six patients of diabetic nephropathy were enrolled in current study who hospitalized in Beijing Tongren Hospital affiliated to Capital Medical University from March 2009 to February 2012.All subjects were divided into hospitalized group (n =29) and non hospitalized group (n =27).The information including age,dialysis age,blood pressure,hemoglobin,blood glucose,serum creatinine,serum potassium,plasma albumin,serum calcium,serum phosphorus,albumin,intact parathyroid hormone (iPTH) and hemodialysis sufficienc (KT/V) were collected.Stepwise multiple regression analysis was applied to explore the main causes and related risk factor.Results Twenty-nine out of 56 patients were hospitalized and they had 56 hospitalization records during 24 months of observed period.Average hospitalization was 1.0 times per patient and hospitalized days were (29.62 ± 14.30) days per hospitalized patients.The main causes of hospitalization were cardiac vascular diseases (35.7％),vascular access stenosis (30.4％),and pulmonary infection (17.8％).Compare with non-hospitalization group,age of patient hospitalization group was older((66.97 ± 9.94) vs.(57.42 ± 11.77),t =2.917,P =0.02) and the level of albumin and Kt/V were lower(albumin:(34.02 ± 4.76) vs.(38.93 ± 3.82),t =-4.573,P =0.000 ; Kt/V:(1.16 ± 0.09) vs.(1.39 ± 0.18),t =6.503,P =0.000).Stepwise multivariate regression analysis showed plasma albumin and KT/V were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis (β =-1.724,-0.040 respectively,P =0.00,0.02 respectively) Conclusion Cardiovascular disease,vascular access stenosis and pulmonary infection were the important factors for hospitalization in hemodialysis patients with diabetic mellitus.Cardiovascular disease was the top reason of hospitalization in diabetic patients with maintenance hemodialysis.Hypoalbuminia and inadequacy dialysis were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis.

Abnormalities, Multiple ; diagnosis ; diagnostic imaging ; Aorta, Thoracic ; abnormalities ; diagnostic imaging ; Aortic Aneurysm, Thoracic ; congenital ; diagnosis ; diagnostic imaging ; Aortic Diseases ; congenital ; diagnosis ; diagnostic imaging ; Child ; Diagnosis, Differential ; Humans ; Male ; Radiography ; Rare Diseases ; X-Rays

Objective To explore the relationship of hydrogen sulfide (H2S) and the extracellular matrix of the diabetic nephropathic rats' glomerulars.Methods Twenty-one male rats(Sprague-Dawley) were randomly divided into Control group(n =7),DN group (n =7) and DN + H2 S group (n =7).Diabetes was induced in the rats except Control group rats by STZ (60mg/kg).The rats of the DN + H2S group were injected with NaHS every day,and rats of other groups were injected with NS.Eight weeks later,three groups were compared in proteinuria of 24 hours,KW/BW,the proportion of the BrdU positive cell and the distribution of α-SMA in glomerulars.Results Compared with Control group,DN group rats were significantly increased in proteinuria of 24 hours and KW/BW (P ＜ 0.01).Kidney biopsy in DN groups rats were typical DN pathological manifestation.In treatment with NaHS,the DN rats in the DN + H2S group were decreased in proteinuria of 24 hours,KW/BW,the proportion of the BrdU positive cell and the distribution of α-SMA in glomerulars (P ＜ 0.01),and was similar with the control group in the pathology of renal.Conclusion The H2 S control the multiplication of myofibroblast,and were decreased in the distribution of α-SMA in glomerulars.The H2S treatment may put off the progress of the extracellular matrix in the DN rats' glomerulars.

Objective:To explore the learning experience of the medical massive open online course (MOOC) teaching design standard system constructed by the research group in the early stage.Methods:In this study, the questionnaire was adapted from four dimensions: academic analysis, curriculum content design, teaching process design, and teaching evaluation design, including 519 students majoring in clinical medicine of a university who had studied MOOC cases like "Ultra-early Diagnosis and Treatment of Acute Cerebral Infarction" based on the system. SPSS 25.0 was used for statistical analysis.Results:The system had a high degree of recognition in all dimensions, with 64.5% of academic analysis, 57.6% of content design, 54.5% of teaching design process, and 59.3% of teaching evaluation design.Conclusion:The study has found that the medical MOOC teaching design system has good learning experience effect. According to the data feedback, the key teaching design points such as the core factors of learning experience analysis and the suitability of teaching content in the practical operation of teaching design has been explored, providing the practical basis and method reference for the design of medical MOOC teaching design.

Objective To investigate the influence of body temperature on the recovery from vecuronium-induced neuromuscular block.Methods Sixty-eight ASA I - II patients (39 male, 29 female) aged 19-69 yr undergoing elective surgery under general anesthesia were randomly divided into 2 groups: group I in which patients' body temperature was maintained at 37 ℃ using warming blanket; group II in which no measures were taken to maintain the patients' body temperature. The patients were premedicated with phenobarbital 2 mg?kg-1 and atropine 0.01 mg? kg-1 intramuscularly. Anesthesia was induced with fentanyl 5 ?g? kg -1, propofol 2 mg? kg-1 and vecuronium 0. 1 mg?kg-1 . After tracheal intubation anesthesia was maintained with inhalation of 0.8%-2.5% isoflurane and propofol infusion at a rate of 2-4 mg ? kg-1? h-1 .Neuromuscular block was monitored using accelograph (Biometer, Denmark) .The changes in TOF and T1 were monitored. T1was maintained at 10% by vecuronium infusion during operation. At the end of operation a bolus of vecuronium 80?g ? kg-1 was given intravenously and T1 was completely depressed. The time for T1 to returned to 5% ,25% and 90% and the time required for T1 to return from 25 % to 75 % were recorded. The total amount of vecuronium given was recorded. Temperature probe was placed in the esophagus ( core temperature) . The room temperature was also recorded. Results The body temperature was lower, the total dose of vecuronium was smaller and the vecuronium-induced neuromuscular block lasted longer in group II as compared with group I . There was close correlation between body temperature and vecuronium-induced neuromuscular block. Conclusions Lower core body temperature could prolong the vecuronium-induced neuromuscular block.

Objective To evaluate the screening effect of osteoporosis self-assessment tool for Asians (OSTA) in middle aged and elderly healthy men in Chengdu.Methods A total of 4042 healthy men aged 40 to 106 years received dual energy X-ray absorptiometry (DXA) assay,and OSTA index evaluation.Measurement sites included lumbar spine (L1-4),left femoral neck,trochanter,Ward's area,total hip and femoral shaft.All persons were classified into highosteoporosis-group (OSTA≤-4),mediumosteoporosis-group (-4 ＜ OSTA≤≤-1),low osteoporosis-group (OSTA＞-1),or the low risk-group (OSTA＞-1) and high risk-group (OSTA≤-1) by OSTA scores.T-scores were compared between different measurement sites detected by DXA.The sensitivity,specificity,Kappa value and the area under receiver operating characteristic (ROC) curve (AUC) of OSTA in screening osteoporosis were evaluated.Results The prevalence of osteopenia and osteoporosis in lumbar spine,proximal femur were gradually increased along with aging.The detection rate of osteoporosis in lumbar spine and proximal femur were 16.2％ and 24.0％ respectively in subjects aged over 80 years.OSTA index in low-risk,medium-risk group,high-risk group were 85.0％,11.0％,4.0％ respectively.The detection rate of osteoporosis in lumbar spine and proximal femur were 2.6％ and 1.6％ in low-risk group,10.4％ and 10.4％ in medium-risk group,and 29.3％ and 30.5％ in high-risk group,respectively.Taking OSTA ≤-1 as the cut-off value,the sensitivity and specificity of OSTA in screening osteoporosis in lumbar spine and femur by T-score＜-1 were 28.1％,28.7 ％,89.0％ and 92.4％ respectively,and by T-score≤-2.5 were 51.6％,63.2％,86.7％ and 86.8％ respectively.The consistency of diagnosis result between T-score and OSTA index according to the three versus two risk levels was 0.153 and 0.197 versus 0.195 and 0.243 Kappa value,respectively.The AUC of OSTA index for lumbar spine and femur by T-score＜-1 and T-score≤-2.5 were 0.689 and 0.823,and for different age groups and different measurement sites were 0.639 and 0.899 (all P＜0.001).Conclusions OSTA index has a certain ability in screening osteoporosis in men aged over 50 years.There are different screening results on osteoporosis among the different age groups.

Objective To investigate the mechanism of quinolone resistance in Psendomonas aeruginosa.Methods The minimum inhibitory concentrations (MICs)of ciprofloxacin and levofloxacin with and without carbonylcyainde-m-chlorophenylhydrazone(CCCP)were determined by agar dilution method.Polymerase chain reaction(PCR)and DNA sequencing were used to study the mutations in quinolone resistance-determining region of gyrA and parC genes.The strains were genotyped by enterbacterial repetitive intergenie consensus-PCR(ERIC-PCR).Results Sixteen quinolones-resistant Pseudomonas aeruginosa strains were obtained.The MICs of ciprofloxacin and levofloxacin were not reduced significantly by adding CCCP.Thr-83→Ile of gyrA and Ser-87→Leu of parC were found simultaneously in 16 strains of resistant Pseudomonas aeruginosa.Analysis of ERIC-PCR products indicated that 16 quinolone-resistant strains had an identical band pattern which was different from that seen in the sensitive strains.Conclusion Mutations in gyrA and parC may be the main mechanism of quinolone resistance in clinical isolates of Pseudomonas aeruginosa.

Objective To study comprehensive nursing meassures for small area of diabetic foot ulcer. Methods A total of 58 patients with small area of diabetic foot ulcer in our department were divided into two groups.The comprehensive nursing group (CN group,30 cases) adopted comprehensive nursing and treatment as follows, surgical dcbridement, infrared radiation of wound surface,sprinkling of growth factors(bFGF and rhEGF),covered by hydrocolloid dressing(Algoplaque).The control group(28cases) received hydropathic compress with 0.5% povidone iodine or 5% furacillin solution.Wound heal-ing progreasion,average healing time and the positive rate of wound germiculture of the two groups were observed. Results The average healing time of the CN group was (29.6±9.4)d,which was shorter than that of the control group,( 39.2±13.5 )d, P < 0.05. Statistical difference existed in the positive rate of wound germiculture at the 7th day and the 14th day between the two groups (P < 0.05). Conclusions Routine medical treatment and general nursing measures plus surgical debridement,infrared radiation of wound sur-face,sprinkling of growth factors and hydrocolloid dressing possess facilitative healing effect for small area of diabetic foot ulcer.

Murine norovirus (MNV) was first discovered in mice in 2003. MNV is a member of the genus Norovirus in the family Caliciviridae. It is one of the most important and prevalent pathogens of laboratory mice, and almost all mouse strains are susceptible to MNV infection. In this study, a MNV strain was isolated from the cecal contents of infected mice and identified by the cytopathic effect (CPE) assay, virus plaque assay, 50% tissue culture infectious dose (TCID50) assay, electron microscopy, indirect immunofluorescence assay (IFA) and nucleotide sequencing. On infection, the RAW264.7 cell line showed obvious cytopathic effects within 24 to 48 hours post-inoculation, as infected cells became rounded, bright and shrunken, with ultimate disintegration of the cell sheet. After the isolation of the MNV virus, the virus was plaque-purified in RAW264.7 cells. The TCID50 of the virus was 10(5.25/0.1 mL. Electron microscopic observations of the purified virus showed the presence of spherical and non-enveloped viral particles that were 30 to 35 nm in diameter. According to the identification results, the isolate was named as MNV Guangzhou/K162/09/CHN. Thereafter, five overlapping gene fragments that covered the entire open reading frame (ORF) were amplified by RT-PCR, and the 3'-untranslated region (UTR) and 5'-UTR were amplified using the 3'-rapid amplification of cDNA ends (RACE) and the 5'-RACE method, respectively. Each of the gene fragments were cloned and sequenced, and whole genome sequences of the strain were obtained by assembling the cDNA fragment sequences. The results showed that the length of the complete genome was 7 380 nucleotides (GenBank accession number: HQ317203). The comparison of nucleotide and deduced amino acid sequences of the isolate was performed against other MNV strains in the GenBank database. A phylogenetic tree based on VP1 nucleotide sequences was constructed using MEGA5.0 software. The homology of nucleotides between the MNV Guangzhou/K162/09/CHN strain and other MNV isolates ranged from 87.4% to 89.7%. Phylogenetic analysis showed that there was a close genetic relationship between the Guangzhou/K162/09/CHN strain and MNV strains isolated from Japan (S7-P2 and S7-PP3 isolates), Korea (K4 isolate), and Germany (Berlin/04/06/DE and Berlin/05/06/DE isolates). This is the first report of the isolation and identification of MNV in China, and the first report of the genetic analysis of its complete genome.
Animals ; Caliciviridae Infections ; veterinary ; virology ; Mice ; Molecular Sequence Data ; Norovirus ; classification ; genetics ; isolation & purification ; physiology ; Open Reading Frames ; Phylogeny ; Rodent Diseases ; virology ; Sequence Homology, Amino Acid ; Viral Proteins ; chemistry ; genetics