Age-related white matter changes are common in the elderly and are considered as manifestation of arteriolosclerotic small vessel disease. Most recent studies have shown that the white matter changes are associated with cognitive impairment and dementia, urinary incontinence, gait disturbances, depression and increased risk of stroke and death. Although the clinical phenotypes of the white matter changes have been extensively studied, to date, only few clinical trials have been conducted in this area. In this review, we discussed the current understanding in the epidemiology, pathogenesis, imaging features, chemical biomarkers, clinical importance, and management of age-related white matter changes, with special emphasis in studies that were conducted among Asians.

Objective To analyze the risk factors for healthcare-associated pneumonia (HAP) in patients with orthopedic injury,provide the basis for making prevention and control measures.Methods HAP occurred in patients with orthopedic injury and admitted to the department of orthopedics of a hospital from June 2011 to May 2015 were investigated retrospectively,risk factors were analyzed by univariate and multivariate logistic regression methods.Results A total of 2 578 patients with orthopedic injury were investigated,92 patients developed HAI,incidence of HAP was 3.57％.107 strains of pathogens were detected,the major were Klebsiella pneumoniae (n =22,20.56％),Escherichia coli (n =14,13.08％),and Acinetobacter baumannii (n =13,12.15％).Risk factors for HAP in patients with orthopedic injury were length of hospital stay≥15 days,smoking history≥3 years,bedridden ≥7 days,associated with underlying diseases,complications,indwelling catheter≥7 days,surgical operation,mechanical ventilation,admitted to intensive care unit,open injury,blood sugar≥11 mmol/L,plasma albumin＜30 g/ L,hemoglobin concentration＜90 g/L,and use of glucocorticoid≥4 days (all P＜0.05).Multivariate logistic regression analysis showed that smoking,bedridden,surgery,mechanical ventilation,glucocorticoid use,and anaemia were independent risk factors for HAP in patients with orthopedic injury.Conclusion The occurrence of HAP in patients with orthopedic injury is related with multiple factors,the major are surgical operation,mechanical ventilation,glucocorticoid use,long term smoking,bedridden,and anaemia.

Objective: To prepare betahistine dihydrochloride sustained-release matrix tablets. Methods: The tablets were pre-pared with water soluble HPMC matrix, and the release behaviors were investigated by single factor study. The formula and preparation procedures were optimized by orthogonal design. Results:The optimal technology was as follows:using 60% HPMC K15M as the ma-trix material, calcium hydrogen phosphate as the filler, 10% PVP in 90% alcohol as the bonding agent;wet granulation compression technique was used to prepare the tablets with the tablet weight of 500mg. The in vitro drug release fits a Higuchi equation and the drug can be sustained-released within 12 h. Conclusion:The preparation technology is simple and the tablets have sustainol release behav-ior.

Humans ; Muscular Dystrophy, Duchenne ; Research ; trends

Objective To research the expression of mitofusin-2 (mfn2) and tumor metastasis suppressor genes (nm23)in bladder cancer cells and its correlation with clinical pathological feature. Methods Immunohistochemistry was used to measure the expression of mfn2 and nm23.Sixty-five cases of bladder cancer were sampled,which include fif-ty cases of male and fifteen cases of female. TNM stage:Forty-seven cases were in stage I;Ten cases were in stage II; Five cases were in stageⅢ; Three cases were in stageⅣ. Other fifteen cases were sampled from normal bladder or benign tumor of bladder as control . All cases were collected from department of pathology,affiliated Hospital of hebei union university. Results The positive expression rate of mfn2 in bladder cancer tissues was significantly higher than those in normal blad-der tissues and benign tumor of bladder(χ2=32.528,P<0.05);The positive expression rate of nm23 in bladder cancer tis-sues was significantly lower than those in normal bladder tissues and benign tumor of bladder (χ2=19.719,P<0.05);the high expression level of mfn2 in bladder cancer was associated with tumor differentiation and TNM stage(P<0.05),but not corre-lated with age,sex,lymph node metastasis and clinical grade. The low level of nm23 was associated with TNM stage,clinical grade and LN metastasis. Conclusion The positive expression rate of mfn2 was increased in bladder cancer. It indicated that there was a close relationship between mfn2 and the occurrence and development of bladder cancer;The expression rate of nm23 was decreased in bladder cancer,it may be a predictor for metastasis and prognosis of bladder cancer.

Objective To analyze the distribution and antimicrobial resistance of pathogenic strains in wound infec-tion,and provide scientific evidence for rational use of antimicrobial agents in treatment of wound infection as well as reducing the emergence of drug-resistant organisms.Methods Data about pathogenic strains isolated from wound specimens of patients with wound infection in a hospital between June 2011 and April 2014 were analyzed retrospectively.Results A total of 965 pathogenic strains were isolated from wound specimens,the main infection sites were limbs(50.47%);infected patients mainly distributed in department of orthopaedic surgery(44.97%);trauma and incisional wound infection were the major infection types(47.98%,36.48%,respectively).Among iso-lated pathogens,gram-positive bacteria,gram-negative bacteria,and fungi accounted for 37.20%,59.59%,and 3.21 % respectively.The main gram-positive bacteria were highly susceptible to vancomycin,teicoplanin,and linezolid,the main gram-negative bacteria were highly resistant to most commonly used antimicrobial agents except cefoperazone/sulbactam,piperacillin/ tazobactam,imipenem,and meropenem.Conclusion Patients with wound infection are mainly distributed in department of orthopedics,the main infection types are trauma and surgical site infection,antimicrobial resistant rates of the major gram-positive and gram-negative bacteria are both high.Sur-geons,especially orthopedics surgeons,should pay attention to the culture of pathogens and monitoring of antimi-crobial susceptibility,use antimicrobial agents rationally,and strengthen the prevention and control of surgical site infection,so as to reduce the infection incidence and occurrence of drug-resistant organisms.

Ecotoxicology ; methods ; Epigenesis, Genetic ; Gene-Environment Interaction ; Toxicogenetics ; methods

Objective To compare the efficacy of different doses of ropivacaine for ultrasound-guided axillary brachial plexus block in children.Methods One hundred and twenty ASA Ⅰ or Ⅱ children,aged 5-12 yr,scheduled for elective surgery for hand injury,were equally and randomly divided into 4 groups according to the doses of ropivacaine:0.35,0.3,0.25 and 0.20 ml/kg groups.The children received oral midazolam 30 min before surgery.Propofol was given by target-control infusion after admission to the operating room.When the pediatric patients lost consciousness and had no response to verbal command,axillary brachial plexus block was performed under the guidance of ultrasound.0.25 ％ ropivacaine 0.35,0.3,0.25 and 0.20 ml/kg were injected to block the radial,median,ulnar,musculocutaneous and medial antebrachial cutaneous nerves.Additional ketamine was given when needed during operation.The duration of block and consumption of general anesthesia and complications were recorded.The degree of sensory block of the region innervated by each nerve and effectiveness of block were assessed.Results The rate of effective block of the radial nerve,median nerve and musculocutaneous nerve was significantly lower,the number of patients requiring ketamine was larger and the duration of block was shorter in group 0.2 ml/kg than in 0.35,0.30 and 0.25 ml/kg groups (P ＜ 0.05).There was no significant difference in the parameters mentioned above between 0.35,0.30 and 0.25 ml/kg groups (P ＞ 0.05).No pediatric patients developed block-related complications in each group.Conclusion Ultrasound-guided axillary brachial plexus block with 0.25 ％ ropivacaine 0.25 ml/kg can provide better block in children.

Objective To evaluate the mitochondrial function of chondrocytes in Kashin-Beck disease (KBD) patients and its correlation with age.Methods Mitochondrial function was evaluated by analyzing the activities of respiratory chain enzyme complexes and citrate synthase (CS),intracellular adenosine triphosphate (ATP)contents, changes in mitochondrial membrane potential (ΔΨm),as well as the intracellular reactive oxygen species (ROS) contents.Correlation of mitodhondrial function and age was analyzed with linear regression.Results Activities of complexes Ⅱ (P = 0.001 ),Ⅲ (P = 0.005 )and Ⅳ (P = 0.005 )were reduced in KBD articular chondrocytes compared with cells from normal controls.However,the mitochondrial mass was increased in KBD samples. Cultured KBD chondrocytes had reduced cellular ATP level (P = 0.001 )and mitochondrial membrane potential (P =0.001),but increased citrate synthase activity (P =0.04)and intracellular ROS level (P <0.001).We found no correlation between mitochondrial function and donor age either in normal or in KBD chondrocytes. Conclusion Mitochondrial function is altered in articular chondrocytes of KBD,and no correlation was found between mitochondrial function and donor age.