BACKGROUND:Chitosan (CS) holding a good biocompatibility, biodegradability, antibacterial property and hemostasis effect cannot only promote wound healing and tissue repair, but also exhibit sustained-control release when carrying berberine hydrochloride (Bh). Therefore it functions as an excellent antibacterial and hemostatic material. OBJECTIVE:To prepare the porous CS/Bh composite xerogel and observe its antibacterial and hemostatic properties. METHODS:The porous CS/Bh composite xerogel was prepared using freeze-drying method, and its microstructure was characterized by scanning electron microscope and Fourier transform infrared spectrometer. The biocompatibility was detected through MTT assay and the in vitro antibacterial and hemostatic properties were observed through antibacterial test and blood clotting index. RESULTS AND COCNLUSION:The porosity of the CS/Bh composite xerogel was 83.1%-90.5%and almost degraded after 72 hours of immersion in PBS. The in vitro antibacterial and hemostatic properties of the composite xerogel were significantly better than those of CS, which were enhanced with the Bh content increasing. Additionally, the CS/Bh (10%) composite xerogel showed the best hemostatic and antibacterial abilities in vitro. To conclude, the CS/Bh composite xerogel possesses a good biocompatibility and strong hemostatic and antibacterial abilities, which is a promising postoperative antibacterial and hemostatic material.

OBJECTIVE To study the epidemiology and the sensitivity to antibiotics of bacteremia in intensive care unit,and provide the reference for the clinical antimicrobial agents usage. METHODS 465 cases of bacteremia from Jan 2005 to Dec 2007 in the First Affiliated Hospital,Medical College of Zhejiang University were retrospectively analyzed. RESULTS Totally 1465 strains of pathogens were isolated in three years,and the positive rates were 22.6%.From them 155 strains were fungi(10.6%),611 strains were Gram-positive bacteria(57.9%) and 392 strains were Gram-negative bacteria(37.1%).G + strains mainly included coagulase-negative Staphylococcus(CNS,43.0%) and Staphylococcus aureus(2.1%);the sensitive antibiotics were vancomycin and teicoplanin.G-strains mainly included Acinetobacter baumannii(8.6%);Stenotrophomonas maltophilia(6.6%);Pseudomonas(5.1%) and Klebsiella pneumoniae(5.3%),the sensitive antibiotics were cefoperazone/sulbactam. CONCLUSIONS The positive rates of blood culture are higher in intensive care unit than in others.We should pay more attention to CNS for its high infection rate.The sensitive antibiotics of G + are vancomycin and teicoplanin.The sensitive antibiotics of G-are cefoperazone/sulbactum.Antimicrobial therapy should be conducted according to susceptibility test.The candidemia caused by non-Candida albicans(NCA) is increaseing in recent 3 year.

Objective To compare the advantages of three-dimensional(3D) and two-dimensional(2D) ultrasound in embryo transfer. Methods A total of 319 patients accepted embryo transfter were included in this study. 2D and 3D ultrasound were used to investigate the uterine cavity and transfer distance from the fundus (TDF),respectivly. They were divided into four groups according to TDF difference(D-TDF) between 2D and 3D ultrasound(group of DTDF<3mm,group of DTDF3～5mm,group of 6～9 mm,group of DTDF≥10 mm. Pregnancy outcomes among the four groups were compared. Results Of the 319 patients, 41 were observed to have abnormal uterine cavity. For 140 patients, the TDF measured by 2D ultrasound were different from that measured by 3D ultrasound. Clinical pregnancy rate and implantation rate were found lowest in group of TDF≥10 mm mm (7.7% vs 34.1%,38.1% ,40.0% and 3.6% vs 18.2% ,21.2% ,20.0%, P <0.05). Conclusions 2D ultrasound is limit and deficient for embryo transfer, especially for the visualization of uterine cavity and location of catheter tip, however, it may be better achieved with 3D ultrasound. It is helpful to use the 3D ultrasound to place the catheter tip accurately and improve the pregnancy rate of embryo transfer.

Objective To investigate the sexual problems during early postpartum period and the awareness of postpartum sexual health. Methods A questionnaire survey was carried out in 109 women who received routine postpartum check-up in our outpatient department between October and November 2010 to identify postpartum sexual problems and the awareness of postpartum sexual health. Results The first postpartum check-up was received 6 to 12 weeks after the delivery. Of 109 participants,6 (5.5%), 17(15.6%) and 46 (42.2%) resumed sexual activity within 6,6 to 8,and 12 weeks after the delivery,respectively. Postpartum sexual problems included dyspareunia (35/46,76. 09% ), vaginal dryness (29/46,63.04% ), hypoactive sexual desire (25/46,54. 35% ) and lack of orgasm ( 11/46,23.91% ). 10. 87% (5/46)took contraceptive measures,21.10% (23/109) understood the appropriate time to resume sexual activity, 12. 84% (14/109) was aware of the possible postpartum sexual problems, 13.76% (15/109) knew how to avoid pregnant,6.42% (7/109) would visit a doctor in case of the sexual disorders,and 9. 17%(10/109) hoped that their husband know about sexual health. Conclusion Postpartum sexual problems may be common and maternal awareness of postpartum sexual health could be low.

Objective:To compare the properties of three kinds of denture base materials treated and untreated by hydraulic pressure cooker. Methods: The impact strength, flexural strength, flexural elastic modulus and color difference roughness of three denture base materials, Kunshan Rijin(KR),GC UNIFAST Trad(GC), Shanghai Zhangjiang(SZ), were measured in vitro. All results were statistically analyzed with SPSS software to have ANOVA and Tamhane's T2 tests, α=0.05. Results: Comparison of the same materials between the treated materials and the untreated materials by hydraulic pressure cooker: there were significant statistical differences of impact strength for all the materials. There were significant statistical differences of color difference for KR and SZ. Comparison of the three materials: impact strength, GC>SZ>KR;flexural strength, KR>SZ>GC;flexural elastic modulus, KR>SZ>GC;roughness, GC>KR>SZ. Conclusion: The properties of denture base materials treated by hydraulic pressure cooker are good.

The study aimed to establish a population pharmacokinetic/pharmacodynamic (PPK/PD) model of warfarin. PCR-RFLP technique was used to genotype the CYP2C9 and VKORC1 polymorphisms of 73 patients. RP-HPLC-UV method was used to determine the 190 plasma concentrations of warfarin. Application of NONMEM, the clinical information and 263 international normalized ratio (INR) monitoring data were used to investigate the effect of genetic, physiological, pathological factors, other medication on clearance and anticoagulant response. The final model of warfarin PPK/PD was described as follows: CL = θCL · (WT/60)θWT · θCYP · eηCL (if CYP2C9*1/*1, θCYP = 1; if *1/*3, θCYP = 0.708); EC50 = θEC50 · θVKOR · eηEC50 (if VKORC1- 1639AA, θVKOR = 1; if GA, θVKOR = 2.01; V = θV; K(E0) = θK(E0); Emax = θEmax; E0 = θE0 · eηE0. Among them, the body weight (WT), CYP2C9 and VKORC1 genotype had conspicuous effect on warfarin PK/PD parameters. The goodness diagnosis, Bootstrap, NPDE verification showed that the final model was stable, effective and predictable. It may provide a reference for opitimizing the dose regimen of warfarin.
Anticoagulants ; pharmacology ; Body Weight ; Cytochrome P-450 CYP2C9 ; genetics ; Genotype ; Humans ; International Normalized Ratio ; Nonlinear Dynamics ; Polymorphism, Genetic ; Vitamin K Epoxide Reductases ; genetics ; Warfarin ; pharmacokinetics

Objective:To investigate the clinical therapeutic effect of low-dose chemotherapy in advanced gastrointestinal cancer patients with weak physical condition, and to evaluate the related factors affecting the prognosis.Methods:The clinical data of 118 advanced gastrointestinal cancer patients with weak physical condition who were admitted to Xiamen Branch, Zhongshan Hospital, Fudan University from March 2018 to May 2019 were retrospectively analyzed. Kaplan-Meier method was used to make survival analysis in patients stratified by different factors, and log-rank was used to test. Multiple factor analysis of prognosis was performed by using Cox regression model. The association of clinicopathological factors with the prognosis was evaluated.Results:Among 118 patients, 16 (13.6%) cases were esophageal cancer, 41 (34.7%) cases were gastric cancer, 48 (40.7%) cases were colorectal cancer, 13 (11.0%) cases were pancreatic cancer. The overall survival (OS) rates of 6 months and 1-year were 44.1% and 10.2%, respectively. Survival analysis showed that patients with hemoglobin ≥100 g/L, serum albumin > 40 g/L and normal gastrointestinal function had better OS (all P < 0.05), while patients with physical status score of 3 scores and pain had worse OS (all P < 0.05). Cox multivariate analysis showed that after adjusting age and gender, hemoglobin level ( HR = 0.314, 95% CI 0.241-0.977, P = 0.001), pain ( HR = 2.016, 95% CI 1.697-7.038, P = 0.008) and gastrointestinal function ( HR = 1.751, 95% CI 1.607-6.080, P = 0.036) were independent influencing factors of OS in advanced gastrointestinal cancer patients with weak physical condition after receiving low-dose chemotherapy. Conclusions:Low-dose chemotherapy can still benefit advanced gastrointestinal cancer patients with weak physical condition. Hemoglobin level, pain and gastrointestinal function are independent prognostic factors for these patients.

OBJECTIVETo evaluate the clinical results of the medial patellofemoral ligament (MPFL) reconstruction combined with the lateral retinacular release for the treatment of recurrent patellar dislocation.

METHODSFrom March 2011 to June 2013, 15 patients with recurrent patellar dislocation underwent arthroscopic MPFL reconstruction combined with the lateral retinacular release. The graft was autogenous semitendinosus and semimembranosus tendon. There were 5 males and 10 females with an average age of 19.4 years old (ranged,14 to 32 years old). The patients suffered recurrent patellar dislocation at least twice preoperatively. Preoperative conventional X-ray, CT, and MR examination were used to analyze the causes of the patellofemoral joint and MPFL injury. Preoperative Lysholm score was 69.85 ± 11.52. During operation, the arthroscopic examination was performed to evaluate the patellofemoral alignment and patellar tracking.

RESULTSAll the patients were followed up for an average of 27.6 months (ranged,12 to 36 months) with no recurrent dislocation and sub-dislocation. All the patients showed negative apprehension test at straight and 30 ° flexions of knee. The range of motion of knee returned to normal level at 12 months after operation. There were no patients with subjective discomfort of knee. Postoperative Lysholm score was improved to 92.60 ± 5.75.

CONCLUSIONThe technique of arthroscopic MPFL reconstruction combined with the lateral retinacular release is an effective surgical procedure for the treatment of recurrent patellar dislocation, which can relieve the symptom of knee and improve the patella stability and knee function.

Adolescent ; Adult ; Arthroscopy ; Female ; Humans ; Knee Joint ; surgery ; Male ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; physiopathology ; surgery ; Patellofemoral Joint ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome ; Young Adult

Objective To sum up the measures for nursing the patients with laparoscopic gastrectomy-induced anastomotic leakage treated by open center vacuum aspiration. Method We retrospectively reviewed the histories of 22 patients with laparoscopic gastrectomy-induced anastomotic leakage to look into the nursing measures to look into the management of open vacuum aspiration , observation of the drainage, leakage care, mental care. Results The time for open center vacuum aspiration was between 10 to 17 days, averaged (15.63 ± 3.22)d. The hospital stay was between 13 to 23 days, averaged (17.21 ± 5.47)d. No complications were observed. Conclusions The nursing measures for managing the anastomotic leakage can be effective in improving the effect of peritoneal irrigation. The mental care can be effective for the reduction of patients′pains so as to promote the heal of the leakages.

Objective To analyze the language function impairment differences between the two steps from the form to sound processing and from the sound to meaning processing for pseudo-words reading in Alzheimer' s disease (AD).Methods The pseudo-words reading test consists two parts:pseudo-true words and pseudopseudo words.Each part had 10 words.All of the 20 words were presented randomly.Correct reading presents the processing of from form to sound,and correct judging presents the processing of from sound to meaning.Each correct respond get 1 score,otherwise get 0.Each part had a total score of 20.Results The pseudo-words reading test was performed to 41 mild AD participants with Mini-mental State Examination (MMSE) average scores of (21.06 ±2.86),and 135 normal controls with MMSE average scores of (28.08± 1.52).The two groups were matched in age,gender and education.For all of the mild AD group and normal control group,there was no significant difference between reading score and judging score in either pseudo-true words or pseudo-pseudo words (P＞0.05).Comparing with mild AD group and normal control group,there was no significant difference in reading score in either pseudo-true words or pseudo-pseudo words (P＞0.05).For judging score,there was significant difference in pseudotrue words (P＜0.01) but not in pseudo-pseudo words (P＞0.05).Conclusion Understanding real syllable is impaired in patients with mild AD.