Objective To compare the safety and effectiveness between ozone (O3) and hyaluronic acid (HA) in treating knee osteoarthritis(KOA) by using the meta analysis method.Methods The relevant randomized controlled trials(RCTs) in PubMed,Cochrane Library (issue 1,2016),Embase,CNKI,CBM,VIP,and Wan-Fang databases were retrieved from their establishment to January 23,2016.Two reviewers independently screened the literatures,extracted the data and evaluated the quality of the included RCTs.The results were performed the statistical analysis by using the RevMan5.3 and Stata13.0 software.Results Twenty RCTs involving 2 136 KOA patients were included.Compared with the HA treatment of KOA,the O3 treatment had higher treatment effective rate[odds ratio(OR) =2.78,P＜0.01],and better pain relief effect[at 1,3,6 month after treatment:mean difference(MD) =-0.25,-0.71,-1.70,P＜0.01].There were no statistically significant differences in complications between the two treatment methods[OR=0.84,P=0.56].Conclusion Current evidences indicate that the short-term therapeutic effect of O3 for KOA is superior to HA,and the safety is similar.

Objective To investigate the effect of psychological intervention and anti-inflammatory and analgesic ointment on phlebitis caused by intravenous indwelling needle. Methods Selected from December 2015 to April 2017 in our hospital treated with intravenous indwelling needle caused by phlebitis patients 96 cases, were randomly divided into control group and study group, each group of 48 cases.The control group received phlebitis caused by intravenous indwelling needle, and the study group received phlebitis, analgesic plaster and psychological intervention in the treatment of phlebitis caused by intravenous indwelling needle. The clinical efficacy of the two groups was recorded. The data were input into SPSS statistical software and analyzed. Results The study group of intravenous indwelling needle induced phlebitis of patients with clinical total efficiency up to 87.50%, total effective rate of the control group was only 70.83%, (P<0.05) data; after treatment, the scores of SDS and SAS scales in the two groups were significantly lower than before, and the negative effect of the study group was better (P<0.05). Conclusion The application of anti-inflammatory analgesic cream combined with psychological intervention can significantly improve the clinical efficacy of phlebitis caused by intravenous indwelling needle, and is conducive to the protection of their quality of life, physical and mental health.

OBJECTIVETo explore the relationship between the proliferation, differentiation of rat hepatic stem like cell line WB-F344 and cytokines in vitro.

METHODS(3)H thymidine labelling of new synthesized DNA was used to examine the mitogenic responsiveness of WB-F344 cells to cytokines, western blot was used to study the expression of cytokines receptors on hepatic stem cells, and apoptotic cells were detected by Flow cytometry.

RESULTSWB-F344 cells showed a proliferative response to the cytokines of hepatocyte growth factor (HGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), Insulin at the dose of 80 ng/ml, and the relative cpm values are 982.95, 906.32, 863.98 and 968.67 respectively, while non response to interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) at the same dose, and an inhibition or apoptosis response to transforming growth factor-beta (TGF-beta) at 80 ng/ml with a 26.89% apoptotic rate. Western blot showed that there were HGF, EGF, FGF, TGF-beta receptors expressed on WB-F344 cells. When WB-F344 cells were cultured in the differential system (DMEM, 10% Fcs, HGF 10 to approximately 50 ng/ml, EGF 20 ng/ml, Insulin 1 microg/ml, Dex 1 micromol/L), the cells could differentiated into hepatocytes. In addition, HGF could scattered WB-F344 cells.

CONCLUSIONThe proliferation and differentiation of liver stem cells are regulated by various cytokines which may play an important role when liver is damaged seriously.

Animals ; Cell Differentiation ; drug effects ; Cell Division ; drug effects ; Cytokines ; pharmacology ; Epidermal Growth Factor ; pharmacology ; Hepatocyte Growth Factor ; pharmacology ; Insulin ; pharmacology ; Liver ; cytology ; Rats ; Rats, Inbred F344 ; Stem Cells ; cytology ; drug effects ; Transforming Growth Factor beta ; pharmacology

Objective To evaluate aorta's compliance after repair of coarctation of the aorta (CoA)using the pulse wave velocity (PWV)of MRI.Methods A retrospective analysis of cardiac MR images in 22 patients after repair of CoA was performed.PWV was measured and calculated with phase contrast MRI,and echocardiography was performed to measure both ventricular function and myocardial thickness during the same period.Age and sex-matched 22 normal subjects were served as a control group and their aortic PWVs were measured.Results The averaged PWV in study group was significantly higher than that in control group [(4 .42 ± 3 .02 )m/s vs (2 .73 ± 0 .76 )m/s,P =0.02].In study group,the PWV value of children with moderate anastomotic stenosis was the highest. ROC curve analysis showed the highest sensitivity and specificity could be achieved to distinguish the mild or moderate anastomotic stenosis when the threshold for PWV was 3.37 m/s.No significant correlations were found between left ventricular end-diastolic volume,left ventricular end-systolic volume,ejection fraction,left ventricular thickness and PWV.Conclusion PWV is increased in children after repair of CoA.Significant aortic remodelling can be observed in patients with moderate anastomotic stenosis.

AIMTo investigate the toxic response in auditory cortex of guinea pigs caused by cis-platinum (DDP), and the protective role of melatonin in this effect.

METHODSCis-platinum and melatonin were injected peritoneally. LDH, MDA, NO in the auditory cortex were detected by spectrophotometeR.

RESULTSThe body weight of the guinea pigs was diminished by peritoneal injection of Cis-platinum for 7 days (P < 0.01). Peritoneal injection of Cis-platinum induced the increased leakage of LDH (P < 0.05 vs injection of normal saline). This effect was reduced by injection of MT (P < 0.05). The content of MDA in the auditory cortex was also increased because of injection of Cis-platinumv for 7 days (P < 0.01) and MT reduced this effect (P < 0.05). The change of NO in the auditory cortex was not statistically significant after injection of Cis-platinum or Cis-platinum with MT.

CONCLUSIONPeritoneal injection of Cis-platinum could destroy neurons in the auditory cortex. This effect could be reduced by melatonin by an anti-free radials mechanism.

Animals ; Auditory Cortex ; drug effects ; metabolism ; pathology ; Cisplatin ; antagonists & inhibitors ; toxicity ; Female ; Free Radical Scavengers ; pharmacology ; Guinea Pigs ; Male ; Malondialdehyde ; metabolism ; Melatonin ; pharmacology ; Neurons ; drug effects ; pathology ; Random Allocation

Objective To evaluate the influences of susceptibility interpretation of Escherichia coli,Klebsiella pneumonia and Proteus mirabilis in China mainland according to the old and new ceftazidime,cefotaxime and ceftriaxone breakpoints in CLSI M100-S20 and CLSI M100-S19. Methods First, We analyzed the antibacterial susceptibility results of the three bacteria by agar dilution method in the SEANIR surveillance item, which were collected from 15 national hospitals between the year of 2005 and 2007 and excluded the AmpC enzyme positive isolates according to the PGR-DNA sequencing method and/or the antibacterial susceptibility phenotype. ESBL phenotype was confirmed by the CLSI phenotypic confirmatory test. Antibacterial susceptibility of the total 2733 Escherichia coli, Klebsiella pneumonia, Proteus mirabilis isolates was retrospectively analyzed by WHONET 5. 4 software according to the breakpoints of the CLSI M100-S19 (S19) and CLSI M100-S20 (S20). Second, 207 isolates of Peking Union Medical College Hospital with the results of both agar dilution method and disk diffusion method were performed by recurrent analysis. Then we observed the inter-method agreement through the scatter diagram according to the breakpoints of S19 and S20. Results First, as to the ESBL positive Escherichia coli, Klebsiella pneumonia and Proteus mirabili.s, the resistant rate of cefotaxime increased from 65.2% , 55.5%, 14. 6% under S19 (64 μg/ml) to 99. 7%, 96. 2% , 93. 8% under S20 (4 μg/ml). The susceptibility rates decreased from 6. 0%, 11.5%, 33.3% under S19 (8 μg/ml) to 0%, 0. 2%, 0% under S20 ( 1 μg/ml). Ceftriaxone had the same trend as cefotaxime. Though ceftazidime was more active than cefotaxime and ceftriaxone, as to the ESBL positive Escherichia coli and Klebsiella pneumonia, the resistant rates slightly increased from 30. 3%,43. 2% under S19 (32 μg/ml) to42.0%, 56. 0% under S20 (16 μg/ml). The susceptibility rates slightly decreased from 58. 1%, 44. 1% under S19 (8 μg/ml) to 44. 7%, 28.0% under S20 (4 μg/ml). Second,as to the ESBL negative Escherichia coli, Klebsiella pneumonia and Proteus mirabilis, all the susceptibility rates of ceftazidime, cefotaxime and ceftriaxone were between 99. 2%-100. 0%, the resistant rate were between 0%-0. 4%. Third, the S20 MIC breakpoints had a good correspondence with the ESBL phenotype.Fourth, according to the recurrent analysis of MIC testing and disk dilution method, r value was 0. 67,0. 79, 0. 77 for ceftazidime, cefotaxime and ceftriaxone, respectively, and all P value were under 0. 01. The intermethod rates of S19 and S20 were both acceptable. Conclusions If the cefotaxime and ceftriaxone S20 new breakpoints were used, the concordance of antibacterial susceptibility results and ESBL phenotype would increase greatly. The clinician could select proper antibiotics according to the antibacterial susceptibility results and clinical symptoms. It is no longer necessary to edit results for cephalosporins, aztreonam, or penicillins from susceptible to resistant. However, until laboratories implement the new interpretive criteria,ESBL testing should be performed as described in Supplemental Table 2A-S1. The relationship between the new breakpoints of ceftazidime and clinical outcomes need to be further evaluated.

OBJECTIVETo compare the differences of the clinical effects, side effects and treatment-related cost between two kinds of negative-pressure wound therapy (NPWT).

METHODSForty-four inpatients with acute, subacute, and chronic wounds were divided into simplified NPWT group (A group) and conventional NPWT group (B group) according to the random number table. Wounds of patients in A group were treated with gauze + continuous suction with hospital central negative pressure (-10.64 kPa) for 24 hs; wounds of patients in B group were treated with sponge + interrupted suction with a purpose-designed suction appliance (-16.63 kPa) for 24 hs. Gross wound condition, treatment time, survival rates of skin graft and flap, changes of bacterial species on wound, treatment cost, and ratio of side effects between two groups were compared.

RESULTSThere was no significant difference between A and B groups in respect of gross wound condition, treatment time [A group (29 +/- 12) d, B group (26 +/- 13) d, P > 0.05], changes of bacterial species, survival rates of skin graft [A group (98 +/- 4)%, B group (98 +/- 4)%, P > 0.05] and flap (A group 98%, B group 100%, P > 0.05). Treatment cost of A group yen(374 +/- 134) was obviously lower than that of B group yen(9825 +/- 4956) (P < 0. 01), while more side effects were observed in A group (33.3%) than that in B group (5.0%) (P < 0.05).

CONCLUSIONSBoth simplified NPWT and NPWT with purpose-designed appliance can effectively improve wound healing. The simplified method may cause many side effects and has a potential risk of inciting nosocomial infection, but it can be conveniently employed with a low cost. In contrast, the cost of using purpose-designed appliance should be cut down to meet the aim of generalization.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; methods ; Wound Healing ; Young Adult

OBJECTIVETo study the effects of negative-pressure wound therapy (NPWT) on the treatment of complicated and refractory wounds.

METHODSSixty-seven patients with complicated or refractory wounds admitted to our hospital from September 2005 to November 2008 were randomly divided into NPWT group (n = 35) and conventional treatment (CT) group (n = 32). Wounds of patients in NPWT group were treated with interrupted suction under a pressure of -16.63 kPa for 24 hs, or continuous suction under a pressure of -10.64 kPa for 24 hs. Wounds of patients in CT group were covered with petrolatum gauze overlaid with isotonic saline gauze and dry gauze. Duration of treatment, times of operation, treatment cost, and the process of healing were compared between two groups.

RESULTSThe duration of treatment, treatment cost and times of operation of patients in NPWT group were obviously less or fewer than those of CT group (P < 0.05). Wounds of patients in NPWT group were mainly healed by themselves (40.0%) or healed after free skin grafting (40.0%). While wounds in patients in CT group healed mainly after tissue flap transplantation (66.7%) or free skin grafting (23.3%).

CONCLUSIONSCompared with CT, NPWT can shorten the length of hospital stay, reduce operation frequency and treatment cost, and it is easier to carry out in the surgery of treating complicated and refractory wounds, which is worth generalization.

Adult ; Aged ; Diabetic Foot ; surgery ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Pressure Ulcer ; surgery ; Wound Healing

Objective To explore the imaging features of primary cardiac tumors detected by echocardiography,CT and MR in children,and to analyze the value of each examination and the clinical examination strategies.Methods The clinical,pathological and imaging data of the children with primary cardiac tumors confirmed by surgery and pathology from Jun 2008 to Feb 2022 in Children's Hospital,Fudan University were analyzed retrospectively.Tumor size,location,motion,signal characteristics on different sequences,and pericardial involvement were evaluated on MR images.Results A total of 23 children(16 males and 7 females)were included.The age of onset ranged from 1 month to 13 years old,average on(54.45±58.57)months.While the onset age of rhabdomyomas was only(7.23±6.30)months.The clinical manifestations mainly included 6 cases of cardiac murmur,3 cases of cardiac insufficiency,3 cases of epilepsy,2 cases of cerebral infarction,and 1 case of arrhythmia.Pathological results showed that there were 22 cases of benign tumors(9 cases of fibromas,8 cases of myxomas,4 cases of rhabdomyomas and 1 case of lipoma)and 1 case of malignant tumor(rhabdomyosarcoma).Echocardiography has a high diagnostic accuracy for myxoma.CT showed a case of malignant rhabdomyosarcoma with invasion of the pericardium and compression of the pulmonary artery and bronchus.MR showed that the fibroma had significantly late gadolinium enhancement.The signal of rhabdomyoma was equal on T1WI,and slightly increased on T2WI,perfusion and late gadolinium enhancement sequences.Myxoma had high signal on T2WI and late gadolinium enhancement.It had obvious motions in Cine sequence.The signal of lipoma on each sequence was consistent with that of fat tissue,and there was no high signal of perfusion and late gadolinium enhancement.Conclusion All types of primary cardiac tumors in children have imaging characteristics.MR has great advantages in diagnosing cardiac tumors.The clinical team needs to select the appropriate examination method according to the actual medical situation.

Objective To investigate antimicrobial resistance among Streptococcus pneumoniae clinically isolated from 14 teaching hospitals located at different areas in China in 2005-2008 and to give logical guidance for clinical empirical therapy.Methods A total of 1 317 non-repetitive S.pneumoniae isolates in 14 teaching hospitals from 2005-2008 were collected and sent to the central lab for reidentification and susceptibility testing, including 271 isolates collected in 2005, 391 isolates collected in 2006, 363 isolates collected in 2007 and 292 isolates collected in 2008. Most of the isolates were from community-acquired respiratory tract infections, which were isolated from outpatient or emergency department patients with respiratory tract infections or those patients with respiratory tract infections within ≤48 hours hospitalization.The districts where the organisms were isolated include North China, Northeast China, South China, Central and Northwest China and East China.The patients included adults, teenagers and children.The minimum inhibitory concentrations (MICs) or inhibitory zone diameter of 17 antimicrobial agents were determined by Etest method, agar dilution method or disk diffusion method.WHONET5.5 software was used to analyze susceptibility rate, intermediate rate, resistance rate, MIC50 and MIC90.Results Linezolid (100%) and fluoroquinolones (95.2%-99.7%) showed excellent activities against S.pneumoniae.Among β-lactams, amoxicillin-clavulanic acid remained high activities (73.8%-92.1%),followed by penicillin, ceftriaxone and cefepime with year-over-year decrease in activities.The activities of three second-generation cephalosporins were low (36.3%-38.4% in 2008).The activities of erythromycin, azithromycin, clindamycin, trimethoprim/sulfamethoxazole and tetracycline against S.pneumoniae were poor and decreased year over year.The incidence of penicillin non-susceptible S.pneumoniae (PNSP) was increasing especially for PISP (from 4.4% in 2005 to 20.2% in 2008).The incidence of PNSP in North China was low (6.0%), while this value were high in central China and East China (30.1% and 38.7%, separately).The incidence of PNSP in adults (15.7%) was obviously lower than that in children(≤5 years:33.0%) and teenagers (6-17 years:38.2%).Conclusions linezolid and fluoroquinolones showed excellent in vitro activity against S.pneumoniae, followed by penicillin and cephalosporins with year-over-year decrease of activity. Clinicians should pay more attention when using those antimicrobial agents with poor activity against S.pneumoniae, which include macrolides, clindamycin, trimethoprim/sulfamethoxazole and tetracycline.