Objective To observe the changes of brain oxygenation in patients with extremely severe craniocerebral injury and the therapeutic effect of early normobaric hyperoxia.Methods Sixtyeight patients with extremely severe craniocerebral injury treated from January 2011 to January 2013 were assigned to two groups according to the random number table:50％ oxygen breathing for one week in control group (34 cases) and 80％ oxygen breathing for one week in treatment group (34 cases).Blood samples from jugular vein and radial artery were collected at 1,3,5,and 7 days to measure indices of blood gas analysis,i.e.,PaO2,PjvO2,CaO2,CjvO2,Da-jvO2,CERO2 and Djv-a Lac.GCS and content of neuron-specific enolase (NSE) were recorded as well.Results Values of PaO2 at each time point and GCS at 5 and 7 days were significantly higher in treatment group than in control group (P ＜0.05).Djv-a Lac at 3,5 and 7 days and NSE at 7 days revealed significantly higher levels in treatment group than in control group(P ＜ 0.05).Whereas at each time point,there were no significant differences between the two groups in aspects of PjvO2,CaO2,CjvO2,Da-jvO2 and CERO2 (P ＞ 0.05).Conclusion Early use of 100％ oxygen in patients with extremely severe craniocerebral injury may be beneficial to the prognosis.

BACKGROUND:Old femoral neck fractures with senile osteoporosis have more surgical difficulties.There are a lot of intraoperative and postoperative complications and long-term effects are poor.OBJECTIVE:To explore the clinical outcomes of hip arthroplasty in patients with old femoral neck fractures with senile osteoporosis.METHODS:From October 2012 to July 2014,20 patients with old femoral neck fractures and senile osteoporosis were enroled in this study.Posterolateral approach was used to perform hip arthroplasty.Of them,14 patients received primary total hip arthroplasty with biological prosthesis,and 6 patients were subjected to semi-hip arthroplasty with straight shank cylindrical renovated biological prosthesis.RESULTS AND CONCLUSION: The patients were folowed up for 3 to 24 months.Harris score was apparently increased after arthroplasty in patients with old femoral neck fractures and senile osteoporosis compared with pre-arthroplasty.Postoperative radiographs revealed that femoral stem biological fixation was good.Bone fixation was visible in radiographs at 3 months after arthroplasty.These findings suggested that old femoral neck fractures and senile osteoporosis could be treated with hip arthroplasty.To select the type of prosthesis and surgical methods according to the femoral calcar-medulary cavity ratio in patients with old femoral neck fractures and senile osteoporosis can effectively restore the function of hip joint.

Objective To explore the relationship between Stathmin-1 and human papilloma viruse (HPV) persistent infection after conization of uterine cervix, and to show the clinical significance to recurrent of cervical intraepithelial neoplasia (CIN). Methods One hundred and six patients who were treated with conization of uterine cervix for CIN 2-3 grades were enrolled. Thirty-six recurrent patients were enrolled in recurrence group, and the others were enrolled in control group. The expression of Stathmin-1 in primary CIN tissues in two groups was detected by immunohistochemistry. The HPV infection was detected by HPV-DNA test. The relationship of HPV persistent infection and recurrence was analyzed. Results The positive expression rate of HPV persistent infection and HPV persistent infection rate in recurrence group were 88.89%(32/36), 83.33%(30/36), in control group were 34.29%(24/70) and 22.86%(16/70), and there were significant difference (P <0.01). Forty-two patients had HPV persistent infection in 56 patients with stathmin-1 positive expression, and 4 patients had HPV persistent infection in 46 patients Stathmin-1 negative expression. There was positive correlation (r=0.97, P<0.01). The type of HPV persistent infection in two groups was no significant difference (P >0.05). Conclusions Stathmin-1 positive expression is related to HPV persistent infection. The two factors can affect the prognosis of high-grade CIN, and can provide new cues and theory basis for the prevention of recurrence.

Objective:To investigate the diagnosis and treatment of children with parainfluenza pneumonia complicated with rhabdomyolysis syndrome and acute kidney injury (AKI).Methods:The clinical manifestations, laboratory and imaging examination results and diagnosis and treatment process of a child with parainfluenza pneumonia complicated with rhabdomyolysis syndrome and AKI admitted to the department of intensive medicine of the Second Affiliated Hospital of Fujian Medical University on July 14th, 2014 were retrospectively analyzed to provide experience and methods for the treatment of such patients.Results:The patient, a Chinese 11-year-old boy, admitted to hospital with "sore throat, fever, and double lower limb pain for 2 days". The clinical manifestations were sore throat, fever, pain in both lower extremities, fatigue, and soy sauce urine. Limb muscle tenderness, bilateral lower limb was obvious. Laboratory examination showed that blood creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), aspartate transaminase (AST), lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (HBDH) and hematuria myoglobin (Mb) were significantly elevated, and blood parainfluenza viruses (1, 2, 3 types) was positive for immunoglobulin M (IgM) antibodies. Chest X-ray shown bronchial pneumonia in the right lower lung. Pneumonia with rhabdomyolysis syndrome was considered. Anti-infection, fluid hydration, alkalized urine, diuresis and other treatment was initially prescribed. However, the condition became worse, combined with secondary epilepsy, AKI, acute heart failure, transferred to the intensive care unit (ICU). The child was put on mechanical ventilation through oral tracheal intubation, continuous hemofiltration, anti-infection and anti-virus treatment. The child's condition gradually recovered, symptoms and signs disappeared, and finally he was discharged with full recovery.Conclusions:Children with parainfluenza pneumonia can induce rhabdomyolysis. If myalgia is progressively worsened and walking is difficult, we should be highly alert to the occurrence of rhabdomyolysis. And when soy sauce urine, hematuria were noticed, and blood CK, Mb increased significantly, rhabdomyolysis syndrome can be diagnosed. Once the diagnosis is established, rehydration, alkaline urine and diuresis should be carried out in a timely manner to increase myoglobin tubular excretion. Antiviral treatment can reduce the dissolution of striated muscles. If blood purification is needed, hemofiltration and/or plasma exchange can be selected.

Nosiheptide is a typical thiopeptide antibiotic displaying potent activity toward various drug-resistant strains of Gram-positive pathogens.Although nosiheptide lacks in vivo activity, and good water-solubility with a series of uncontrollable analogues, which may limit its clinical application, glycosylated analogues may overcome problem of low activity and may improve its druggability.In search of novel glycosylated nosiheptide producers, we applied a genome mining strategy that identified Actinoalloteichus sp.AHMU CJ021 that contains all genes required.However, despite the presence of a predicted glycosyltransferase, glycosylated derivatives of nosiheptide were not detected, after following one strain many compounds (OSMAC) strategy and heterologous expression of a regulatory protein NocP.Nevertheless, nosiheptide produced by this strain was remarkably pure, and further experiments were conducted to improve its production by optimization of the culture medium.Under optimal conditions, 58.73 mg/L nosiheptide was produced, representing an almost 6-fold improvement compared to the original fermentation medium.Therefore, we consider Actinoalloteichus sp.AHMU CJ021 a suitable potential candidate for industrial production of nosiheptide, which provides the basis for solving the problem of nosiheptide structural analogues.

Objective:To explore the effect of setting up an internal-cross disciplinary team (ICDT) in the intensive care unit (ICU) on a new model of overall treatment for patients with chronic critical illness (CCI).Methods:A 60-year-old male patient with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to ICU in the Second Affiliated Hospital of Fujian Medical University was introduced. The role of ICDT composed of physicians, nurses, respiratory therapists, physiotherapists, clinical dietitians and patients' family members in ventilator withdrawal and super-early rehabilitation was analyzed in this case.Results:The patient was diagnosed as AECOPD, type Ⅱ aspiration penumonia respiratory failure, septic shock. The ICDT in ICU carried out early rehabilitation treatment for the patient on the basis of traditional infection control and supportive treatment. Under the care of the ICDT, peripheral blood white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT), arterial partial pressure of carbon dioxide (PaCO 2), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), right excursion of diaphragm, sputum viscosity, tidal volume (VT) and respiratory rate (RR) were improved. Subsequently, the ventilator mode was gradually changed and the ventilator parameters were down-regulated. The ventilator was successfully weaned on the 10th day of treatment. After weaning, the patient's bedside pulmonary function indicators improved, and he was transferred out of ICU on the 15th day of treatment and discharged on the 20th day. The mental state of the patients was good and the quality of life was greatly improved in CCI outpatient follow-up. Conclusions:ICDT cooperation is very important for monitoring and treatment of CCI patients, which is beneficial to the super-early rehabilitation and prognosis improvement of critically ill patients.