Objective To investigate the risk factors of surgical site infection ( SSI) in adult patients undergoing major heart surgery, and to provide the reference of controlling the development of SSI. Methods A case-control study was conducted with 54 SSI patients underwent major heart surgery from January 2001 to December 2009 in the case group and 162 controls in the control group. Univariate and multivariate conditional logistic regression analysis were used to analyse the risk factors of SSI development Results Univariate conditional logistic regression showed the risk factors for the development of SSI were left ventricular ejection fraction ( LVEF) < 50% (odds ratio ( OR) = 2.134,95% C/: 1.095 - 4. 159, P = 0. 026) , heart function New York Heart Association classification (NYHA) ≥Ⅲ grade, (OR =2. 390,95% CI: 1. 218 -4. 690; P = 0. 011) .diabetes (OR=3.275, 95% CI: 1.391 - 7. 708; P = 0.007), chronic obstructive pulmonary disease (COPD) ( OR = 5. 408,95% CI: 1.248- 23.445,P = 0.024),extracorporeal circulation time>90 mins ( OR =3. 045,95% CI: 1.540 - 6.024, P = 0. 001 ) , operation time > 4 h ( OR = 3. 281, 95% CI: 1. 610 - 6. 685, P = 0.001 ) , blood product consumption >2 u ( OR = 1. 929,95% CI; 1. 018 -3. 675;P =0. 044) .incision continuous suture close ( OR = 2.344,95%CI: 1.221 -4.498;P =0.010) exploration for bleeding (OR =6. 625,95%CI: 1.597-27.491 ;P =0. 009) , postoperative hyperglycemia (OR = 3. 510,95%CI:l. 5% -7. 718;P =0. 002) ,the stay in intensive care units (ICU) > 72 h ( OR = 3. 281,95% CI: 1. 505 - 7. 150;P = 0. 003). Multivariate analysis showed 3 variables increased with the risk of SSI: operation time >4h (OR = 3. 100,95% CI: 1.470 - 6. 537,P = 0.003 ) , incision continuous suture close (OR =2. 340,95% CI: 1. 183 - 4. 692, P = 0. 015 ) , and postoperative hyperglycemia (OR = 3. 272,95% CI:1.427 -7. 505,P=0. 005 ). Conclusions This study shows that the operation time >4 h, incision continuous suture close and postoperative hyperglycemia are risk factors most likely associated with SSI development in major heart surgery.

OBJECTIVETo observe the effect of Modified Zuoguiwan (MZ) on the balance between helper T cell subsets 17 (Th17) and regulatory T cell subsets (Treg) in estrogen deficiency induced bone loss mice and to explore its mechanism.

METHODSTotally 50 BALB/c mice were divided into the sham-operation group, the ovariectomy model group, the low dose MZ group, the middle dose MZ group, and the high dose MZ group by random digit table, 10 in each group. Mice in the low, middle, and high dose MZ groups were respectively administered with MZ at the daily dose of 7.25, 14.50, and 29.00 g/kg by gastrogavage, 0.5 mL each time for 12 successive weeks. Meanwhile, mice in the sham-operation group and the ovariectomy model group were administered with equal volume by gastrogavage, 0.50 mL each time. The serum estradiol (E2) level was assessed by enzyme linked immunosorbent assay (ELISA). Bone mineral density (BMD) of thigh bone was measured with dual energy X ray absorptiometry. In addition, the population of Th17/Treg subsets in spleen mononuclear cells was analyzed by extracellular and intracellular staining method using flow cytometry. Moreover, the mRNA expression of IL-17A and TGF-β in the spleen mononuclear cells was detected by reverse transcription polymerase chain reaction (RT-PCR).

RESULTSCompared with the sham-operation group, both E2 and BMD significantly decreased, the percentage of Th17 subset and Th17/Treg ratio both increased, the percentage of Treg subset obviously decreased, the expression of IL-17A mRNA significantly increased, and the expression of TGF-β mRNA significantly decreased in the ovariectomy model group (all P < 0.05). Compared with the model group, BMD obviously increased, the percentage of Th17 subset and Th17/Treg ratio both decreased, the percentage of Treg subset obviously increased, the expression of IL-17A mRNA significantly decreased, and the expression of TGF-β mRNA significantly increased in the middle dose MZ group and the high dose MZ group (all P < 0. 05). Correlation analyses showed that BMD was positively related to both the serum E2 level and the percentage of Treg subset (P < 0.05), but negatively related to the percentage of Th17 subset (P < 0.05). In addition, the serum E2 level was positively related to the percentage of Treg subset, but obviously negatively related to that of Th17 subset (P < 0.05).

CONCLUSIONSThere was correlation between Th17/Treg imbalance and E2 deficient bone loss. MZ could decrease the proportion of Th17 subset, but elevate the proportion of Treg subset in E2 deficient bone loss mice. It could achieve therapeutic effect through adjusting the balance of Th17/Treg in E2 deficient bone loss mice.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Estrogens ; deficiency ; metabolism ; Female ; Flow Cytometry ; Humans ; Interleukin-17 ; Mice ; Mice, Inbred BALB C ; Osteoporosis, Postmenopausal ; drug therapy ; RNA, Messenger ; Spleen ; T-Lymphocyte Subsets ; T-Lymphocytes, Helper-Inducer ; T-Lymphocytes, Regulatory ; Th17 Cells ; Transforming Growth Factor beta ; metabolism

OBJECTIVETo investigate the expression and clinical significances of HGFA, Matriptase, HAI-1 and HAI-2 in patients with acute myeloid leukemia (AML).

METHODSThe bone marrow samples from 91 AML patients, 41 AML patients in complete remission, and 32 normal controls were collected. Real time fluorescence quantitative RT-PCR (qRT-PCR) was used to detect the mRNA expressions levels of HGFA, Matriptase, HAI-1, HAI-2 . The expressions of these genes were compared among AML untreated group, the complete remission group and the healthy control group. The correlation of their expression with clinical characteristics was analyzed.

RESULTSThe level of HGFA in the AML untreated group was higher than that in the healthy control group（P<0.05）, while the HAI-2 mRNA level was lower than that in the healthy control group（P<0.05）. The mRNA levels of HAI-1 and Matriptase were not changed significantly in all groups. The HAI-2 mRNA expression level was significantly lower in the high white blood cell group (P<0.05).

CONCLUSIONThe abnormal activation of HGF/c-Met signaling system in AML may result from the increase of HGFA expression and the decrease of HAI-2 expression of the upstream regulatory factors.

Hepatocyte Growth Factor ; Humans ; Leukemia, Myeloid, Acute ; Membrane Glycoproteins ; Proteinase Inhibitory Proteins, Secretory ; Serine Endopeptidases