Objective To understand the expiration date of alcohol-based hand disinfectant after it is opened for use,and provide reference for rational clinical application of alcohol-based hand disinfectant.Methods 20 bottles of the same brand alcohol-based hand disinfectant which opened at the same time by the clinical departments were selected as the study object,hand hygiene compliance in theses departments ranked fourth from the end in the hospital,specimens were taken on the first day after opening,and repeated every 10 days until the disinfectant was used up.Hand specimens were also taken after disinfected by disinfectant.Qualified condition of disinfectant and hand specimens was detected.Results A total of 98 disinfectant specimens were collected,by naked eye observation,20 bottles of alcohol-based hand disinfectant were free of discoloration,precipitation,and suspended matter during the whole study period.The qualified detection rates of alcohol-based hand disinfectant within 60 days after opening were all 100%.44 hand specimens were taken and detected after disinfection,3 of which were unqualified(all were disinfected by alcohol-based hand disinfectant 50 days after opening),then detected again after disinfected by the same batch of disinfectant,all were qualified,which suggested that unqualified detection result of hand specimens was not due to disinfectant.Conclusion Alcohol-based hand disinfectant still has a good bactericidal effect on the sixth day after opening.

ObjectiveTo observe the effect of the nine points for hemiplegia plus MOTOmed exercise training system on the lower-extremity function of the patients with post-stroke hemiplegia.MethodForty-five patients with post-stroke hemiplegia were randomized into 3 groups, 15 each.Group A was intervened by regular acupuncture treatment, group B was by the MOTOmed training system, and group C was by the nine points for hemiplegia during the exercise training by the MOTOmed system in addition to the regular acupuncture treatment. The National Institute of Health Stroke Scale (NIHSS) and Fugl-Meyer (FMA) scale were adopted for evaluation and comparison before intervention and after 4-week intervention.ResultBefore intervention, there were no significant differences in comparing the function of lower extremity among the three groups (P>0.05);after 4-week intervention, the observation indexes were improved in the three groups, and the improvement in group C was the most significant (P<0.05), and it was significantly different from that of group A and B at the corresponding time point (P<0.05). ConclusionThe nine points for hemiplegia plus MOTOmed exercise training can effectively improve the lower-extremity function in the patients with post-stroke hemiplegia.

AIM: To detect unknown CD44 variants(CD44v) in nasopharyngeal cancer by using reverse transcription-polymerase chain reaction(RT-PCR) to analyze the expression of cell adhesion protein CD44 gene in nasopharyngeal cancer tissue and cell lines.METHODS: Specific primers at up start code,down terminal code of CD44 and primers at the middle,splicing points of variable splicing exon v10 of CD44 were designed.cDNA of nasopharyngeal cancer tissues,5-8F and HNE1 cell lines were analyzed by RT-PCR.Products of RT-PCR were sequenced and further analyzed by bioinformatics.RESULTS: The new CD44v sequence possessed 1634 bp with a completed open reading frame.The start code was at 12 bp site and terminal code at 1301bp site.It was predicted to code 429 amino acids,and only variable splicing exon 10 existed in the flexible region.It was given an accessible number EF581837 by GenBank.CONCLUSION: A new CD44 variant predicted to code 429 amino acids exists in the studied nasopharyngeal cancer tissues and cell lines.

OBJECTIVETo observe the effect of sirolimus-based immunosuppression administered on heart transplant recipients with chronic renal dysfunction.

METHODSFrom June 2004 to December 2008, standard calcineurin inhibitors (CNI)-based immunosuppressive regimen was changed to reduced-dose CNI plus sirolimus due to CNI-related chronic renal dysfunction in 20 out of 138 cardiac transplant recipients at Fuwai Hospital. The standard immunosuppressive regimen included steroid, CNI (cyclosporine or tacrolimus), and mycophenolate mofetil or azathioprine. Sirolimus was started at 0.75 - 1.50 mg/d with titration to achieve levels of 5 - 15 µg/L, and CNI dose was reduced gradually to 1/2-2/3 of the baseline level. Patients were followed for changes in renal function, lipid level and clinical side effects related to immunosuppressive therapy. Endomyocardial biopsy (EMB) was performed routinely at 3 weeks, 3, 6 and 12 months after transplantation. EMB was also performed at 3 months after regimen change within 1 year post-transplantation or when rejections were suspected in patients beyond 1 year post-transplantation. Echocardiography was performed for monitoring purpose.

RESULTSThe mean follow-up after regimen change was (7.9 ± 6.3) months. Final sirolimus dose was (0.89 ± 0.22) mg/d and blood drug level was (7.6 ± 3.8)µg/L. Cyclosporine dose was reduced from (191.7 ± 60.0) mg/d to (123.6 ± 34.8) mg/d, with blood drug concentration reduced from (175.5 ± 58.0) µg/L to (111.9 ± 56.0) µg/L in 18 patients (P < 0.01). Tacrolimus average dose was reduced from 4.25 mg/d to 3.00 mg/d, with blood drug concentration reduced from 13.5 µg/L to 10.5 µg/L in 2 patients. Serum creatinine level fell from (160.4 ± 25.5) µmol/L to (134.4 ± 26.8) µmol/L (P < 0.01) and urea nitrogen fell from (13.8 ± 4.7) µmol/L to (10.4 ± 3.0) µmol/L (P < 0.01) at one month after regimen change. Twenty two EMBs were performed in 11 patients within 1 year post-transplant, there were 4 episodes of acute rejected (ISHLT grade 2). Twenty patients are all alive and cardiac function was normal. The most common side effect was hyperlipidemia, and triglycerides, total cholesterol and low density lipoprotein levels were significantly increased at 1 month post regimen change (P < 0.05 or P < 0.01). Leukocyte, hemoglobin and platelet as well as liver function remained unchanged at 1 month post regimen change (all P > 0.05).

CONCLUSIONOur results show that change from CNI-based immunosuppressive regimen to reduced-dose CNI plus sirolimus is an effective and safe approach for the management of patients with CNI-related chronic renal dysfunction, leading to an improvement in renal function without compromise in anti-rejection efficacy and with tolerable side effects.

Calcineurin Inhibitors ; Female ; Heart Transplantation ; Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Kidney Failure, Chronic ; drug therapy ; Male ; Middle Aged ; Retrospective Studies ; Sirolimus ; therapeutic use

Objective To explore the epidemiological status of abnormal glucose metabolism and its influential factors among middle and aged population with hypertension in Chengdu area. Methods In 2008, after adopting the methods of stratified cluster sampling, the authors investigated 4685 subjects of the middle and aged population between the age of 40-79 in Chengdu urban and rural area by checking blood pressure and oral glucose tolerance test (OGTY). Patients with previously known diabetes mellitus (DM) were only asked to perform fasting glucose and to carry out a questionnaire. Comparison of the prevalence rates of abnormal glucose metabolism in hypertensive and non-hypertensive subjects was carried out. The prevalence rates of isolated impaired glucose tolerance (I-IGT) and isolated postprandial hyperglycemia (IPH) among middle and aged subjects with hypertension were acquired and the influential factors of abnormal glucose metabolism among middle and aged subjects with hypertension were analyzed. Results The prevalence rate of abnormal glucose metabolism in the hypertensive subjects was obviously higher than that in the non-hypertensive subjects; without using OGTT, 72.9% of the pre-diubetic and 54. 4% of the new diagnosed DM patients would remain undiagnosed if fasting plasma glucose detection was used alone. Age, diabetic history of first degree relatives ,overweight or obesity were the risk factors for the development of abnormal glucose metabolism among middle and aged male subjects with hypertension in Chengdu area. Exercise training and high education level were the protective factors. Age, diabetic history of first degree relatives,abdominal obesity and hypertriglyceridemia were the risk factors for the development of abnormal glucose metabolism among middle and aged female subjects with hypertension in Chengdu area. Conclusions More than 50% of middle and aged subjects with hypertension in Chengdu area has accompanying abnormal glucose metabolism. OGTT easily discloses the abnormal status and should be a routine procedure in the diagnosis of pre-diabetes or DM in such population. Appropriate exercise, learning diabetes-related knowledge to take reasonable lifestyle, and intervention of metabolic factors such as overweight or obesity are advised. Abdominal obesity and hypertriglyceridemia play important roles in leading to abnormal glucose metabolism among middle and aged population with hypertension.

To introduce a method of classification with high precision-the artificial neural network (ANN),and to compare the results using logistic method. Using data from 1070 landless peasants'mental health survey,the artificial neural network models and logistic regression model were built and compared on their advantages and disadvantages of the two models.The prediction accuracy for artificial neural network was 94.229% and for logistic regression it was 51.028%. ANN appeared to have had good ability on generalization. ANN displayed advantages when conditions of classical statistical techniques could not be met or the predictive effect appeared to be unsatisfactory. Hence, ANN would make a better facture of its application in medical researche.

OBJECTIVETo investigate the reconstructive operative procedures of funnel chest with "sternum-costicartilage" flap carried by the abdominal rectus pedicle.

METHODS(1) In accordance with the lesioned area of funnel-like depressed deformity of anterior thoracic wall, a perpendicular median incision was designed and made; (2) The "sternum-costicartilage" flap carrying the abdominal rectus pedicle was used and reversed and transplanted to reconstruct severe funnel chest deformity.

RESULTSThe procedure was used in 7 cases from 1999 to 2005. The results of surgery were satisfactory. There were no recurrence after operation.

CONCLUSIONSThe procedure reported here is rather safe, solid and sound with good therapeutic results, and is of great value in clinical practice.

Bone Transplantation ; Child ; Child, Preschool ; Female ; Funnel Chest ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Rectus Abdominis ; transplantation ; Ribs ; transplantation ; Sternum ; transplantation ; Surgical Flaps

OBJECTIVETo elucidate the reconstruction of neovascularization that occurred in the superiorly and inferiorly based posterior pharyngeal flaps in different time postoperatively.

METHODSTen mongrel dogs were randomly divided into two experimental groups, which were performed superiorly or inferiorly based posterior pharyngeal flap surgery respectively. Each group was then subdivided into five subgroups, and were sacrificed immediately after operation or on 3, 7, 30, 90 day postoperative respectively. Microangiography was used to exhibite the vessel.

RESULTS1. The blood vessel reconstruction of the superiorly based posterior pharyngeal flap was more rapid compared with the inferiorly based flap. The 3-day flap has established an axial vascular network, which was mature on the 30-day flap. The superiorly based posterior pharyngeal flap was mainly supplied by the pedicle. 2. The blood vessels reconstruction of the inferiorly based posterior pharyngeal flap was firstly occurred in the pedicle and apex of the flap, which grew slowly to the middle of the flap. The inferiorly based posterior pharyngeal flap was supplied by the pedicle and the soft palate. A mature axial vascular network was exhibited on the 90-day flap, which was not mature on the 30-day flap.

CONCLUSIONBoth superiorly and inferiorly based posterior pharyngeal flap can establish an axial vascular network and gain ample blood supply.

Animals ; Dogs ; Neovascularization, Physiologic ; Palate, Soft ; blood supply ; Pharynx ; blood supply ; Random Allocation ; Reconstructive Surgical Procedures ; Surgical Flaps ; blood supply

OBJECTIVEThe aim of the present work was to investigate the potential relationship between acute rejection and serum concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP)/high sensitivity C reactive protein (hs-CRP) in post-transplant patients.

METHODSSixty-one consecutive orthotopic heart transplantation recipients were prospectively recruited from the cardiac transplantation programme at Fuwai Hospital. Endomyocardial biopsies (EMB) were performed routinely at 3 weeks, 3, 6 and 12 months after transplantation. EMB were also performed when patients had new symptoms of heart failure or at 2 weeks after steroid pulse therapy. Serum NT-proBNP and hs-CRP were simultaneously measured before EMB procedure.

RESULTSA total of 126 biopsy samples were obtained from the 61 patients. Serum NT-proBNP concentrations progressively decreased after transplantation (spearman correlation coefficient -0.520, P = 0.000). NT-proBNP levels within 6 months after transplantation were significantly higher than those beyond 6 months post transplantation [(11.86 +/- 11.16) x 10(-16) mol/L vs.(5.83 +/- 6.58) x 10(-16) mol/L, P = 0.002]. NT-proBNP concentrations in patients with rejection tended to be higher than patients without rejection (13.68 x 10(-16) mol/L vs. 9.26 x 10(-16) mol/L, P = 0.073). After time adjustment, the difference of NT-proBNP concentrations between patients with or without rejection becomes statistically significant (14.45 x 10(-16) mol/L vs. 9.1 x 10(-16) mol/L, P = 0.025). Receiver operating characteristics analysis for NT-proBNP versus rejection grade revealed an area under the curve of 0.566, indicating a low predictive value for NT-proBNP. A cutoff of 6.00 x 10(-16) mol/L yielded poor specificity (44.8%) and sensitivity (57.1%), the sensitivity and specificity were 38.1% and 61.0%, respectively with a cutoff of 8.00 x 10(-16) mol/L. hs-CRP levels within 6 months after transplantation tended to be higher than those beyond 6 months [(2.39 +/- 3.90) mg/L vs. (1.34 +/- 2.73) mg/L, P = 0.069]. hs-CRP concentrations in patients with rejection were similar as patients without rejection (2.995 mg/L vs. 1.833 mg/L, P = 0.138). The incidence of rejection was similar in patients with two higher biomarkers (5/20, 25%) compared to patients with two low biomarkers (3/26, 11.5%, P = 0.232).

CONCLUSIONSNT-proBNP level decreased after transplantation. Although increased NT-proBNP concentrations were related to rejection, the diagnostic capacity was low. Elevated hs-CRP concentrations were not related to rejection after heart transplantation.

Adolescent ; Adult ; Aged ; C-Reactive Protein ; metabolism ; Female ; Graft Rejection ; blood ; Heart Transplantation ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Prognosis ; Retrospective Studies ; Young Adult

OBJECTIVETo investigate the effect of arctiin on advanced oxidation protein product (AOPP)-induced epithelial-to-mesenchymal transition (EMT) in tubular cells and explore the mechanisms underlying this effect.

METHODSHuman proximal tubular cells (HK-2 cells) were treated with bovine serum albumin (BSA) or AOPPs in the presence or absence of arctiin. The expressions of E-cadherin, vimentin, and GRP78 at the protein and mRNA levels in the cells were examined using Western blotting and quantitative real-time PCR. The level of reactive oxygen species (ROS) was measured by flow cytometry with DCFH-DA as the fluorescent probe.

RESULTSCompared with BSA-treated cells, the cells treated with AOPPs showed decreased expression of epithelial cell marker E-cadherin and overexpression of mesenchymal marker vimentin and endoplasmic reticulum stress marker GRP78 with an increased ROS level. These changes induced by AOPPs were partly inhibited by arctiin.

CONCLUSIONArctiin can ameliorate AOPP-induced EMT in tubular cells by inhibiting endoplasmic reticulum stress, and oxidative stress response may participate in this process.

Advanced Oxidation Protein Products ; adverse effects ; Cadherins ; metabolism ; Cell Line ; Endoplasmic Reticulum Stress ; Epithelial Cells ; cytology ; drug effects ; Epithelial-Mesenchymal Transition ; Furans ; pharmacology ; Glucosides ; pharmacology ; Heat-Shock Proteins ; metabolism ; Humans ; Kidney Tubules ; cytology ; drug effects ; Oxidative Stress ; Reactive Oxygen Species ; metabolism ; Vimentin ; metabolism