BACKGROUND: The present study aims to investigate whether mannitol facilitates central nervous system (CNS) entry of vancomycin and alleviates methicillin-resistant Staphylococcus aureus (MRSA) intracranial infection. METHODS: Blood-brain barrier (BBB) permeability was assessed by measuring the concentration of sodium fluorescein (NaF) in the brain tissues of rats and fluorescein isothiocyanate-dextran (FITC-dextran) in a single-cell layer model. Neutrophil infiltration in the brain tissue, inflammatory cytokine levels in the serum, neurological function, and 7-day survival rates were used to evaluate therapeutic effects of mannitol and vancomycin in MRSA-infected rats. Syndecan-1 and filamentous actin (F-actin) levels were measured, and the relationship between F-actin and the endothelial glycocalyx layer (EGL) was explored via the depolymerization agent cytochalasin D and the polymerization agent jasplakinolide. RESULTS: Following mannitol administration, the NaF and vancomycin concentrations in the brain tissue increased rapidly within 5 min and remained stable for 30 min, indicating that mannitol increased BBB permeability for 30 min. In vitro, mannitol treatment led to significantly greater FITC-dextran permeation through a single-cell layer compared to controls. In the MRSA intracranial infection model, rats treated with mannitol and vancomycin simultaneously presented less inflammation, improved neurological function, and increased 7-day survival rate compared to rats treated with vancomycin and mannitol at 10-hour intervals. Further experiments revealed that mannitol decreased the expression of syndecan-1 in brain tissues, which was confirmed by in vitro experiments showing that mannitol significantly decreased syndecan-1 via F-actin depolymerization. CONCLUSION: Mannitol may enhance the therapeutic efficacy of vancomycin against intracranial MRSA infection by decreasing the endothelial glycocalyx of the BBB via F-actin depolymerization.

Acute traumatic coagulopathy (ATC) is one of coagulopathy induced by severe trauma in the early phase of trauma.It is always with high morbidity,mortality and multiple organ failure.Early diagnosis and treatment is the main content of trauma surgery in the department of emergency and the key to reduce mortality.Thrombelastography (TEG) can comprehensively assess the different stages of coagulation,early diagnose disturbance of blood coagulation and guide the goal-directed therapy with low complications,mortality and medical costs.TEG has been widely used in the operation of cardiac surgery,liver transplantation and trauma surgery to monitor coagulation and guide therapy.This paper mainly reviews the clinical value of thrombelastography in diagnosis and treatment of acute traumatic coagulopathy.

Asialoglycoprotein receptor(ASGPR),also called galactose receptor,is predominantly expressed on the sinusoidal surface of mammalian hepatocytes and is involved in many physiological functions.For many years ASGPR has been applied for targeting hepatocytes in drug and gene delivery and for functional mapping of the liver,and considerable progress has been made.ASGPR-mediated liver-targeted drug delivery mainly involved anti-tumor drugs and cholesterol-lowering drugs,etc.Liver-targeted gene delivery was often seen in antisense drugs.The research of hepatic imaging mainly involved the evaluation of liver function and identification between hepatocellular carcinoma and hepatic metastasis of tumors.In addition,researchers have also extended its applications to some new fields,such as three-dimension culture of hepatocytes,hepatocytes screening,and hepatocytes transplantation.New achievements in studies of ASGPR-mediated liver targeting are reviewed in this article.

ObjectiveTo evaluate two "up and down stair" methods used by hemiplegic patients.Methods40 cases with hemiplegia were randomly divided into two groups with 20 cases in each group. Patients in the group A went upstairs with health leg and downstairs with affected leg, while, patients in the group B upstairs with affected leg, downstairs with health leg, and then up and down stairs with health and affected leg alternated. Effects of two training menthods were compared.ResultsEach of two training methods had its advantage and disadvantage, but motor function and mobile ability of patients in the group B were better than patients in the group A (P<0.05).ConclusionHemiplegic patients Should choose different training method of up and down stairs according to his status, and not always choose the method of going upstairs with health leg and downstairs with affected leg.

Adult ; Ear Ossicles ; injuries ; Humans ; Joint Dislocations ; Male ; Wounds and Injuries

OBJECTIVETo investigate the epidemiological characteristics, clinical manifestations, diagnosis, and treatment of Brucella orchitis, so as to provide reliable evidence for the prevention and treatment of the disease.

METHODSWe conducted retrospective statistical analyses on the medical records of 48 outpatients and 21 inpatients with Brucella orchitis.

RESULTSBrucella orchitis was diagnosed in 6.67% of the male patients with brucellosis (69/1 034). The disease exhibited typical epidemiological features, with a higher incidence rate among those in frequent contact with sheep and elderly people, in the period from April to July, and in the areas with sheep husbandry. All the Brucella orchitis patients had such local symptoms as testicular pain and swelling, more frequently involving both testes, and other most common symptoms included fever, chills, sweating, and painful joints. Based on IIEF-5, 45 of the patients suffered from severe erectile dysfunction, with their reproductive function temporarily affected in the course of the disease. Misdiagnosis easily occurred in the early stage of the disease. Therapeutic options mainly included doxycycline hydrochloride and rifampicin, administered orally or intravenously, which could effect a cure, though relapse might occur in some cases.

CONCLUSIONBru- cella orchitis has distinct epidemiological characteristics, with clinical manifestations of testicular pain and swelling. Though a transient disease, it affects the reproductive function of the patient before cured. It can be treated by combined oral and intravenous medication, with painkillers or ice bags for testicular pain and swelling.

Animals ; Brucella ; pathogenicity ; Brucellosis ; complications ; diagnosis ; therapy ; Humans ; Male ; Orchitis ; diagnosis ; microbiology ; therapy ; Retrospective Studies ; Sheep

This study was aimed to carry out pharmacological research on the hemostatic activity and mechanism of Yi medicine Ma-Bu (Paris polyphylla Smith var stenophylla Franch.). One kind of C27 steroidal saponin from P. polyphylla Smith var stenophylla Franch. was isolated and identified as Paris saponin H (PSH). The effect of PSH on the index of bleeding time (BT), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) of mice were measured. The results showed that PSH have significant hemostatic activity by shortening BT. The effect of PSH on shortening PT and APTT of mouse was not significant. However, the FIB was enhanced significantly after treatment with PSH. It was concluded that PSH had no significant promoting effect on the extrinsic coagulation pathway (ECP) or the intrinsic coagulation pathway (ICP). The enhancement of FIB may be a pathway for the effect of hemostatic activity by PSH.

Objective To explore the characteristics and regulations of CD28 and CTLA-4 expressions in the process of mice' T-cell inefficiency induced by staphylococcal enterotoxin A(SEA).Methods Twelve mice were averagely divided into three groups(4 each).The mice in group 1 received single injection of SEA,and the mice in group 2 and 3 received SEA injection twice and three times,respectively,with a 3 days interval.Mice were sacrificed at day 1,3,7 and 14 after the last injection,and then the splenic lymphocytes were isolated.The expressions of CD28 and CTLA-4 in cellular membrane and the intracellular expressions of CTLA-4 and IL-2 were detected with flow cytometry.Results In group 1,the CD28 expression in cellular membrane and the intracellular expression of IL-2 were significantly up-regulated,while the CTLA-4 expressions both in cellular membrane and intracellular expression were lower with no obvious changes.In group 2,the expressions of both CD28 and IL-2 were up-regulated slightly,the expressions of CTLA-4 increased significantly both in cellular membrane and intracellular expression,even more increase was the intracellular CTLA-4 expression.In group 3,the expressions of CD28 and CTAL-4 in cellular membrane and the intracellular CTLA-4 expression declined,and at day 7 the intracellular IL-2 expression was undetectable.Conclusions SEA may obviously promote the activation of naive T-cells when initially used to induce the splenic lymphocytes,while multiple stimulations(e.g.3 times) of SEA may lead T-cells to anergy.On the process of inefficiency,the declined IL-2 production may be closely related to the down-regulation of CD28 expression;the up-regulation of CTLA-4 expression may profit inducing inefficiency,but is not on the maintenance of inefficiency.

Objective To investigate the changes and significance of I?B kinase-?(I?K-?) in the lung tissues of rabbits with hemorrhagic shock.Methods The expressions of I?K-? and NF-?B in the lung tissues and the concentration of tumor necrosis factor-?(TNF-?) in the plasma were measured by in situ hybridization(ISH),immunohitochemistry and enzyme linked immune adsorbent analysis(ELISA), respectively. And the pathological changes were examined with light microscope in lung tissues.Results In hemorrhagic shock group,the expressions of I?K-?(0 1685?0 0164)and NF-?B( 0 1469?0 0083)in lung tissues , the level of TNF-?(636 72?100 23) in the plasma were obviously higher than those of normal group [I?K-?(0 0427?0 0241),NF-?B(0 0358?0 0048),TNF-?(199 51?35 69)ng/L](all P

Inheirted metabolic disodrers(IMD)involves in multiple substance dysbolism,which usually results in irreversible neurological lesions because of various categories and complicated clinical manifestations.In resent years,IMD became one of the hot spots in medical domain around the world,original diagnostic technique and management progressed unceasingly.This paper provides an overview of the traditio-nal detection and treatment about IMD,and reviews the new techniques such as gene analysis,gene chip,organ transplantation and enzyme replacement therapy at the same time.