OBJECTIVE To investigate the clinical and etiologic characteristics and treatment of central venous catheter-related(sepsis).METHODS Forty cases of patients with central venous catheter-related sepsis and their clinical manifestation,etiologic profiles and outcome of treatment were retrospectively analyzed.RESULTS Forty six strains were isolated including 23 strains of Gram-positive cocci,19 of Gram-negative bacilli and 4 of fungi.The most frequent(isolates) were Staphylococcus epidermidis.CONCLUSIONS The most common organism causing CRS is S.epidermidis;the key preventive measure is to avoid inner and outer pollution of catheter;antibiotic lock-technique can be taken for the treatment of uncertain CRS.If it is no effect after 24-48 hours,it is necessary to remove venous catheter promptly.

A combination vaccine which consists of ≥2 immunogens is intended to provide protection against two or more diseases or against multiple serotypes of a single disease. The use of combination vaccines decrease the number of vaccine injections in the regular immunization schedules. However,the development of combination vaccines is more complicated than monovalent vaccines,preservatives and adjuvants used with one component may alter the potency of other components. Physical,chemical,and biological interactions between the components of combination vaccines must be considered to avoid detrimental effects on safety or efficacy. Therefore combination vaccines present unique challenges for product evaluation. This paper presents a review of research application status,the evaluation of effectiveness and safety,as well as development prospects on combination vaccines.

Objective Evaluate the outcome of aortic root reconstruction on the analysis of the risk factors influencing surgical results. Methods Between August 1996 and November 2009, 92 patients(56 men, 36 women) aged from 14 to 77years [mean (44.8 ±1.4) years] with aortic root aneurysm underwent aortic root reconstruction. 72 patients had over moderate aortic valve insufficiency. 47 patients suffered from Marfan syndrome. The aortic pathology was aortic dissection in 45. Bentall technique was used in 59 patients, the button technique in 13, the David I with the Valsalva graft in 6 patients and the aortic valve resuspension in 14 patients. Results The hospital mortality rate was 8.7%. The major complications 31. 7%. 18patients died during the period of follow-up. Late complications among 55 survivors were 12. Univariate predictors of the morbidity were the presence of male, non-Marfan, concomitant procedure, deep hypothermia cardiac arrest, aortic cross clamp time and blood infusion. Risk facts for mortality were emergent or urgent operation, aortic dissection, concomitant procedure, aortic cross clamp time and blood infusion. Multivariate analysis revealed risk factors of concomitant procedure and blood infusion were responsible for both morbidity and mortality. The overall long-term survival rate is (97.1 ±2.0)% at 1-year, (88.1 ±4.7)% at 5-year, (54.0 ±9.2)% at 10-year. The mean for survival time is (9.9 ±0.59) years, 95% confidence interval 8.70 -11.01. Conclusion The aortic root restitution procedures are safe and effective in general. The short and long-term outcome is satisfactory. The button technique is the first choice for reimplantation coronary patch. Valve-sparring aortic root reconstructions show promise in safety and applicability.

Objective To analysis the spiral CT scan diagnosis value of lymph node metastasis in thoracic esophageal carcinoma and investigate the rules of lymph node metastasis distributions.Methods 117 patients with surgically and pathologically proved esophageal carcinoma underwent CT scans of the chest before the surgical operation to identify the presence of lymph node metastasis and evaluate the diagnosis value of spiral CT in lymph node metastasis.CT imaging which was detected by CT and histopathological analysis performed with attention to the distribution characteristics.Results In 117 cases of esophageal patients,the diagnosis of sensitivity,specific and accuracy degree on lymph node metastasis were 86.0 ％,80.6 ％,84.6 ％.The most lymph node metastasis in the upper thoracic esophagus is the mediastinum group[8/14(57.1％)]and the trachea group[4/14(28.6 ％)].the middle is on the trachea surrounding group[21/41(51.2 ％)],the main pulmonary artery window group[17/41(41.5 ％)]and subcarinal group[15/41(36.6 ％)].the lower thoracic esophagus is around the side of preventriculus[7/19(36.8 ％)]and the left gastric artery[5/19(26.3 ％)]respectively.Conclusion Spiral CT imaging can accurately evaluate the lymph node metastasis of esophageal and distribution characteristics.

Objective To investigate the peripheral blood Th17 and CD4 + CD25 + regulatory T cell levels and their correlations in patients with primary hepatocellular carcinoma (PHC).Methods Peripheral blood samples were collected from 30 PHC patients and 25 healthy controls in the First Affiliated Hospital of Zhejiang University from June 2008 to May 2009.Mononuclear cells were isolated and the Th17 and CD4 + CD25 + regulatory T cells were detected by flow cytometry and compared between patients and controls by t test.Spearman test was performed to analyze the correlation of Th17 with CD4 + CD25 +regulatory T cell concentrations.Results The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood in healthy controls were (2.10 ± 0.87) ％ and (7.10 ± 2.32) ％ ; while those in PHC patients were (3.38±1.68)％ and (11.78±5.62)％ (t=3.640 and 4.162,P＜0.01).The level of Th17 cells was positively associated with that of CD4 + CD25 + regulatory T cells in PHC patients (r =0.821,P ＜0.01).Conclusion The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood are high in PHC patients and positively correlated with each other,which indicates that CD4 + CD25 + regulatory T cells may contribute to the disease progression and pathogenesis of carcinoma through inducing Th17 cells differentiation.

Dengue virus (DENV) is a re-emerging disease transmitted by the Aedes mosquitoes and has become a major public health problem in southern China. Currently, no antiviral drug or effective vaccine exist to control this disease. The chimeric DENV structural protein vaccine cannot elicit balanced levels of protective immunity to each of the four viral serotypes; therefore, non-structural protein components may be required to construct an effective DENV vaccine. The Dengue virus non-structural 1 (DENV NS1) protein plays a critical role in viral pathogenesis and protective immunity. Therefore, immunity to Dengue 1-4 NS1 subtypes may be crucial for the prevention of severe disease. This review attempts to provide an overview about the structure and function of DENV NS1.
Animals ; Dengue ; immunology ; prevention & control ; virology ; Dengue Vaccines ; chemistry ; genetics ; immunology ; Dengue Virus ; chemistry ; genetics ; immunology ; Humans ; Viral Nonstructural Proteins ; chemistry ; genetics ; immunology

Anti-Bacterial Agents ; therapeutic use ; Antitubercular Agents ; therapeutic use ; Coal Mining ; Drug Therapy, Combination ; Follow-Up Studies ; Humans ; Male ; Ofloxacin ; therapeutic use ; Pneumoconiosis ; complications ; Silicotuberculosis ; drug therapy

BACKGROUND:It has been confirmed that carboxymethylated chitosan has an promoting effect on Schwann cel proliferation and secretion, but its impact on the cyclic adenosine monophosphate-mediated protein kinase A signaling pathway in schwann cel stil needs further study. OBJECTIVE:To investigate the effect of carboxymethylated chitosan on cyclic adenosine monophosphate/ protein kinase A signaling pathway in rat schwann cels. METHODS:The Schwann cels of the second generation neonatal rats were obtained and seeded in 6-wel plate at a concentration of 1×109/L. These Schwann cels were cultured and divided into four groups. The Schwann cels in the control group were cultured by adding PBS. The Schwann cels in the experimental groups were cultured by adding 50, 100 and 200 mg/L of carboxymethyl chitosan solution, respectively. After 24 hours, the concentration of cyclic adenosine monophosphate, protein kinase A activity and cyclic adenosine monophosphate response element binding protein mRNA expression were detected. RESULTS AND CONCLUSION:Compared with the control group, carboxymethyl chitosan increased cyclic adenosine monophosphate concentrations, the activity of protein kinase A and cyclic adenosine monophosphate response element binding protein mRNA expression within the Schwann cels in a dose-dependent manner (P < 0.05). These results demonstrate that carboxymethyl chitosan can increase the concentration of cyclic adenosine monophosphate within the Schwann cels and promote protein kinase A activity, thereby activating cyclic adenosine monophosphate/protein kinase A signaling pathway.

Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

Objective To evaluate the prevalence of macrosomia in Beijing in 2013 and identify its risk factors. Methods Retrospective six months analysis of 14 188 full-term singleton pregnant women from 15 hospitals with different levels in Beijing in 2013. Each participant′s demographic data and medical information were collected individually by questionnaires. Multiple logistic regression analysis was used to examine the associations between variables and the risk of macrosomia. Results (1)The total prevalence of macrosomia was 7.069%(1 003/14 188) in Beijing in 2013. (2)The prevalence varied between the 15 hospitals, the lowest was 5.36%(89/1 659), while the highest reached 8.80%(46/523). Furthermore, the incidence of macrosomia was 1.284 times (95%CI: 1.114-1.480, P=0.001) higher in the second graded hospitals than that in the tertiary hospitals. (3) Multiple logistic regression analyses showed that risk factors for macrosomia were maternal height≥160 cm (adjusted OR=1.875, 95%CI: 1.559-2.256), pre-pregnant body mass index (p-BMI) ≥24.0 kg/m2 (24.0-27.9 kg/m2:adjusted OR=1.696, 95%CI: 1.426-2.018; p-BMI≥28.0 kg/m2:adjusted OR=2.393, 95%CI: 1.831-3.127), gestational weight gain (GWG)≥15.9 kg (adjusted OR=2.462, 95%CI: 2.125-2.853), gravidity>1 (adjusted OR=1.408, 95%CI: 1.224-1.620), gestational weeks≥40 (adjusted OR=2.007, 95%CI:1.745-2.308) and gestational diabetes mellitus (adjusted OR=1.522, 95%CI:1.298-1.784). GWG≥15.9 kg, p-BMI≥28.0 kg/m2 and gestational weeks≥40 were three risk factors that had the strongest associations with macrosomia (all P<0.01). Conclusions The prevalence of macrosomia in hospitals with different levels is obvious different. Gestational weeks, p-BMI and GWG are three main controllable risk factors for macrosomia, thus should receive more attentions.