Objective To study the current status of antibiotic usage in Southwest hospital, so as to improve the rationality in applying antibiotic. Methods A total of 1 668 patients in Southwest hospital during Jan 1 to Dec 30, 2003 were investigated in antibiotic usage and the data were sorted and analyzed. Results Antibiotics were administered in 1 247 cases (74.76%), including only 76 cases (6.09%) based on susceptibility test, 39 cases (3.12%) occurred hospital infection. 297 cases (23.81%) abused antibiotics, among which 131 cases (38.04%) were without definite symptoms or with weak signs, 93 cases (31.31%) used more than two kinds of antibiotics, 24 cases (8.08%) frequently changed antibiotic in the treatment, 27 cases (9.09%) inappropriately prolonged administration and 22 cases (7.40%) improperly combined the same antibiotics. Conclusion Irrational utilization of antibiotics exits in clinical work. Therefore, the rational use of antibiotic based on susceptibility tests should be emphasized.

Objective To investigate the effect of damage control laparotomy in multiple trauma care.Methods A retrospective review was made on clinical data of 33 multiple trauma cases who received damage control laparotomy from January 2009 to June 2015.Twenty-four cases were males and 9 females, with the age range of 19-68 years(mean, 41.0 years).The trauma causes included traffic injury in 21 cases, high fall injury in 6 cases, falling object injury in 5 cases, and detonator blast injury in 1 case.Injury severity score (ISS) ranged from 14 to 64 points (mean, 27.0 points).All cases presented abdominal injury.Complicated injuries included brain injury in 10 cases, chest injury in 23 cases, and pelvic limb injury in 21 cases.All cases underwent damage control laparotomy, and then temporary abdominal closure after abdomen surgery.Abdominal closure time, intro-abdominal hypertension (IAH) or abdominal compartment syndrome (ACS), related treatment methods, hospital length of stay, and complications were recorded after operation.Results Twenty-nine cases had primary fascial closure 5-12 d after surgery.Four cases were unable to complete definitive abdominal wall reconstruction within the short term, and underwent skin grafting to form planned ventral hernia.Twelve cases developed IAH or ACS, and were cured using intra-abdominal volume increment assisted by vacuum sealing draining (VSD).Hospital length of stay was 21-70 d (mean, 31.4 d).There were wound infections in 2 cases of open fractures and abdominal incision infections in 4 cases, but all were cured after debridement plus VSD treatment.Abdominal abscess occurred in 1 case, and was cured by abdominal puncture and drainage.All cases were discharged from hospital smoothly.Conclusion Rational application of damage control laparotomy is a safe and effective treatment method for multiple trauma combined with abdominal injury.

The significance of identification of mild cognitive impairment (MCI) is to intervene as soon as possible and delay or even prevent its progression to dementia.However,due to the limitations of diagnostic methods and standards,the diagnosis of in patients with MCI is more difficult.In recent years,as an emerging functional neuroimaging technique,resting-state functional magnetic resonance imaging (rsfMRI) has developed rapidly.It has been widely used in the studies of MCI.It may be provide objective biomarkers for the diagnosis of MCI.This article reviews the advances in research on rs-fMRI in MCI.

Objective To summary the clinical characteristics of epileptic spasm(ES)that is the unique form of seizures in childhood. Methods A total of 149 patients with ES who visited our hospital from May 2009 to June 2015 were collected. The documents of clinical data, treatment and outcome were analyzed retrospectively. The statistical analysis of some clinical characteristics and prognosis of patients were performed. Results There were 97(65.1%) male and 52 (34.9%) female in the 149 patients. The onset age of ES was from 30 days to 42 months (median value was 6 months) including 17 patients more than 12 months.The peak age of onset was 4-7 months. One hundred and forty-seven patients manifested clustered spasm. One pair of twins showed single spasm.Other types of seizure were seen before ES onset in 13 (8.7%) patients, and after ES onset in 42 (28.2%) patients.Eighty-three patients (55.7%) were diagnosed as West syndrome (WS). There were 46 patients (30.9%) with cryptogenic cause, 103 patients (69.1%) diagnosed with symptomatic epilepsy, in which 69 patients were with a clear cause. The proportions of developmental delay in the cryptogenic and symptomatic patients were 74.5% and 92.2% after the onset of the ES. The degree of developmental delay was linearly related to the course of ES. The hyperarrhythmia of electroencephalogram (EEG) background was seen in 122 patients (81.9%), and there was no significant difference in hyperarrhythmia between different etiology groups or different onset age groups. The short-term efficiency of topiramate evaluated within one month was 30.5% in 59 newly diagnosed patients. The short-term effective rate of adrenocorticotropic hormone (ACTH) was 80.3% in total 76 patients, but single ACTH treatment was associated with an increased recurrent rate. Conclusion ES is a highly age dependent seizure type that mainly found in WS,which typically follows a EEG hyperarrhythmia and developmental delay. The treatment of ES is difficult. ACTH combined with effective antiepileptic drugs (AEDS) is currently the most reasonable drug treatment program.

ObjectiveTo investigate the change of lipoxin A4 (LXA4), leuotriene B4(LTB4) in blood and urine and leukocyte 15-lipoxygenase (15-LO) of the children with acute poststreptococcal glomendonephritis (APSGN) and to evaluate its significance. MethodsBlood and urinary levels of LXA4 and LTB4 were measured with ELISA within 3 days (acute phase), 10 to 14 days (early resolution phase) and 6 to 8 weeks (late resolution phase) respectively after onset of APSGN in 22 patients. In 8 children with APSGN, expression level of leukocyte 15-LO mRNA was examined with RT-PCR. Leukocyte LTB4 synthesis was assessed with ELISA. Chemotactic effect of LTB4, LXA4 and 15-S-hydroxyeicosatetraenoic acid (15-S-HETE) on neutrophils was determined by in vitro chemotaxis assay. Twenty-two healthy children were served as control. ResultsBlood and urinary levels of LXA4 and leukocyte 15-LO mRNA were up-regnlated in acute phase, further increased in early resolution phase, and decreased in late resolution phase of APSGN, which were stir higher than those in the controls (P＜0.01). Blood and urinary levels of LTB4 were increased in acute phase (P＜0.01) and then were decreased in early resolution phase and hte resolution phase of APSGN, which were still higher than those in the controls (P＜0.01). Administration of 15-S-HETE or LXA4 in vitro inhibited LTB4-induced chemotactic effect on neutrophils of the patients,and inhibited the production of leukocyte LTB4. ConclusionsChanges of blood and urinary levels of LXA4 and LTB4 in early resolution phase of APSGN are contrary. 15-S-HETE and LXA4may play a role in anti-inflammation and resolution of APSGN via inhibiting LTB4.

Objective:To observe whether nitric oxide (NO) could enhance the damaging effect of cyclophosphamide on L1210 cells cultured in vitro, and to investigate the mechanism of this action. Methods:L1210 cells were co-cultured with 3T3 cells in DMEM medium supplemented with cyclophosphamide (400 ?g/ml). The L1210 cells were divided into three groups based on different transfected 3T3 cells: pcDNA3.0-iNOS plasmid transfected 3T3 cells (Group 1), pcDNA3.0 plasmid transfected 3T3 cells (Group 2), pcDNA3.0-iNOS plasmid transfected 3T3 cells plus DEVD-CHO(Group 3). The viability and apoptosis rate of L1210 cells at different culture periods were determined by trypan blue exclusion and TUNNEL method, respectively. And the cell cycles at G_1 and S phase were detected by flow cytometry. Results:①After cyclophosphamide treatment, the viability of L1210 cells was significantly lower in Group 1 than that in Group 2 during 12-72 h (P

Objective To investigate clinical and pathologic features of hypertension patients with adre -noeorticotropic hormone ( ACTH)-independent adrenal hyperplasia , and to analyze the relationship between them . Methods The data of patients with ACTH-independent adrenal hyperplasia and hypertension was collected in Department of Urology , the First Affiliated Hospital of Zhengzhou University from Jan .2012 to Dec.2012.The clinical manifestations , endocrine examination results , imaging findings and the pathological changes of adrenal gland were retrospectively analyzed .Results 75 cases were followed-up.Among them, 39 cases were male and 36 were female.Their ages ranged from 20 to 74 years(with 47 as the average).Pathological results showed that diffusive hyperplasia was observed in 42 cases, tubercle hyperplasia in 26 cases, mixed corticomedullary patho-logical changes in 6 cases, and medullary hyperplasia in 1 case.No significant difference was found among diffu-sive, tubercle and mixed corticomedullary hyperplasia in clinical manifestations except for headache , endocrine examination results, or imaging findings(P>0.05).Conclusion There is no relation between clinical manifes-tations, endocrine examination results , imaging findings and pathological changes in adrenal gland for patients with ACTH-independent adrenal hyperplasia and hypertension .

Objective To explore the relationship between expression of P-glycoprotein (P-gp), a product of multidrug resistance (MDR) gnne, in the peripheral blood of children with intractable or newly diagnosed epilepsy for drug resistance. To establish a marker of drug resistance. To evaluate the therapeutic effect of flunarizine in the treatment of intractable epileptic patient with or without overexpression of P-gp. Methods The expression of P-gp in peripheral blood were investigated in 86 epileptic children (41 in intractable epilepsy group, 45 in newly diagnosed epilepsy group) and 44 healthy children (controlled group) by flow cytometry. Intractable epileptic patients with or without overexpression of P-gp were given flunarizine 2.5 - 5 mg, po, qn, for 3 months and followed up. Results Overexpression of P-gp were found in 23 (56.1%) patients of intractable epilepsy group, in 10 (22.2%) patients of newly diagnosed epilepsy group and three (6.8%) children of the controlled. In intractable epilepsy group, 17 out of 23 cases (73.9%) patient with overexpression of P-gp became tolerant to antiepileptic drugs, while 3 out of 18 cases (16.7%) patient without expression of P-gp became tolerant to antiepileptic drugs, and there was significant difference between them (P < 0.01) . In the newly diagnosed epilepsy group, seven out of 10 cases (70%) with overexpression of P-gp became intractable epileptic patient and three out of 35 eases (18.6%) without expression of P-gp became intractable epileptic patient, there was significant difference between them (P < 0.01). Twenty patients of intractable epilepsy group were given flunarizine for three months, 11 of 17 patients with P-gp overexpression and 1 of 3.patients without P-gp expression were effective. When reexamined, P-gp expression in 6 out of 11 patients became negative. Conclusions It is suggested that overexpression of P-gp in the peripheral blood of intractable epileptic patients might be a significant marker of drug resistance. Newly diagnosed epileptic patients with overexpression of P-gp may develop intractable epilepsy. P-gp was a predictable marker of intractable epilepsy. Flunarizine could be a choice in treatment of intractable epilepsy with overexpression of P-gp. The antiepileptic mechanism of flunarizine may involve in reversing of P-gp.

Objective To explore the clinical efficacy of renal lymphatic stripping with laparo scope.Methods Twenty cases of chyluria (12 men and 8 women; mean age,52 years) were treatedwith laparoscopic renal lymphatic stripping.The diagnosis of chyluria was setup by chylous tests andcystoscopy.The ultrasonic harmonic scalpel was used during the dissociation and ligation.ResultsThe average operation time was 100 min.The average blood loss was 50 ml and the average hospitalstay after operation was 6 d.No surgical complications occurred.The urine was clear and the chyloustests were negative in 19 patients when the patents discharged Irom the hospital.No recurrence ofchyluria was found during the follow up of 6-24 months.One patient with bilateral chyluria occation ally showed chyluria during follow up.Conclusion Laparoscopic stripping of renal lymphatic vesselsfor the treatment of chyluria could be an efficient method with the advantages of simple operating,mini invasion and rapid recovery.

This paper is to evaluate the biocompatibility and cytotoxicity of a new Ni-free Zr-based bulk metallic glass (BMG), Zr60.14 Cu22.31 Fe4.85 Al9.7 Ag3, by comparing it with conventional Ti6Al4V alloy. According to ISO 10993-5: 1999 and GB/T 16886.5-1997 standards, Zr60.14 Cu22.31 Fe4.85 Al9.7 Ag3, pure Zr and Ti6Al4V materials were extracted with surface area of sample/volume of medium ratio being 1 cm2/mL and 0.5 cm2/mL, respectively. The viabilities of MG-63 cells (Human osteosarcoma cell line) cultured in the BMG medium extracts for 1, 3 and 5 days were determined by CCK-8 assay. The cellular morphology of MG-63 cells cultured on the surface of samples for 3 days was tested through laser scanning confocal microscopy (LSCM) and scanning electron microscopy (SEM). The relative growth rate (RGR) of MG-63 cells cultured in Zr60.14 Cu22.31 Fe4.85 Al9.7 Ag3 and pure Zr were both more than 85%, indicating that the cytotoxicity of BMG was relatively low and met the national biomedical material eligibility standard. There was insignificant difference in the morphology of MG-63 cells cultured in the BMG medium extracts and the control group through LSCM and SEM, which showed the BMG had excellent biological compatibility. The Zr-based bulk metallic glass Zr60.14 Cu22.31 Fe4.85 Al9.7 Ag3 and the conventional Ti6Al4V alloy both had no obvious cytotoxicity to MG-63 cells. These results provided evidence that the new Zr-based bulk metallic glass could be potential replacement material for the orthopedic surgical implant.
Alloys ; Biocompatible Materials ; Cell Line ; Glass ; Humans ; Microscopy, Electron, Scanning ; Nickel ; Titanium ; Zirconium