Objective To investigate the causes of an outbreak of healthcare-associated infection with methicillin-resist-ant Staphylococcus aureus (MRSA)in a neurosurgical intensive care unit(NSICU).Methods Epidemiological investigation on 8 patients with lower respiratory tract infection (LRTI)in a NSICU between June 15 and June 28,2104 were performed by combination methods of prospective and retrospective survey.Results The attack rate of MRSA LRTI in NSICU patients was 22.86%,a total of 16 MRSA isolates were detected from patients’clinical specimens,nasal vestibule,as well as hospital surroundings during the period,pulsed-field gel electrophoresis (PFGE)result revealed that infection outbreak was caused by two subtypes of MRSA;risk factors analysis showed that long length of stay in ICU and aspiration of spu-tum through bronchoscopy were risk factors for MRSA LRTI.Conclusion Contamination of bronchoscope was the key factor for this epidemic spread of healthcare-associated MRSA infection.

Objective To understand the effect of improving compliance rate to multidrug-resistant organism (MDRO)prevention and control measures on reducing MDRO transmission in the intensive care unit (ICU ). Methods All patients in 5 ICUs of a hospital in March-June 2014 were chosen,March 1-April 30,2014 was base-line survey stage,May 1-June 30,2014 was intervention stage (comprehensive intervention measures were taken), the implementation of patients contact isolation measures,as well as awareness of MDRO-related knowledge among health care workers(HCWs)in 5 ICUs before and after intervention were compared respectively. Results HCWs' awareness rates of MDRO transmission modes,contact isolation measures,and informing of department transfer after intervention were all higher than before intervention(100.00% vs 67.22% ,98.89% vs 61.11% ,93.33% vs 45 .56% ,respectively);except single-room isolation,compliance rates to other prevention and control measures (including doctor's advice on isolation,bedside isolation,wearing isolation gowns,adding isolation logo)were all higher than before intervention(>70% vs <50% ,all P<0.01). Detection rate of MDROs after intervention was lower than before intervention (7.16% [90/1257]vs 9.65% [117/1212],χ2= 5.00,P= 0.03). Conclusion Com-prehensive intervention measures can improve HCWs'compliance to prevention and control measures on MDROs, and reduce the transmission of MDROs.

Objective To analyse expression levels of protein kinase C θ (PKC θ ) and its association with Th1/Th2,Tc1/Tc2 cytokines in peripheral blood mononuclear cells (PBMC) of patients with myelodysplastic syndromes and aplastic anemia (AA),and understand the pathogenesis of MDS and AA.Methods Fourteen patients with MDS-RA, fifteen patients with AA, and thirty health controls of PBMC were collected.mRNA expression levels of PKC θ were measured by RTQ-PCR,and the expression levels of Th1/Th2,Tc1/Tc2 cytokines were measured by the flow cytometry. Results The expression PKC θ mRNA (AA group:23.54±1.01,MDS group:23.76±1.58 ;health control group:27.12±1.12, P=0.004) and Th1and Tc1cytokines were statistically significant of among groups (all P＜0.05). Th2 and Tc2 cytokines were no statistical difference among groups (allP＞0.05). There were no statistical difference in the PBMC of PKC θ mRNA and Th1/Th2,Tc1/Tc2 cell cytokine (allP＞0.05) between MDS and AA.Conclusions The expression levels of PKCθmRNA and Th1,Tc1cells correlated cytokine in MDS and AA patients of PBMC are increases.

BACKGROUND: Adipose-derived stem cells (ADSCs) represent one of the promising cell sources for myocardial regeneration due to their easy accessibility and efficacy in the improvement of cardiac function following myocardial infarction. However, previously reported studies on the underlying mechanism of ADSCs-mediated cardioprotective effect mainly focused on the ADSCs cultured at room air. OBJECTIVE: To test the paracrine actions and anti-apoptotic effect of ADSCs under hypoxic conditions. METHODS: After isolation and culture, neonatal rat myocardial cells were injured by hydrogen peroxide and co-cultured with rat ADSCs under normoxia and hypoxia (10% O2) conditions. Ratio of reduced glutathione to oxidized glutathione (GSH/GSSG) in the cell pellet and levels of vascular endothelial growth factor (VEGF), insulin-like growth factor 1 (IGF-1), and basic fibroblast growth factor (bFGF) were tested by ELISA. Expression of apoptotic proteins Bax and Bcl-2 were determined by western blot. RESULTS AND CONCLUSION: GSH/GSSG, VEGF, IGF-1, and bFGF were decreased in neonatal rat myocardial cells injured by hydrogen peroxide. ADSCs significantly attenuated hydrogen peroxide-induced myocardial apoptosis by increasing the ratio of GSH/GSSG and the secretion of VEGF, IGF-1 and bFGF. ADSCs also down-regulated Bax expression and up-regulated Bcl-2 expression. To conclude, hypoxic conditions can enhance the anti-apoptosis and cardioprotective effects of ADSCs through the paracrine mechanism.

Adult ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; diagnosis ; drug therapy ; Prurigo ; diagnosis ; drug therapy ; Recurrence

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Azithromycin ; therapeutic use ; Ceftriaxone ; therapeutic use ; Humans ; Levofloxacin ; therapeutic use ; Male ; Middle Aged ; Nitrofurantoin ; therapeutic use ; Urethra ; microbiology ; pathology ; Urethral Diseases ; drug therapy ; therapy ; Young Adult

OBJECTIVETo explore the detection rate of myocardial bridge (MB) in coronary angiography and its clinical significance.

METHODThe clinical data of 2 165 cases who had received selective coronary angiography were studied retrospectively.

RESULTSMB was detected in 66 patients (3. 0% ) , among whom 62 were found in left anterior descending artery. Among the 58 cases with isolated myocardial bridge, 24 had no remarkable symptoms, whereas 34 showed clinical symptoms such as angina. The arterial stenosis beneath MB was significantly correlated with clinical symptoms (P < 0. 05 ).

CONCLUSIONThe improvement of the detection rate of MB can effectively decrease misdiagnosis and benefit the treatment.

Adult ; Aged ; Aged, 80 and over ; Coronary Angiography ; Coronary Vessel Anomalies ; diagnostic imaging ; therapy ; Humans ; Middle Aged ; Retrospective Studies

BACKGROUNDOver past two decades, vagus nerve stimulation (VNS) has been widely used and reported to alleviate seizure frequency worldwide, however, so far, only hundreds of patients with pharmaco-resistant epilepsy (PRE) have been treated with VNS in mainland China. The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.

METHODSWe retrospectively assessed the clinical outcome of 94 patients with PRE, who were treated with VNS at Beijing Fengtai Hospital and Beijing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients. The clinical data analysis was retrospectively examined.

RESULTSSeizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve. At last follow-up, we found McHugh classifications of Class I in 33 patients (35.1%), Class II in 27 patients (28.7%), Class III in 20 patients (21.3%), Class IV in 3 patients (3.2%), and Class V in 11 patients (11.7%). Notably, 8 (8.5%) patients were seizure-free while &ge;50% seizure frequency reduction occurred in as many as 60 patients (63.8%). Furthermore, with regard to the modified Engel classification, 12 patients (12.8%) were classified as Class I, 11 patients (11.7%) were classified as Class II, 37 patients (39.4%) were classified as Class III, 34 patients (36.2%) were classified as Class IV. We also found that the factors of gender or age are not associated with clinical outcome.

CONCLUSIONSThis comparative study confirmed that VNS is a safe, well-tolerated, and effective treatment for Chinese PRE patients. VNS reduced the seizure frequency regardless of age or gender of studied patients.

Adolescent ; Adult ; Child ; Child, Preschool ; Drug Resistance ; Epilepsy ; therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Vagus Nerve Stimulation ; methods ; Young Adult

OBJECTIVETo construct a three-dimensional (3D) model of arteries supplying the extrahepatic bile duct with a new segmentation algorithm based on submillimeter CT data.

METHODSThe new image segmentation algorithm based on interactive volume rendering was integrated into Medical Image Three-Dimensional Visualization System (MI-3DVS) as an intersected plug-in. The abdominal submillimeter CTA data of 10 patients were imported into MI-3DVS and the 3D model of the extrahepatic bile duct and its supplying arteries were constructed. The 3D model was zoomed in, zoomed out and spinned for observation and analysis of the arteries supplying the extrahepatic bile duct.

RESULTSThe 3D models of the blood supply to extrahepatic bile duct allowed stereoscopic, and accurate display of the fourth- and fifth-level branches of the hepatic artery, the second-level branches of the cystic artery, the pancreatic duodenal artery arch and the retroportal artery. The 3D models also provided a clear vision of the biliary structures including the hepatobiliary tract, the left and right hepatic ducts, gallbladder, the liver duct, and the common bile duct.

CONCLUSIONBased on the segmentation method of interactive volume rendering, the CT data of the arterioles supplying the extrahepatic bile duct can be extracted and segmented for 3D reconstruction to display the three-dimensional anatomical structures of the extrahepatic bile duct and its supplying arteries.

Bile Ducts, Extrahepatic ; anatomy & histology ; Hepatic Artery ; anatomy & histology ; Humans ; Imaging, Three-Dimensional ; Liver ; blood supply ; Models, Anatomic

OBJECTIVETo analyze the CT and magnetic resonance imaging (MRI) findings of craniopharygioma and explore the correlation between the pathological findings and clinical features of the disease.

METHODSThe CT and MRI findings of 123 pathologically confirmed craniopharygioma cases were reviewed retrospectively in conjunction with the pathological findings and surgical data.

RESULTSThis patient cohort consisted of 70 male and 53 female patients with their age ranging from 1 to 72 years (mean 23.82 years). Of the 123 craniopharyngioma patients, 59 were found to have adamantinous craniopharyngiomas, 41 had papillary squamous craniopharyngiomas, and 23 had mixed tumors. Solid tumor was found in 18 cases, cystic tumor in 38 cases, and calcification in 78 cases; in 23 cases, the posterior of the tumor did not exhibit clear boundary from the wall of the three cerebral ventricles, and in 11 cases CT and MRI displayed hypophysial stalk, which was found intraoperatively in 53 cases.

CONCLUSIONSMRI allows clear vision of the range of craniopharyngioma involvement and the anatomical structures surrounding the tumor. CT, on the other hand, shows better performance in displaying the calcification foci. Accurate identification of the site, dimension, calcification patterns and relation between the hypophysial stalk and hypothalamus by the imaging modalities significantly benefits the optimization of the surgical plan for the tumor.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cohort Studies ; Craniopharyngioma ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult