Objective To analyze the effect of perioperative blood transfusion in orthopedic surgery.Methods A total of 201 patients who underwent an orthopedic surgery in our hospital in October 2015 to September 2016 were reviewed.Hemoglobin concentrations,hematocrit,postoperative hospital stay,infection and other related data were analyzed.Results 90 patients were transfused with blood and in 111 patients were not during orthopedic surgery (massive blood transfusion group including 17 cases;non massive blood transfusion group including 94 cases).Hemoglobin concentrations of transfusion group (103.09±16.37)g/L was lower than the non transfusion group (115.79± 13.68)g/L before liying hospital,postoperative hospitalization time of transfusion group (12.012±8.36) was longer than that of non transfusion group (16.14 ± 10.47)days.Postoperative infection rate in non transfusion group was 1.11％,and in transfusion group was 15.32％,in massive transfusion group is 52.94％.Conclusion Perioperative blood transfusion is not conducive to the recovery of hemoglobin level patients in orthopedic surgery,prolong hospital stay and increase the rate of infection after surgery.Perioperative blood transfusion makes it difficult to support the outcome of the disease

Research of the impacts of probation administration on teaching quality for students'clinical probation study is to control the whole process of probation teaching,which is through the strengthening of administration on three parts,including pre-clinical probation,clinical probation and post-clinical probation,so that administration elements of teaching for probation forms close links,including formulation of teaching plan goals,organization and implementation of the probation process,means and methods of probation,and evaluation of effects and quality of probation results and quality of student evaluation of teaching management trainee factors into a closed ring. Considering highly the administration process,refining the administration flow-sheet,identifying administration objectives,and systematic evaluation of the quality of teaching trainees to achieve continuous improvement of the quality of probation teaching reflect the concept of "student-centered" teaching management concepts,and provides a new approach to enhancing the quality of clinical probation teaching for adapting to the new model of medical education and management development needs.

AIM:To investigate the effects of ?v?6 integrin-mediated cell adhesion on 5-fluorouracil (5-FU) induced apoptosis in colon carcinoma cell lines.METHODS: The expression of the ?v?6 integrin in colon carcinoma cell lines HT-29 and WiDr cells was analyzed by flow cytometry. The apoptosis induced by 5-FU and the effects of ?v?6 integrin-mediated cell adhesion on 5-FU induced cell apoptosis were measured by enzyme-linked immunosorbent assay (ELISA) method and acridine orange-ethidium bromide (AO-EB) double fluorescent dye staining.RESULTS: Both the colon carcinoma cell lines HT-29 and WiDr cells expressed the ?v?6 integrin. The percentages of HT-29 and WiDr cells expression were 80.82% and 82.96%. 5-FU induced the apoptosis of colon carcinoma cell lines HT-29 and WiDr. The result of ELISA method displayed that enrichment factor (EF) of HT-29 and WiDr cells planted on fibronectin (FN)-ligand of ?v?6 integrin was lower significantly than the EF of HT-29 and WiDr cells planted on non-integrin ligand polylisin (1.11?0.04 vs 3.68?0.03, 1.09?0.02 vs 3.72?0.02, P

Objective　To find out the morbidity and main pathogens of ventilator-associated pneumonia(VAP) in PICU.Methods　44 VAP cases were reviewed.Results　44 VAP cases were diagnosed and analyzed from 1998, 2 to 2001,1,the morbidity of VAP was 69.8%.The predominant pathogen was Pseudomonas aeruginosa.Conclusion　It has reference value in consideri ng the possible pathogens of pneumonia.

Objective To further investigate the pathohistology of chronic gastritis in children and the relationship between helicobacter pylori(Hp) infection and mucosal chronic inflammatory.Methods Gastric antrum biopsies were carried out from children who had chronic gastritis confirmed by gastroendoscopy during the past 3 years in our hospital.The results of pathohistological observation were analyzed by retrospectire method.Results One thousand six hundred cases of chronic gastritis were included,in which 1007 cases without Hp infection,593 with Hp infection.Among the patients without Hp infection,mild inflammatory were much more than mode-(rate) or severe inflammatory(86% vs 14%).Although,in patients with Hp infection,mild inflammatory were the most common presentation(63%),moderate and severe inflammatory were more predominant in patients with Hp infection.The degree of inflammatory was increased with the quantity of Hp infection.The ratio of lymphocytes,neutrophils and lymphoid follicles in gastric mucosa was much higher in Hp positive group than negative one(94%,40%,22% vs 60%,11%,5%,respectively),and the difference was significant in statistic analysis.Gastric mucosal atrophy was found more in Hp positive group(16.5%) than negative one(7%).The proportion of intestinal metaplasia in cases with Hp infection was 1.5% compared with 0.1% in these children.Conclusion The study shows that there is a close relationship between Hp and antrun chronic inflammation and mucosal atrophy.

Objective To investigate the efficacy and the mechanism of different dose hepatitis B immunoglohulin(HBIG)on prevention of HBV intrauterine infection and HBV S gene mutation. Methods HBV carrier mothers were randomly divided into three groups.Eighty-one HBsAg carrier pregnant women were divided into HBIG A group.HBIG B group and control group.Each subject in the HBIG A group received 200 U or 400 U(for HBsAg and HBeAg double positive carrier)intra muscularly at 3,2,1 month before delivery.Each subject in the HBIG B group received 200 U intra muscularly at 3,2,1 month before delivery.The subjects in the control group did not receive any treatment.Maternal blood samples were taken before HBIG injection and at delivery.Neonatal blood samples of all newborn infants after birth were taken before immunopropbylaxis.Their sera were ob tained to test HBV markers by enzyme immunoassay(EIA)and HBV DNA by fluorescence quantita- tive polymerase chain reaction(FQ-PCR),then to amplify and sequence HBV S gene region.Results The rate of HBV intrauterine infection in the HBIG group(14.5%)was lower than that in the control group(35.7%)(X~2=4.896,P=0.027).The rate of HBV intrauterine infection of newborns from HBsAg and HBeAg double positive carrier mother in the HBIG A group(37.5%)were lower than control group(100.0%)(X~2=7.273,P=0.007),while the rate was no different in the HBIG B group(71.5%)and the control group(X~2=2.637,P=0.104).Maternal HBsAg titer and HBV DNA level were of no difference among three groups before HBIG injection.Maternal HBsAg titers and HBV DNA levels of the HBIG A group were lower than those of the HBIG B group and the con- trol group at delivery.Among the 26 neonatal serum samples in the HBIG A group,10(38.5%)were positive for anti-HBs,while in the HBIG B group and in the control group,no neonatal serum sam- ples was positive.There was no significant difference of nucleotide and amino acid changes in the S gene between the HBIG group and the control group.Conclusions HBV infection in the uterus may be interrupted by injection HBIG intramuscularly before delivery.More efficacy would be found using variable HBIG dose according to different HBV virema and must be once more again injected just he- fore one week of delivery;anti-HBs transported to the fetus via the placenta and it's may be the im- portant mechanism of HBIG prevention.Asymptomatic HBsAg carrier mother received injections of HBIG before delivery should not influence HBV S gene mutation.Gene mutation of HBV is not the main factor in intrauterine transmission of HBV.

Objective To investigate the effects of caveolin-1 overexpressing on the growth of cervical squamous cell cancer Hela cell line. Methods Eukaryotic expression vector of human caveolin-1 gene was introduced into Hela cells by Lipofectamine. The clones stably overexpressed caveolin-1 were identiffed by RT-PCR, immunofluorescence cell staining techniques and Westernblotting. Cells proliferation viabihty was tested by MTT assay, and flow cytometry was used to assay the cell cycle and apoptosis, and the relative phosphorylation level of extracellular regulated protein kinases (Erk1/2) were detected by Westernblotting. Results The clones stably overexpressed caveolin-1 were obtained. Compared with the parental Hela cells, the tranfected cells exhibited a slower rate of growth. FAGS analysis results revealed that overexpression of caveolin-1 resulted in the cell cycle arrest in the G0/G1 [ ( 68. 04 ± 2. 57 ) % vs ( 53.41 ±1.01)%] phase and increased the apoptotic cell fraction[ (19. 18 ±2.20)% vs (5.63 ±0.55)%, P <0. 05 ]. Western blotting results showed that overexpression of caveolin-1 reduced the phosphorylation of Erk1/2(0.28 ±0.05 vs 0.81 ±0.07, P <0.05). Conclusions Overexpression of caveolin-1 suppressed the growth of Hela cells and induced apoptosis, down-regulation of Erk1/2 phosphorylation might be involved in its mechanism.

Child ; Child Welfare ; China ; Health Services, Indigenous ; Humans

Objective To investigate the resistance of clinical isolated gram negative bacilli to tigecycline.Methods One hun-dred and fifteen Escherichia coli isolates,110 Klebsiella pneumoniae isolates and 99 Acinetobacter calcoaceticus-Acinetobact-er baumannii complex isolates were collected from Affiliated Second Hospital of Zhejiang University College of Medicine from the year 2012.The other 393 A.calcoaceticus-A .baumannii complex isolates were collected from 15 hospitals of nine cities in Zhejiang province during September to October 2012.Species identification and susceptibility test were confirmed by VITEK-2 compact system,while the 393 A.calcoaceticus-A .baumannii complex strains isolated from Zhejiang province were identified by MALDI-TOF MS.Moreover,159 A.baumannii isolates with tigecycline MIC value ≥8 μg/ml or 4 μg/ml and part of the MIC value ≤0.5 μg/ml,1 μg/ml and 2 μg/ml which were firstly determined by VITEK 2 GN AST-16 Suscepti-bility card were then determined by Etest.Results The 393 A.calcoaceticus-A .baumannii complex strains were identified as 317 of A.baumannii,32 of A.pittii and 44 of A.nosocomialis.When using the FDA breakpoints,the resistance rate of tige-cycline against 115 E.coli isolates,110 K.pneumoniae isolates and 99 A.calcoaceticus-A .baumannii complex isolates were 0.0%,7.3% and 6.1%,respectively.Interestingly,85.7% of the tigecycline-resistant gram negative bacilli were resistant to carbapenems.However,only 10.0% of the carbapenem-resistant gram negative bacilli were resistant to tigecycline.Conclu-sion Tigecycline had a good activity against clinical isolated multi-drug resistant or even pan-drug resistant gram negative bacilli.No matter which criteria for tigecycline was referred to,the resistance rate oftigecycline was slightly lower by Etest than by GN AST-16 Susceptibility card.

Objective Investigate the relationship between thromboelastography and coagulation tests,and evaluate of two kinds of methods in guiding significance in cardiac surgery patients perioperative blood transfusion.Methods Analysis of 108 patients with cardiac surgery in September 2014-August 2016 treated in our hospitalwere randomLy divided into TEG detection guide blood transfusion group (experimental group) and coagulation test guide blood transfusion group (control group),Respectively on two groups of blood transfusion rate,different components of blood transfusion and transfusion effect comparison.Results Through the comparison of the heart surgery perioperative blood use rate guided by TEG and coagulation test,found the transfusion rate of experimental group guide cryoprecipitate 25.9％ and fresh frozen plasma(FFP) 33.3％ was significantly lower than the control group 68.5％,however,platelet transfusion rate was significantly higher than the control group of 57.4％ to 20.4％.There was no statistically significant difference of red cell suspension (RCS) infusion rate between two groups,but the RCS infusion quantity of experimental group(3.6+ 1.6) was clearly lower than the control group (5.8+ 1.9),and the FFP and cryoprecipitate infusion quantity of experimental group was obviously lower than control group(P＜0.05),too.Experimental groups of intraoperative blood loss,postoperative blood loss and rebleeding rate was lower than control group (P＜ 0.05).Concltsion That TEG guide cardiac surgery patients perioperative blood transfusion can reduce the use amount of blood products,and the prognosis of disease outcome is better than that of routine coagulation tests guidance.TEG can reduce the surgical complications and the bleeding amount,and it has great sense to guide clinical composition blood transfusion,so it is worth promoting.