1.Risk factors for multidrug-resistant bacteria recurrent infections in orthopedic patients from 2011 to 2017
Chun LIU ; Zhiming ZHANG ; Yanlin CAO ; Yanglei JIN ; Lixin ZHU
Chinese Journal of Orthopaedic Trauma 2018;20(5):419-424
Objective To explore the clinical characteristics of multidrug-resistant organisms (MDROS) and analyze the risk factors for MDROS recurrent infections in orthopedic in-patients.Methods A retrospective study was conducted of the clinical data of 296 in-patients with MDROS infection from June 2011 to August 2017.They were 216 males and 80 females with an average age of 49.9 years.Their average hospital stay was 37.2 days.Univariate analysis was conducted for items like age,hospital stay,bedridden time,concomitant internal disease (chronic obstructive pulmonary disease,chronic cardiovascular disease and diabetes),open or closed fracture,uninary catheter,use of hormone,stay in ICU,implantation material,incision grade,albumin level,hemoglobin level,reoperation,type of antibiotics and duration of antibiotics use.Multivariate logistic regression analysis was performed using SPSS 20.0 for items with significant differences.Results A total of 352 strains of pathogens were isolated,including methicillin-resistant staphylococcus aureus (26.7%),extended-spectrum β-lactamase-producing Escherichia coli (24.4%) and multidrug-resistant acinetobacter baumannii (24.1%).The pathogens were observed mostly at surgical sites (34.1%) and open wounds (23.0%).Forty-two patients reinfected the same strain after treatment.The multivariate logistic regression analysis revealed the following as the independent risk factors for MDROS recurrent infections in the orthopedic in-patients:hospital stay [OR =4.918,95% CI (1.642,14.731),P =0.004],long bedridden time [OR=3.583,95% CI (1.081,11.876),P=0.037],open injury [OR=2.375,95%CI (1.291,4.368),P=0.005],diabetes [OR=6.360,95% CI (2.112,19.149),P=0.001],and chronic obstructive pulmonary disease [OR=4.170,95% CI (1.419,12.251),P=0.009].Conclusions To prevent recurrent MDROS infections in orthopedic patients,surgeons should shorten unnecessary hospital stay,encourage ambulation as early as possible,effectively control blood sugar and actively treat concomitant internal diseases in addition to regular use of antibiotics.
2.Microsatellite analysis and hMLH1/hMSH2 expression detection in young patients with colorectal cancer: value in screening hereditary nonpolyposis colorectal cancer.
Lei YANG ; Yan-qing DING ; Guo-xin LI ; Jiang YU ; Yu WANG ; Jun ZHOU ; Hong-jun YANG ; Jin-hua ZHANG
Journal of Southern Medical University 2007;27(6):779-782
OBJECTIVETo evaluate the frequency of microsatellite instability (MSI) and absence of hMLH1/hMSH2 expression in young patients with colorectal cancer, and investigate their role in screening hereditary nonpolyposis colorectal cancer (HNPCC).
METHODSeventy-three young patients (below 40 years old) with colorectal cancer were examined for DNA mismatch repair deficiency by microsatellite testing and immunohistochemical detection of hMLH1/hMSH2 gene products.
RESULTSThe frequency of MSI and absence rate of hMLH1/hMSH2 expression are 56.16% and 49.32% in these patients, respectively, which increased significantly with younger age for cancer diagnosis.
CONCLUSIONDefects in the DNA mismatch repair system are frequent in Chinese young patients with colorectal cancer. Microsatellite analysis and immunohistochemical detection are useful for efficient identification of HNPCC in these young patients.
Adaptor Proteins, Signal Transducing ; biosynthesis ; Adolescent ; Adult ; Colorectal Neoplasms ; genetics ; metabolism ; pathology ; Colorectal Neoplasms, Hereditary Nonpolyposis ; diagnosis ; genetics ; metabolism ; Female ; Humans ; Immunohistochemistry ; Male ; Mass Screening ; Microsatellite Instability ; Microsatellite Repeats ; genetics ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; biosynthesis ; Nuclear Proteins ; biosynthesis ; Young Adult
3.The experimental study on repair of rat femoral condyle defect with peripheral blood mesenchymal stem cells combined with absorbable gelatin sponge-self assembling peptide
Zhiming ZHANG ; Chun LIU ; Guofeng WU ; Yanlin CAO ; Yanglei JIN ; Yihang WANG ; Jiasong GUO ; Lixin ZHU
The Journal of Practical Medicine 2018;34(6):924-928,932
Objective This study aimed to explore the effect of peripheral blood mesenchymal stem cells combined with porous absorbable gelatin sponge/self assembling peptide composite scaffolds on SD rat femoral con-dyle bone defect reconstruction and provide a new strategy for the repair of bone defects. Methods 30 female SD rats,8W age,were randomly divided into 3 groups,10 every group.The group A was blank control group,group B was porous absorbable gelatin sponge/self assembling peptide composite scaffold group,and group C was periph-eral blood mesenchymal stem cells combined with porous absorbable gelatin sponge/self assembling peptide compos-ite scaffold group. The effect of osteogenesis was observed by paraffin section,hematoxylin eosin staining,X-ray examination,and Micro-CT scanning in 3 dimensional reconstruction of femoral condyle defect. Results Imaging examination showed that the experimental group had better osteogenesis effect. Histological examination showed that a lot of new bone tissue was found in group C,while only a small amount of new bone was found in the group of A and B. Conclusions The experiment shows that peripheral blood mesenchymal stem cells as the seed cells for tissue engineering,combined with porous absorbable gelatin sponge-self assembling peptide has better ability to repair bone defects,and has good application prospect,which is worthy of further research.