OBJECTIVETo investigate the correlation between trauma and pulmonary thromboembolism.

METHODSComminuted fractures and extensive soft-tissue contusion at both hind limbs were made by a falling weight from a height in 16 rabbits. Lung perfusion scanning was performed to obtain the radioactivity counts before trauma, at 1 h, 48 h and 96 h after trauma. All the data were divided into 4 groups based on the above 4 time points. The rabbits were sacrificed when positive findings on the pulmonary perfusion scanning appeared. Their lungs were harvested to be paraffin-embedded and stained with hematoxylin-erosin method for histological examination of thromboembolism. The randomized block design ANOVA and the method of least significant difference (LSD) were used for statistical analysis of the radioactivity counts.

RESULTSThe histological findings showed that pulmonary embolism developed in 6 of the 16 rabbits (37.5%). Five of the 6 pulmonary embolism rabbits presented neither clinical symptoms nor positive pulmonary embolism manifestations in the lung perfusion scanning. A significant difference was found in lung perfusion radioactivity between the pre-traumatic, post-traumatic 1h groups and post-traumatic 48 h and 96 h groups(P less than 0.05).

CONCLUSIONSFractures of the hind limbs accompanied with extensive soft-tissue contusion may cause pulmonary micro-embolism that is not sensitive to lung perfusion scanning and tends to have no clinical symptoms. Pulmonary embolism development may take more than two days after trauma.

Animals ; Female ; Fractures, Bone ; complications ; Male ; Pulmonary Embolism ; etiology ; Rabbits ; Wounds and Injuries ; complications

OBJECTIVETo investigate the surgical site infection (SSI) rate of pancreas operation and its related risk factors.

METHODWe retrospectively analyzed sex, age, hospitalization time before operation, wound class, American Society of Anesthesiologists (ASA) physical status score, and operation time in 196 patients after pancreas operation.

RESULTSSI occurred in 14 patients (7.1%). The sex, age, hospitalization time before operation, wound class, and ASA score had no significant difference between SSI group and non-SSI group (P>0.05), while statistically significant difference was found in the term of operation time (P<0.05).

CONCLUSIONSOperation time is a significant risk factor of SSI. There were no any relations between hospitalization time before operation, wound class, and ASA score.

Female ; Humans ; Length of Stay ; Male ; Pancreas ; surgery ; Retrospective Studies ; Risk Factors ; Sex Factors ; Surgical Wound Infection ; etiology ; Time Factors

OBJECTIVETo investigate the therapeutic effects of Enalaprilat on the myocardial kinetics in rats at early stage of severe scald.

METHODSEighty-four SD rats were inflicted with 30% TBSA full-thickness scald, and randomly divided into scald (S, with intraperitoneal injection of isotonic saline according to Parkland formula, n=30), L (n=30), M (n=12) and H (n=12) groups. The rats in L,M,H groups were intraperitoneally injected with 1,2,4 mg/kg Enalaprilat. Other 6 healthy rats were enrolled into study as control (C group). The myocardial kinetic parameters including left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), +/- dp/dt max and the levels of A II in myocardium were observed at 1,3,6,12 and 24 post scald hour (PBH) in L and S groups,and at 6,12 PBH in M and H groups. The above indices in C group were also examined.

RESULTSThe levels of LVSP, LVEDP, +/- dp/dt max in C group were higher than those in other groups during 3-24 PBH (P < 0.05 or P < 0.01), while those in L,M,H groups were obviously higher than those in S group (P < 0.05 or P < 0.01). The level of +/- dp/dt max in H group at 6,12 PBH were obviously lower than those in L and M groups. The level of A II in S group at 1 PBH was (53.0 +/- 2.6) pg/200 mg, which was significantly higher than thatin C group [(14.8 +/- 0.7) pg/200 mg, P < 0.05 or P < 0.01]; it peaked at6 PBH and lowered afterwards, and they were significantly higher than that in C group at 24 PBH (P < 0.01). The levels of A II in L group during 3-24 PBH were obviously higher than those in C group (P < 0.01), which were also lower than those in S group. The level of A II in S group was significantly higher than in L,M,H groups at 6 PBH [(145.2 +/- 14.5) pg/200 mg. vs. (65.1 +/- 0.9) pg/200 mg, (53.6 +/- 1.1) pg/200 mg, (34.2 +/- 0.9) pg/200 mg, respectively, P < 0.01].

CONCLUSIONMyocardium can be obviously damaged at early stage after severe scald,cardiac function is impaired. Enalaprilat injection (especially at low dose) can significantly ameliorate the myocardial kinetics indices, and it seems to exert a protective effect on cardiac function.

Animals ; Burns ; drug therapy ; physiopathology ; Dose-Response Relationship, Drug ; Enalaprilat ; pharmacology ; therapeutic use ; Myocardium ; pathology ; Rats ; Rats, Sprague-Dawley ; Ventricular Remodeling

The core of standardized training for residents is the cultivation of clinical practice ability,which is also the main content of the professional degree graduate training.With the integration of professional degree graduate training and standardized training of residents,the evaluation system of professional degree graduate tutors should be included in the quality index of graduate clinical skills training.Through the methods of document retrieval and expert consultation,the index structure,the examination content and the weight were set up,and the detailed rules for the evaluation of the professional degree graduate tutors were established to guide them strengthen the training of clinical skills for graduates and improve the cultivation quality of professional degree graduates.

OBJECTIVE: This study aimed to examine the associations of daytime napping with incident risks of cardiovascular diseases (CVDs) and hypertension (HTN). METHODS: Data for napping and CVD outcomes in 25 provinces were collected from baseline (2010) and three waves of follow-up (2012-2017) investigations of the China Family Panel Studies. Cox frailty models with random intercepts for the surveyed provinces were used to assess the longitudinal effects of daytime napping on CVD and HTN. RESULTS: Compared with non-nappers, 30+ min nappers had higher risks of CVD and HTN, while no significant associations were observed among < 30 min nappers. Incident risks among 30- to < 60-min nappers increased by 22% [hazard ratio (HR) 1.22, 95% confidence interval ( CI) 1.08-1.39] for CVD and 21% (1.21, 1.04-1.41) for HTN, respectively, with corresponding HRs of CVD and HTN of 1.27 (1.09-1.47) and 1.38 (1.16-1.65) among ≥ 60 min nappers. Nap-associated CVD risks varied by subgroups, with stronger associations in participants with lower body mass index (< 24 kg/m ²), physically inactive persons, smokers, and participants with longer nighttime sleep (≥ 7 h/night). Significant effects of daytime napping were observed on rural and northern residents only, highlighting great regional variations in CVD risks associated with napping habits. CONCLUSIONS This cohort study revealed strong evidence that long daytime napping (≥ 30 min) is associated with an increased incidence of cardiovascular events.
Adult ; Cardiovascular Diseases/etiology* ; China/epidemiology* ; Cohort Studies ; Female ; Humans ; Hypertension/etiology* ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Risk Factors ; Sleep/physiology* ; Time Factors

The present study was aimed to investigate the role and mechanism of glutaminolysis of cardiac fibroblasts (CFs) in hypertension-induced myocardial fibrosis. C57BL/6J mice were administered with a chronic infusion of angiotensin II (Ang II, 1.6 mg/kg per d) with a micro-osmotic pump to induce myocardial fibrosis. Masson staining was used to evaluate myocardial fibrosis. The mice were intraperitoneally injected with BPTES (12.5 mg/kg), a glutaminase 1 (GLS1)-specific inhibitor, to inhibit glutaminolysis simultaneously. Immunohistochemistry and Western blot were used to detect protein expression levels of GLS1, Collagen I and Collagen III in cardiac tissue. Neonatal Sprague-Dawley (SD) rat CFs were treated with 4 mmol/L glutamine (Gln) or BPTES (5 μmol/L) with or without Ang II (0.4 μmol/L) stimulation. The CFs were also treated with 2 mmol/L α-ketoglutarate (α-KG) under the stimulation of Ang II and BPTES. Wound healing test and CCK-8 were used to detect CFs migration and proliferation respectively. RT-qPCR and Western blot were used to detect mRNA and protein expression levels of GLS1, Collagen I and Collagen III. The results showed that blood pressure, heart weight and myocardial fibrosis were increased in Ang II-treated mice, and GLS1 expression in cardiac tissue was also significantly up-regulated. Gln significantly promoted the proliferation, migration, mRNA and protein expression of GLS1, Collagen I and Collagen III in the CFs with or without Ang II stimulation, whereas BPTES significantly decreased the above indices in the CFs. α-KG supplementation reversed the inhibitory effect of BPTES on the CFs under Ang II stimulation. Furthermore, in vivo intraperitoneal injection of BPTES alleviated cardiac fibrosis of Ang II-treated mice. In conclusion, glutaminolysis plays an important role in the process of cardiac fibrosis induced by Ang II. Targeted inhibition of glutaminolysis may be a new strategy for the treatment of myocardial fibrosis.
Rats ; Mice ; Animals ; Rats, Sprague-Dawley ; Angiotensin II/pharmacology* ; Fibroblasts ; Mice, Inbred C57BL ; Fibrosis ; Collagen/pharmacology* ; Collagen Type I/metabolism* ; RNA, Messenger/metabolism* ; Myocardium/pathology*

OBJECTIVE: To investigate cognitive dysfunction in patients with carotid artery stenosis (CAS) and potential risk factors related to cognitive-especially memory-dysfunction. METHODS: Forty-seven patients with carotid artery stenosis were recruited into our study cohort. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were adopted to assess cognitive function, the Wechsler Memory Scale (WMS) to assess memory function, high-resolution MRI and enhanced ultrasound to evaluate carotid plaques, and computed tomography perfusion (CTP) imaging to evaluate intracranial blood perfusion. Single-factor analysis and multiple-factor regression analysis were used to analyze potential risk factors of cognitive impairment. RESULTS: Mini-Mental State Examination test results showed that 22 patients had cognitive impairment, and MoCA test results showed that 10 patients had cognitive impairment. Analysis of various risk factors indicated that the average memory quotient of female patients was higher than that of males (P = 0.024). The cognitive and memory performance of those with an educational background above high school were significantly better than those of participants with high school or lower (P = 0.045). Patients with abnormal intracranial perfusion performed worse on the MMSE test (P = 0.024), and their WMS scores were significantly lower (P = 0.007). The MMSE scores and the memory quotients were significantly lower in patients with a history of cerebral infarction (MMSE, P = 0.047, memory quotient score, P = 0.018). CONCLUSION A history of cerebral infarction and abnormal cerebral perfusion are associated with decline in overall cognitive function and memory in patients with carotid stenosis. Being female and having an educational background above high school may be protective factors in the development of cognitive dysfunction.
Adult ; Aged ; Carotid Stenosis ; complications ; China ; epidemiology ; Cognition ; Cognitive Dysfunction ; epidemiology ; etiology ; psychology ; Cohort Studies ; Cross-Sectional Studies ; Female ; Humans ; Male ; Memory ; Middle Aged ; Neuropsychological Tests ; Risk Factors

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases