OBJECTIVE To investigate the bacterial distribution and the extent of drug resistance in ICU patients,and offer the first-hand information to the clinical preventive and therapeutic countermeasures. METHODS The antimicrobial susceptibility tests to 28 commonly used antibiotics were performed using the ATB Expression of Bio-Merieux with K-B method.The ESBLs were detected by the disk diffusion tests and the confirmatory tests,and the MRSA,MRCNS,and VRE were also tested at the sametime. RESULTS Totally 264 strains were isolated from the 201 positive samples,among them 192 strains were Gram-negative bacteria,43 strains were Gram-positive ones,and 29 strains were fungi.The percentage of these three groups were 72.7%,16.3% and 11.0%,respectively.The main strains of the Gram-negative bacteria were PAE,ABA,KPN,ECO and SMA,and of the Gram-positive bacteria were EC,SAU and CNS.The major strain of fungi was C.albicans.The pathogens tested showed high drug resistance.The Gram-negative bacteria showed tendency of sensitivity to IPM,AZT,CAZ,FEP,SFC,AMK and CIP,and the Gram-positive bacteria to VAN,SXT,RIF and NIF.For KPN and ECO,the percentage of strains producing ESBLs were 64.7% and 64.3%.And the percentage of MRSA,MRCNS,VRE were 80%,66.7% and 22.2%,respectively. CONCLUSIONS It was showed that the major pathogens infected the ICU patients are Gram-negative bacteria,and the pathogens show the high drug resistance.Doctors should pay more attention to analyze the bacterial resistance profile in order to decrease the incidence of drug resistance and use the antibiotics properly.

OBJECTIVETo investigate the potential of gene therapy of rat prolactinomas mediated by adenoviral vectors with a gene encoding rat tyrosine hydroxylase.

METHODSRecombinant replication-deficient adenovirus named Ad-GFP-TH with rat TH-cDNA and control adenovirus named Ad-GFP were constructed by homologous recombination in bacterial cells. The rat pituitary prolactinoma cell line MMQ are chosen as the target cells to study the effect of gene therapy on their growth and prolactin secretion mediated by Ad-GFP-TH.

RESULTSRecombinant Ad-GFP-TH and Ad-GFP were successfully reconstructed. Transfection of MMQ cells with Ad-GFP-TH not only restrained their growth but also decreased their PRL secretion.

CONCLUSIONGene therapy may serve for a potential treatment for prolactinomas, especially invasive prolactinomas.

Adenoviridae ; genetics ; Animals ; Genetic Therapy ; Genetic Vectors ; Pituitary Neoplasms ; therapy ; Prolactinoma ; therapy ; Rats ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection ; Tyrosine 3-Monooxygenase ; biosynthesis ; genetics

ObjectiveTo explore a new model for lens-induced myopia （LIM） in mice and describe the changes of diopter and ocular biological parameters. MethodsTwenty-seven 21-day-old C57BL/6 mice were divided into three groups （ratio， 5：1：3）： LIM group， plano lens （PL） group and normal control （N） group. The right eyes were intervened while the left eyes were left as control. The refraction was detected with retinoscopy after the pupils were dilated with compound topicamide and ocular axial length was measured by optical coherence tomography （OCT） in vivo at baseline and 1， 2， 3， and 4 weeks after the intervention. Paired t test was performed between left and right eyes within each group. Welch's ANOVA was used for comparison among the three groups. When the difference was statistically significant， the Dunnett's T3 was used to correct P value for pairwise comparison. ResultsAfter 2 weeks of defocus induction， the refraction of the intervened eye in LIM group shifted to myopia about （-2.55±1.54） D（t=6.430， P＜0.000 1）， and the ocular axial length （AL） increased about （0.051±0.024） mm（t=7.837， P＜0.000 1）. The difference of interocular change in refraction in LIM group compared with PL group and N group was -2.30 D （P=0.014） and -2.55 D （P＜0.000 1）， respectively. The difference of interocular change in AL in LIM group was 0.048 mm （P<0.000 1） and 0.047 mm （P<0.000 1） compared with that in PL group and N group， respectively. With the extension of intervention time， the degree of myopia drift increased. ConclusionIn this study， a clasp-based and detachable LIM model was described and validated. After 2 weeks of intervention， the refraction shifted significantly toward myopia and the AL increased significantly. The LIM model is simple to construct and can provide a reference for the model construction of animal experiments in myopia research.

Objective: To compare the clinical effects of autologous semitendinosus tendon and allogenic tendon arthroscopic anatomical reconstruction of anterior talofibular ligament (ATFL) combined with calcaneofibular ligament (CFL) in the treatment of chronic lateral ankle instability. Methods: A retrospective analysis was made of 55 patients with chronic lateral ankle instability who underwent arthroscopic reconstruction of ATFL combined with CFL from January 2012 to June 2017. A total of 28 cases were treated with autologous semitendinosus tendon (autologous group), including 19 males and 9 females, with an average age of 28.5±8.03 years (range, 16-46 years). A total of 27 cases were treated with allogenic tendon (allogenic group), including 17 males and 10 females, with an average age of 27.48±7.89 years (range, 16-46 years). ATFL/CFL was reconstructed by the same method in both groups. The reconstruction methods were the same between the groups. The talus and calcaneus were fixed with absorbable compression nails. Results: The operation duration in the autologous group was 94.07±7.83 min, which was longer than that in the allogeneic group 63.56±7.96 min (t=14.51, P<0.001). Fever days 5.26±0.90 days in allogeneic group were longer than 2.46±0.74 days in autologous group (t=-12.55, P<0.001). Wound healing duration in allogeneic group was 13.44±3.33 days longer than that in autologous group 10.32±2.34 days (t=-4.01, P<0.001). In the autologous group, 28 cases were followed up for 34.54±16.04 months, and 27 cases in the allograft group were followed up for 42.74±17.79 months. The mean AOFAS score improved from 63.64±11.20 before operation to 90.21±4.48 after operation in the autologous group, and that improved from 63.93±10.59 before operation to 89.56±5.15 after operation in the allogeneic group with no significant difference between the two groups after operation (t=0.506, P=0.615). The mean VAS score decreased from 5.79±1.79 before operation to 1.54±1.35 after operation in the autologous group, and from 5.89±1.78 before operation to 2.04±1.32 after operation in the allogeneic group. There was no significant difference between the two groups after operation (t=-1.396, P=0.168). Tegner score increased from 4.07±1.39 to 6.43±1.14 in the autologous group and from 3.85±1.06 to 6.52±0.85 in the allogeneic group with no significant difference between the two groups after operation (t=-0.333, P=0.740). Stress radiographic showed that the talar tilt angle decreased from 15.60°±3.86° to 6.01°±2.64° in the autologous group, 16.99°±3.78° to 7.14°±3.34° in the allogeneic group, and there was no significant difference between the two groups after operation (t=-1.382, P=0.171). Anterior talar displacement reduced from 10.82±3.12 mm to 4.03±1.69 mm in the autologous group, from 10.10±2.02 mm to 4.17±1.52 mm in the allogeneic group, and there was no significant difference between the two groups after operation (t=-0.326, P=0.746). No donor tendon dysfunction was found in the autologous group. At the end of follow-up, there was no difference in ankle dorsiflexion, plantar flexion and hind foot mobility between autologous group and allogeneic group. Conclusion Arthroscopic autologous tendon and allogeneic tendon reconstruction of AFTL combined with CFL can obtain satisfactory short-term results. The autologous tendon group was superior to the allogeneic group in terms of fever, wound healing time. However, there was no significant difference in clinical effects between the two groups.

ObjectiveTo explore the effect of health locus of control on the early rehabilitation after anterior cruciate ligament（ACL） reconstruction. MethodsFrom July 2019 to October 2019， a prospective cohort study of 155 ACL patients receiving reconstruction （male=124 and female=31） in our hospital was conducted. The general data questionnaire， MHLC-C， Tegner activity score， IKDC Score， Lysholm Score and Y-Balance Test were used for further analysis. The correlation between HLC and early rehabilitation after ACL reconstruction was explored by Wilcoxon signed-rank tests， correlation analysis and Logistics regression analysis. ResultsPositive correlations were found between the internality health locus of control （IHLC） and the IKDC score （r_3m=0.77， r_6m=0.70， P<0.001）， as well as the Lysholm scores （r_3m=0.68， r_6m=0.64， P<0.001） and the Tegner activity score （r_3m=0.24， r_6m=0.46， P<0.05） in 3 and 6 months after surgery， and higher IHLC score indicated a better y-balance test outcome［OR 95%CI=0.86（0.76， 0.97）， P=0.016］. Chance health locus of control （CHLC） was negatively correlated with the IKDC score （r_3m=-0.71， r_6m=-0.67， P<0.001）， the Lysholm score （r_3m=-0.49， r_6m=-0.43， P<0.001） and the Tegner activity score （r_3m=-0.22， r_6m=-0.35， P<0.05） in 3 and 6 months after surgery， and higher CHLC score indicated worse outcome of y-balance test ［OR 95%CI=1.26（1.12， 1.41）， P<0.001］. There was a negative correlation between the Powerful others health locus of control （PHLC） and the IKDC score （r_3m=-0.51， r_6m=-0.50， P<0.001）， the Lysholm scores （r_3m=-0.36， r_6m=-0.40， P<0.001）， but there was no correlation with the Tegner activity score in 3 and 6 months after surgery（P>0.05）. The risk of poor y-balance test increased by higher score of PHLC ［OR 95%CI=1.74（1.29， 2.34）， P<0.001］. ConclusionA significant correlation was found between the health locus of control and the early rehabilitation effect after ACL reconstruction. Higher internality health locus of control scores indicated a better rehabilitation outcome， while higher scores of external loci of control indicated higher risk of worse rehabilitation outcome.

OBJECTIVETo investigate the dose and time-dependent effects of lipopolysaccharide (LPS) on cytoskeletal F-acitn and G-actin reorganizations by visualizing their distribution and measuring their contents in human umbilical vein endothelial cell line ECV-304.

METHODSF-actin was labeled with rhodamine-phalloidin and G-actin with deoxyribonuclease I (DNase I)conjugated with fluorescein isothiocyanate (FITC). Contents of cytoskeletal proteins were obtained by flow cytometry.

RESULTSF-actin was mainly distributed peripherally in endothelial cells under normal conditions. LPS stimulation caused the formation of stress fibers and filopodia. G-actin was normally seen in perinuclear and nuclear areas in control ECV-304 cells. Under LPS stimulation, G-actin dots appeared in the cytoplasmic region. The actin disorganization was accompanied by the time- and dose- dependent decrease in F-actin pool and increase in G-actin pool.

CONCLUSIONSLPS can induce characteristic morphological alterations of actin cytoskeleton and formation of intercellular gap in endothelial cells, accompanied by changes in F-actin and G-actin pools.

Actins ; drug effects ; Analysis of Variance ; Cells, Cultured ; Deoxyribonuclease I ; Dose-Response Relationship, Drug ; Endothelial Cells ; chemistry ; Escherichia coli ; Fluorescein-5-isothiocyanate ; Fluorescent Dyes ; Humans ; Lipopolysaccharides ; pharmacology ; Phalloidine ; Rhodamines ; Umbilical Veins ; cytology

OBJECTIVETo evaluate the anatomy basis and clinical effects of the lower trapezius myocutaneous flap to reconstruct defects in the head and neck.

METHODSFrom Jan. 2000 to Jan. 2004, lower trapezius myocutaneous flaps which were used to reconstruct the defects in the head and neck after radical tumors resection in twenty four cases in Center of Craniomaxillofacial Surgery of the Second Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. Male was 14,female was 10. Ages ranged from 35 to 76 (median = 54). The causes of the defects were malignant neoplasm of the tongue (n = 10), buccal (n =4), oral floor (n = 2), parotid (n = 1 ), oropharynx (n = 2), gingiva (n = 3), maxillary sinus (n = 1), zygomatic and frontal part (n = 1). Fifteen patients were primary, nine patients were recurrent. The flaps ranged from 8 cm x 7 cm to 12 cm x 10 cm.

RESULTSTwenty one flaps survived fully and the other three had partial necrosis at the distal portion. Twenty two donor sites were closed primarily. Follow up 6 to 24 months, all flaps were good, the texture and color of the flaps were satisfying.

CONCLUSIONSLower trapezius myocutaneous flap is a thin, pliable and simple myocutaneous with a long pediculi and wide arc of rotation, and it is preferred for reconstructing huge soft-tissues defects in the head and neck regions simultaneously.

Adult ; Aged ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Neck Muscles ; transplantation ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps

Objective To evaluate the efficacy of 131I treatment for bone metastases from DTC and analyze the survival rates after 131I treatment and prognostic factors. Methods One hundred and six DTC patients with bone metastases treated by 131I during January 1991 and January 2009 were retrospectively analyzed. Treatment efficacy was assessed based on serum Tg change, bone pain palliation and changes on medical imaging. Univariate analysis was performed for defining the factors affecting 131I treatment efficacy. Survival curves were estimated using the life table method. Survival analysis was performed using Kaplan-Meier method. Results Serum Tg decreased dramatically in 37/106 (34.9%) patients treated with131I. Thirty-nine of 61 patients (63.9%) with bone pain had pain relief. Age, tumor subtype and presence of non-osseous distant metastases were significant factors affecting 131I treatment efficacy based on serum Tg change (χ2=6.443, 11.455, 6.756, all P<0.05), but had no significant effects on bone pain palliation (χ2=0, 0, 0.060, all P>0.05). There were no imaging changes of bone metastases in 77.4% of patients after 131I treatment. The overall 5-year and 10-year survival rates from initial diagnosis of bone metastases was 86.47% and 57.90%, respectively. Univariate analysis showed that number of metastases, presence of non-osseous distant metastases and pre-131I treatment surgery were significant factors for survival (Log-rank values were 4.05, 5.98, 4.22, all P<0.05). Conclusions 131I treatment for bone metastases from DTC is effective for lowering serum Tg and palliation of bone pain. Single metastasis, absence of non-osseous distant metastases and pre-131I therapy surgery are favorable predictors of prognosis.

Nonalcoholic fatty liver disease (NAFLD), especially nonalcoholic steatohepatitis (NASH), is a common hepatic manifestation of metabolic syndrome. However, there are no effective therapy to treat this devastating disease. Accumulating evidence suggests that the generation of elastin-derived peptides (EDPs) and the inhibition of adiponectin receptors (AdipoR)1/2 plays essential roles in hepatic lipid metabolism and liver fibrosis. We recently reported that the AdipoR1/2 dual agonist JT003 significantly degraded the extracellular matrix (ECM) and ameliorated liver fibrosis. However, the degradation of the ECM lead to the generation of EDPs, which could further alter liver homeostasis negatively. Thus, in this study, we successfully combined AdipoR1/2 agonist JT003 with V14, which acted as an inhibitor of EDPs-EBP interaction to overcome the defect of ECM degradation. We found that combination of JT003 and V14 possessed excellent synergistic benefits on ameliorating NASH and liver fibrosis than either alone since they compensate the shortage of each other. These effects are induced by the enhancement of the mitochondrial antioxidant capacity, mitophagy, and mitochondrial biogenesis via AMPK pathway. Furthermore, specific suppression of AMPK could block the effects of the combination of JT003 and V14 on reduced oxidative stress, increased mitophagy and mitochondrial biogenesis. These positive results suggested that this administration of combination of AdipoR1/2 dual agonist and inhibitor of EDPs-EBP interaction can be recommended alternatively for an effective and promising therapeutic strategy for the treatment of NAFLD and NASH related fibrosis.

OBJECTIVETo use a mathematical model and computer simulation to study transmission dynamics and control of schistosomiasis in mountainous regions of Sichuan.

METHODSBased on studies of schistosomiasis japonica transmission in 20 villages in mountainous regions of Sichuan, a mathematical model was developed to characterize the impact of local environmental factors on transmission intensity. The model integrated site-specific factors and was calibrated to field epidemiological data from 3 subset villages. The dichotomic method was then used to predict different control measures.

RESULTSThe study showed high variations in prevalence of infection and infection intensity across villages, ranging between 3%-73%, 0.1-100 epg (eggs per gram stool), respectively. Important factors including occupation of local residents, exposure to contaminated water, microclimatic characteristics were integrated in the model. The predictions of dichotomic models showed that continuing chemotherapy (coverage between 50%-60%) could reduce infection intensities to 30%-80%, but could not change local transmission potential; therefore, the termination of chemotherapy would be followed by bouncing back of transmission. Sustaining targeted environmental interventions through snail and parasite oval control at certain coverage (30%-50%, respectively) could reduce the transmission to relatively stable levels. The model predictions showed that an integrated control (e.g., including both chemotherapy and environmental interventions) could suppress the transmission to an undetectable level even interruption of transmission between 5-10 years.

CONCLUSIONThe study demonstrated the feasibility of using a dynamic model, calibrated to local data, to gain insights into complicated processes underlying the transmission and informing site-specific control strategies.

Adolescent ; Adult ; Animals ; Child ; Child, Preschool ; China ; Environment ; Humans ; Middle Aged ; Models, Theoretical ; Schistosoma japonicum ; Schistosomiasis japonica ; epidemiology ; prevention & control ; transmission ; Snails ; parasitology