OBJECTIVE:To observe clinical efficacy and safety of intrathecal injection of meropenem combined with vanco-mycin for intracranial infections after craniotomy. METHODS:In retrospective analysis,46 patients with intracranial infections af-ter craniotomy selected from our hospital during May 2014 to Jun. 2016 were divided into control group(20 cases)and observation group(26 cases)according to treatment method. Control group was given Vancomycin hydrochloride for injection 1.0 g,ivgtt,bid+Meropenem for injection 2.0 g,ivgtt,tid. After cerebrospinal fluid release of lumbar cistern drainage,observation group was given Vancomycin hydrochloride for injection 20 mg slowly,and the given Meropenem for injection 20 mg,bid,after washing tube with 0.9% Sodium chloride injection 2 mL. Both groups received treatment for 2 weeks. Cerebrospinal fluid bacterial culture,clinical ef-ficacy,healing time and treatment cost were observed in 2 groups,and the occurrence of ADR and sequela in 6 months after treat-ment were recorded. RESULTS:The positive rate of cerebrospinal fluid bacterial culture of 46 patients was 45.7%. The healing rate of observation group(92.3%)was significantly higher than that of control group(65.0%). Healing time and treatment cost of ob-servation group were significantly shorter or lower than control group;and total incidence of ADR (7.7%) was also significantly lower than control group (40.0%),the incidence of sequelae (3.8%) was significantly lower than control group (20.0%),with statistical significance(P<0.05). CONCLUSIONS:Therapeutic efficacy of intrathecal injection of meropenem combined with van-comycin is superior than intravenous administration for intracranial infections after craniotomy,can significantly shorten the treat-ment time and reduce treatment cost with good safety.

Objective To study the prevalence and distribution of dental trauma in children and adolescents. Method A total of 347 patients with the permanent anterior teeth injured aged from 6 to 25 years were treated and selected from July 2008 to June 2009. Data of gender, age, site of accident occurred, number of teeth injured, and location and type of injury were taken from the dental records. Results Of them, there were male 219, female 128, and the ratio of male/female was 1.7:1.0, The highest incidence of tooth injuries occurred a-mong children of 10 to 13 years old. The common site of dental trauma was school. The majority of dental casualties had one tooth (38.0%) and two teeth (38.0%) injured. Of all types of dental injury, subloxation (19.8%), and enamel and dentin fractures without pulpa involvement (18.7%) were the most seen ones. Con-clusions The dental trauma in children and adolescents is a major problem that can not be ignored, and should be given persistent attention to prevent.

Objective To establish a rabbit model of hypoglycemia and evaluate the accuracy and timeliness of hypoglycemia monitoring by continuous glucose monitoring system (CGMS).Methods Sixteen female New Zealand white rabbits were randomly divided into 4 groups, with 4 rabbits in each group.The rabbits in the control group were given intravenous infusion of saline.The animals in the experimental group were infused with insulin continuously, which were divided into 0.1 U/kg/h insulin group (RI=0.1 U group), 0.2 U/kg/h insulin (RI=0.2 U group) group and 0.4 U/kg/h insulin group (RI=0.4 U group) accordingly.During the experiment, CGMS was monitored for 240 min.Blood samples were collected at a 30-minute interval and the blood glucose level was measured by a hand glucose meter.Results A total of 1296 CGMS monitoring data were obtained during the study period, and 136 BG monitoring data matched with CGMS time were obtained.After the insulin administration, BG and CGMS were significantly decreased.The reduction rates of BG and CGMS were 0.016 and 0.017 mmol/L/min in the RI=0.1 U insulin group, 0.04 and 0.027 mmol/L/min in the RI=0.2U insulin group, and 0.049 and 0.032 mmol/L/min in the RI=0.4 U group.According to whether BG monitoring value was lower than 4.4 mmol/L, the BG-CGMS paring data were divided into hypoglycemia and normoglycemia.In hypoglycemia, the average deviation of BG-CGMS was 0.55 mmol/L (the upper and lower limits were-0.98 and 2.08 mmol/L, respectively) and the absolute difference percentage (RAD) was 40.2% ± 45.2%.The mean deviation of BG-CGMS in normal blood glucose was-0.19 mmol/L (upper and lower limits were-1.38 and 1.00 mmol/L, respectively) and 5.8% ± 5.3% in RAD.The error grid analysis (EGA) showed that the proportion of zone A was 93.4%, 0.7% in zone B, and 5.9% in zone D, and the zone D was distributed in area of low BG and high CGMS.Conclusions The results of this study indicate that CGMS has a significant hysteresis phenomenon when blood glucose is reduced rapidly.When the blood glucose levels fall below 4.4 mmol/L, CGMS may have a risk of overestimating blood glucose.Such risk should be fully considered during CGMS clinical application.

Adult ; Bone Neoplasms ; diagnosis ; surgery ; Cervical Vertebrae ; Humans ; Male ; Osteochondroma ; diagnosis ; surgery

Objective To propose prevention and management of vascular crisis according to cause analysis, and improve the survival rate of digital replantation. Methods The vascular crisis of 132 digits of 98 cases were observed during intraoperative. The replantation was performed under different time and different conditions. The causes of vascular crisis, and propose effective prevention and management of vascular crisis were restrospective analysis. Results From March 2006 to June 2007, 35 amputated digits occurred vascular crisis during intraoperative, 19 amputated digits occurred during postoperative. After using warm physiological saline and injecting the papaverine partly, we proceed operations research with regard to the non-catabatic amputated digits. As result 58 digits survived, the achievement ratio was 89.2%. From July 2007 to March 2009, 10 amputated digits occurred vascular crisis during intraoperative,5 amputated digits occurred during postoperative. After non-surgical treatment, we performed operations research regard to the non-catabatic amputated digits. After blood supply recover, we imbed PCA pump into flex tendinous sheath to avoid the occurrence of vascular crisis postoperative. As result 66 digits survived, the achievement ratio was 98.5%. postoperative 9 cases out of fullow-up, 89 cases follow up ranged from 6 to 8 months. Recovery of the hand function was good. Conclusion Good and adequate anesthetic and an appropriate ambient temperature during operation are important factors to prevent occurrence of vascular crisis in digital replantation. Paying enough attention to these factors can effectively improve the survival rate of replantatian.

Objective To evaluate the clinical effect of vitrectomy for open globe injuries with intraocular foreign bodies in 48 hours after injury.Methods Retrospective analysis was used to evaluate the patients with open globe injuries (OGIs) accompanied by intraocular foreign bodies (IOFB) who underwent vitrectomy of pars plana vitrectomy (PPV) within 48 hours during the period from January 1,2009 to March 1,2015 in our hospital.Results Among the 56 eyes,16 eyes with intraocular foreign bodies occurred endophthalmitis,while the other 40 eyes did not;the intraocular foreign bodies removal rate was 100％.Among all the patient eyes,52 eyes were saved after surgery,while 4 eyes failed.The pars plana vitrectomy operation ratio of the intraocular foreign bodies patients with endophthalmitis and operated within 24 to 48 hours was 2.09 times than that within 24 hours.There was no significant difference in terms of eye preservation,one time of retinal reposition and abnormal intraocular pressure no matter the PPV surgery was conducted within 24 hours or 24 to 48 hours after injury.Conclusion Early vitrectomy is a safe and effective method for the treatment of open globe injuries with intraocular foreign bodies.

Objective To investigate the effect of hepatitis B virus X (HBX) gene on apoptosis and immune molecules of human proximal renal tubular epithelial cell line (HK-2).Methods The eukaryotic vector pcDNA3.1-myc-HBX containing HBX gene was transiently transfected into HK-2 cells by lipofectamine mediation.Untransfected HK-2 cells and those transfected with empty vector were used as controls.The TLR4 expression was detected by real-time PCR and Western blotting.The apoptosis of cells and expression of MHC-Ⅱ and CD40 were detected by flow cytometry,and the contents of IL-4 and IFN-γ in the supernatant were detected by EIISA.Results Compared with control groups,the number of apoptotic cells was significantly increased in the HBX transfection group (P ＜ 0.05),and the expressions of TLR4,MHC-Ⅱ and CD40 were also significantly increased in the HBX transfection group (all P＜0.05).IFN-γ level in the supernatant of HBX transfection group was higher (P ＜ 0.05),but IL-4 level was lower as compared to control groups (all P ＜ 0.05).Conclusions Over-expression of HBX gene may induce apoptosis of HK-2 cells and upregulate the expression of immune molecules of renal tubular epithelial cells leading to injury of cells and dysfunction of immunomicroenviroment.

Objective To investigate the effects of different doses of propofor on ATP-sensitive K~+currents(I_KATP)in human atrial myocytes and the underlying mechsnism.Methods A small piece of myocardiumwas obtained from right atrium in patients undergoing atrial septal defect or ventricular septal defect surgery.Themyocardium specimen was placed in cold Ca~(2+)-free cardioplegic solution aerated with 100% oxygen.Themyocardium specimen was cut into small chunks(1 mm~3).Atrial myocytes were isolated by enzymatic dissociationtechnique.The effects of propofol on I_KATP in atrial myocytes were studied using the whole-cell configuration ofpatch-clamp technique.Results The outward currents were recorded with a pipitte solution containing 0.3mmol?L~(-1) ATP.The currents were inhibited by glibendamide 10 ?mol?L~(-1),a specific K_ATP channel inhibitor,suggesting that the outward currents were I_KATP.I_KATP aws activited by propofol in a dose-dependent manner.Conclusion Propefol can activate the I_KATP in human myocytes in a concentration-dependent manner and themechanism of its myocardial depressant action may be partly explained.

Objective To investigate the effects of hepatitis B virus X (HBX) gene on cell morphology and transdifferentiation of human proximal tubular epithelial cells.Methods The eukaryotic vector pcDNA3.1-myc-HBX containing HBX gene was transiently transfected into HK-2 cells by lipofectamine mediation.The expression of HBX was confirmed by Q-PCR and Western blotting.Untransfected HK-2 cells and those transfected with empty vector were used as control.The morphology of HK-2 cells was observed by microscopy,the expressions of differentiation marker proteins α-SMA and E-cadherin were detected by Western blotting and Q-PCR,and the contents of IL-1,IL-6 and TNF-α in the supernatant were detected by ELISA assay.Results HBX was successfully expressed in HK-2 cells after transfection.After transfection of HBX gene,the shape of HK-2 cells became irregular,HK-2 cells significantly expressed E-cadherin and α-SMA,and had high levels of IL-1,IL-6 and TNF-α in the cell supernatant (P＜0.01).Conclusion Overexpression of HBX gene in renal tubular epithelial cells may damage cell morphology and promote the occurrence of epithelial-mesenchymal transdifferentiation,which may be related to the inflammatory microenvironment.

Objective To investigate the effect of α-crystallin on the proliferation of rat retinal microglia after optic nerve injury. Methods The effect of α-crystallin on number and proliferation of microglia were analyzed by MTT assay.After the rat model with optic nerve injury was established,α-crystallin was iniected into vitreous cavity and the microglia cell number were counted and compared by retinal fiat counting and immunofluorescence labeling in different groups. Results The proliferation and activation of microglia cells could be stimulated by LPS at 10-6g/L to 10-2g/L.α-crystallin at 10-4g/L and 10-6g/L could inhibit proliferation and activation of microglia cells.Compared to BSA iniection group,α-crystallin could inhibit more significantly the number of microglia cells 1-3 weeks after injury (P＜0.05). Conclusions α-crystallin can inhibit proliferation and activation of retinal microglia and alleviate overphagocytosis and secondary damage of retinal microglia to retinal ganglion cells(RGCs),which may be another mechanism that α-crystallin contributes to indirect protection of RGCs.